Eradication rate and adherence with high-dose amoxicillin and proton pump inhibitor as first-line treatment for Helicobacter pylori infection: Experience from University Hospital in Chile.

INTRODUCTION: In Chile, more than 70% of adults are infected by Helicobacter pylori. Clarithromycin should not be used in any regimen if there is >15% resistance to this antibiotic, being greater than 26% in our population. In this scenario, the effectiveness of triple therapy (proton pump inhibitor [PPI], clarithromycin, amoxicillin) was only 63.8%. AIM: To evaluate the eradication rate and safety of dual therapy (esomeprazole and amoxicillin) in high doses, through a prospective, observational, and descriptive study. METHODS: Patients with a positive urease test obtained in an upper digestive endoscopy were included. Any other previous H. pylori eradication regimen were excluded. All patients were treated with esomeprazole 40 mg three times a day and amoxicillin 750 mg four times a day for 14 days. The eradication rate of the dual therapy was evaluated with the H. pylori stool antigen test (the Pylori-Strip® test used) 6 weeks after completing the eradication treatment and with at least 14 days without PPI, being a negative result, confirmation of the effectiveness of this regimen. RESULTS: Of 122 patients, 106 had a negative H. pylori antigen in stool; The intention-to-treat and per protocol analysis, the eradication rates were 91.8% [95% CI: 87%-97%] and 94% [95% CI: 90%-98%], respectively. Four patients discontinued treatment due to adverse effects. Smoking and adherence to treatment were associated with eradication rate. CONCLUSIONS: In this cohort of patients with H. pylori infection, high-dose dual therapy has a high eradication rate and good adherence, raising the possibility that it could be used as first-line therapy in our country. Studies with a larger number of patients should confirm these results.

Navigating a maze: Midwives' identity response to the enactment of an abortion law in Chile.

BACKGROUND: Chilean midwives have been identified as essential for successfully implementing an abortion law, a practice which could potentially be understood as contradicting their central mission. Nevertheless, to date, there has been no investigation into how Chilean midwives have incorporated induced abortion care provision into their professional identity. OBJECTIVE: To elucidate how Chilean midwives understand and provide abortion care and how they have (re)defined their professional identity to include induced abortion care. This article reports the findings of the second part of this aim. METHODS: This study was underpinned by a constructivist grounded theory methodology informed by a reproductive justice and feminist perspective. Midwives from Chile who have cared for women undergoing abortion were invited to participate in the study. After purposive and theoretical sampling, fifteen midwives were recruited. FINDINGS: Midwives' identity is woman-centred, with high value placed on their role protecting life. These two aspects of midwives' identity are in contradiction when providing abortion care. Midwives' identity results from and informs midwives' practice. Midwifery regulation influences both practice and identity. The model 'Navigating a maze' explains the interaction of these three elements. CONCLUSION: Midwives' identity response to the enactment of the Chilean abortion law is an example of how professional identity must navigate regulation and practice to make sense of its purpose. In light of this study's findings, the current tension experienced in midwives' identity should be carefully attended to prevent adverse outcomes for midwives and the Chilean population.

The Montecristo mining district, northern Chile: the relationship between vein-like magnetite-(apatite) and iron oxide-copper-gold deposits.

The Montecristo district, northern Chile, is one of the few places worldwide where there is a direct relationship between magnetite-(apatite) (MtAp) mineralization and iron oxide-copper-gold (IOCG) mineralization. The MtAp mineralization includes Ti-poor magnetite, fluorapatite, and actinolite and is crosscut and partially replaced by a younger IOCG mineralization that includes a second generation of actinolite and magnetite with quartz, chalcopyrite, pyrite, and molybdenite. The MtAp stage at Montecristo is interpreted as the crystallized iron-rich melts that used the pre-existing structures of the Atacama Fault System as conduits. These rocks later acted as a trap for hydrothermal IOCG mineralization. Geochronology data at Montecristo indicate that the host diorite (U-Pb zircon 153.3 ± 1.8 Ma, 2-sigma), MtAp mineralization (40Ar-39Ar in actinolite, 154 ± 2 Ma and 153 ± 4 Ma, 2-sigma), and the IOCG event (Re-Os on molybdenite, 151.8 ± 0.6 Ma, 2-sigma) are coeval within error and took place in a time span of less than 3.4 Ma. The εHfi and εNdi values of the host diorite are + 8.0 to + 9.8 and + 4.3 to + 5.4, respectively. The whole-rock 87Sr/86Sri values of the IOCG mineralization (0.70425 to 0.70442) are in the lower end of those of the MtAp mineralization (0.70426-0.70629). In contrast, εNdi values for the IOCG mineralization (+ 5.4 and + 5.7) fall between those of the MtAp rocks (+ 6.6 to + 7.2) and the host diorite, which suggests that the IOCG event was related to fluids having a more crustal Nd (εNdi < + 5.7) composition than the MtAp mineralization. This likely reflects the mixing of Nd from the MtAp protolith and a deep magmatic-hydrothermal source, very likely an unexposed intrusion equivalent to the host diorite. Sulfur isotope compositions (δ34S, + 0.3 to + 3.4‰) are consistent with a magmatic source. Supplementary Information: The online version contains supplementary material available at 10.1007/s00126-023-01172-0.

Madia sativa (Asteraceae), an Araucanian plant / Madia sativa (Asteraceae), una planta araucana

Madia sativa remains important to the traditional culture of many first peoples of Chile and is being studied for its biological abilities by medical researchers. The used of this specie in Chile is researched through a series of retrospective analysis. This research indicated the use this plant populations mapuche a long time ago.

Madia sativa sigue siendo importante para la cultura tradicional de muchos pueblos originarios de Chile y está siendo estudiada por sus capacidades biológicas por investigadores médicas. El uso de esta especie en Chile se investiga a través de una serie de análisis retrospectivos. Esta investigación indica el uso de esta planta en poblaciones mapuche desde hace mucho tiempo.

Uso de plantas medicinales por adultos mayores en Centros de Atención Primaria de una Comuna de la Región Metropolitana de Chile / Use of medicinal plants among older people attending a public primary care center

BACKGROUND: The use of medicinal plants is common among a significant part of the elderly population. In addition, at present, the use of medicinal plants has been introduced in Primary Health Care centers, and is becoming increasingly popular, especially in this population. OBJETIVES: The present study aimed to determine the main medicinal plants consumed by the elderly attending a primary care unit (Puente Alto, Chile), considering main indications for use, preparation, frequency of use, place of obtaining and the possibility of drug interactions. METHODS: Observational, descriptive and cross-sectional study conducted in a primary care unit. The questionnaire on the use of medicinal plants was applied in self-reliant elderly patients. RESULTS: Were interviewed 310 elderly users who attended primary health care centers in Puente Alto (Chile) and met the eligibility criteria. About 83% were women and 17% men. The first 10 most used plants comprise 70% of the total citations and correspond to mint (15.80%), chamomile (7.96%), rue (7.96%), matico (6.98%), plantain (6.85%), boldo (5.99%), lemon balm (5.80%), pennyroyal (5.06%), paico (4.69%), and lemon verbena (2.72%). The reasons for the use of medicinal plants were mainly gastrointestinal, nervous system, dermal, respiratory, metabolic and genitourinary problems. Home-growing was the most cited method and infusion the most popular form of preparation. The main plants mentioned have some possible interaction already described. CONCLUSIONS: The results reinforce the importance of knowing the plant species used by the population and the correct orientation on their rational use, potential benefits, adverse effects and interactions.

Iron supplementation given to nonanemic infants: neurocognitive functioning at 16 years.

OBJECTIVE: There is concern that high iron uptake during the critical period of early brain development carries potential risks, especially for nonanemic infants. This study examined the neurocognitive functioning of 16-year-olds who were nonanemic as infants and received iron supplementation. METHODS: We studied 562 Chilean adolescents (M 16.2 years; 52.7% female) who participated in a randomized controlled iron supplementation trial in infancy. Between 6 and 12 months, 346 consumed an iron-fortified formula (12.7 Fe mg/L) or, if primarily breastfed, liquid vitamins with 15 mg elemental iron as ferrous sulfate, and 216 consumed unmodified cow milk without iron or liquid vitamins without iron if primarily breastfed. RESULTS: Compared to adolescents in the no-added iron condition in infancy, those in the iron-supplemented condition had poorer visual-motor integration, quantitative reasoning skills, and incurred more errors on neurocognitive tasks. Consuming larger amounts of iron-fortified formula in infancy was associated with lower arithmetic achievement. Of adolescents who had high hemoglobin at 6 months (Hb ≥ 125 g/L), those in the iron supplemented condition had poorer performance on arithmetic, quantitative reasoning, and response inhibition tests than those in the no-added iron condition. Of adolescents who had marginally low 6-month hemoglobin (Hb > 100 and < 110 g/L), those who received no-added iron incurred more errors on a visual searching task than those in the iron-supplemented condition. CONCLUSION: The physiologic need for iron during the period of rapid and critical brain development in young infants should be considered vis-à-vis the risks associated with supplementing nonanemic infants with high levels of iron.Clinical Trials number: NCT01166451.

Chemical composition and heavy metal content of Chilean seaweeds: Potential applications of seaweed meal as food and feed ingredients.

Seaweeds are a rich source of nutritional and functional compounds, but they also accumulate heavy metals. Here, the chemical composition (crude protein, total lipids, Nitrogen Free Extract and fiber) and the presence of minerals (Na, K, Ca, Mg, P, Fe, Mn, Cu, Zn, Mo, Se) and unwanted elements (As, Cd, Hg, Pb, Ni, Cr, Al) were determined in eleven seaweeds from Chile. Depending on the species, a good contribution to the Recommended Dietary Allowance for K, Ca, Mg, Fe, Mn and Se was observed, and low Na/K ratios (<1.0) as well. The health risk assessment indicated low hazard due to intake of seaweed meal. The mean values of As, Hg, and Pb were below the maximum limits set for food supplements and feed ingredients. The seaweeds studied have a suitable chemical composition for their uses as food and feed ingredients, although Cd levels should be monitoring especially in brown seaweeds.

Trends in cannabis or cocaine-related dependence and alcohol/drug treatment in Argentina, Chile, and Uruguay.

BACKGROUND: In the context of changing cannabis and other drug policy and regulation, concerns may arise regarding drug treatment access and use. We assessed cannabis/cocaine-related dependence and treatment in Argentina, Chile, and Uruguay. METHODS: Nationally representative cross-sectional household surveys of people ages 15-64 in Argentina (4 surveys, 2006-2017), Chile (7 surveys, 2006-2018), and Uruguay (4 surveys, 2006-2018) were harmonized. We estimated weighted prevalences of cannabis or cocaine-related (cocaine or cocaine paste) dependence, based on meeting 3+ past-year ICD-10 dependence criteria. We estimated weighted prevalences of past-year alcohol/drug treatment use (Argentina, Chile) or use/seeking (Uruguay) among people with past-year cannabis/cocaine-related dependence. We tested model-based prevalence trends over time and described individual-level treatment correlates by country. RESULTS: Cannabis/cocaine dependence prevalence increased in the region starting in 2010-2011, driven by cannabis dependence. Adjusted cannabis dependence prevalence increased from 0.7% in 2010 to 1.5% in 2017 in Argentina (aPD=0.8, 95% CI= 0.3, 1.2), from 0.8% in 2010 to 2.8% in 2018 in Chile (aPD=2.0, 95% CI= 1.4, 2.6), and from 1.4% in 2011 to 2.4% in 2018 in Uruguay (aPD=0.9, 95% CI= 0.2, 1.6). Cocaine-related dependence increased in Uruguay, decreased in Argentina, and remained stable in Chile. Among people with past-year cannabis/cocaine dependence, average alcohol/drug treatment use prevalence was 15.3% in Argentina and 6.0% in Chile, while treatment use/seeking was 14.7% in Uruguay. Alcohol/drug treatment prevalence was lower among people with cannabis dependence than cocaine-related dependence. Treatment correlates included older ages in all countries and male sex in Argentina only. CONCLUSION: Alcohol/drug treatment use among people with cannabis/cocaine-related dependence remained low, signaling an ongoing treatment gap in the context of growing cannabis dependence prevalence in the region. Additional resources may be needed to increase treatment access and uptake. Future studies should assess contributors of low treatment use, including perceived need, stigma, and service availability.

Factores de riesgo asociados a diabetes mellitus en comunidades indígenas de cuatro países (Argentina, Brasil, Colombia y Chile) en el periodo 2010-2020 / Risk factors associated with diabetes mellitus in indigenous communities of four countries (Argentina, Brazil, Colombia, and Chile) in the period 2010-2020

RESUMEN Objetivos Comparar factores de riesgo asociados a diabetes mellitus en comunidades indígenas de cuatro países (Argentina, Brasil, Colombia y Chile) en el periodo 2010-2020. Métodos Se hizo una revisión de literatura y la recolección de información se realizó a través de consulta en diferentes bases de datos como: SciELO, PubMed, Dialnet, LILACS, en idiomas español, portugués e inglés; la selección de documentos se llevó a cabo a través de una matriz de sistematización y el empleo de criterios preestablecidos. Resultados Se destacaron factores personales como ser adulto mayor, sexo femenino, bajo nivel de escolaridad y hábitos alimenticios poco saludables; dentro de los aspectos culturales, poca adherencia a los tratamientos convencionales y consumo de hierbas y plantas medicinales; respecto a los aspectos sociales, estuvo relacionada la migración, la poca accesibilidad a servicios de salud y la falta de profesionales que conozcan los códigos culturales. Conclusión En cada país existe una predilección por un factor de riesgo específico. Sin embargo, existen similitudes en cuanto a características personales, hábitos nutricionales y factores culturales; la conjugación de estos permite que la enfermedad tenga mayor incidencia en unos países frente a otros. Además, se observa un cambio significativo de factores que incluyen aspectos del entorno.

ABSTRACT Objectives To compare risk factors associated with diabetes mellitus in indigenous communities in four countries (Argentina, Brazil, Colombia, and Chile), in the period 2010-2020. Methods The collection of information was carried out through consultation in different databases such as: SciELO, PubMed, Dialnet, LILACS, in Spanish, Portuguese and English; the selection of documents was carried out through a systematization matrix and the use of pre-established criteria. Results It was highlighted as personal factors to be an older adult, female sex, low level of schooling and unhealthy eating habits; within the cultural aspects the low adherence to conventional treatments and consumption of herbs and medicinal plants; regarding social aspects, migration, poor accessibility to health services and the lack of professionals who know cultural codes were related. Conclusion Each country has a predilection for a specific factor, however, there are similarities in terms of personal characteristics, nutritional habits, and cultural factors; the conjugation of these allows the disease to have a higher incidence in some countries compared to others; in addition, there is a significant change in factors that include aspects of the environment.

Rizoma: a new comprehensive database on traditional uses of Chilean native plants.

Background: We describe Rizoma, a new comprehensive online database on traditional uses of Chilean flora. The Rizoma database was built by reviewing multiple data sources on the uses of native plants and integrating phytogeographic and ecological aspects of plant species. This database attempts to safeguard traditional knowledge by making it available and visible to society, providing 1380 use records from 736 vascular plant species native to Chile. In addition, it contributes to a better understanding of the use patterns of Chilean native plants. New information: The Rizoma database includes 1380 use records from 736 vascular plant species native to Chile, representing 399 genera and 128 families. Each species record provides information on geographic distribution, phytogeographic origin, life form, life span and use category. In addition, the online version includes information on the mode of use of each species, as well as common names and photographs. The database serves as a traditional knowledge repository that contributes to preserving local biological and cultural diversity for future generations.

Neural tube defects prevalence does not increase after modification of the folic acid fortification program in Chile.

BACKGROUND: In 2000, Chile's Ministry of Health mandated fortification of wheat flour with folic acid at a concentration of 2.2 mg/kg to prevent neural tube defects (NTDs), resulting in a 50% reduction in NTD prevalence. Concerns about possible collateral effects of high folic acid intake led, in 2009, to decrease the folic acid fortification to 1.8 mg/kg of flour. Our study evaluated the impact of this modification on the prevalence of NTDs in Santiago. METHODS: This study measured the prevalence of NTDs in live births and stillbirths born in Santiago. We calculated prevalence ratios (PR) and 95% confidence intervals (CI) between pre-folic acid fortification (1999-2000), post-folic acid fortification (2001-2009), and post-modified folic acid fortification (2010-2015) periods for all NTDs and their specific types. We used chi-square tests to analyze proportions, and a Joinpoint regression to visualize prevalence time trends. RESULTS: The NTD prevalence for the period 2001-2015 was 8.9 per 10,000 births, which represents a 48% reduction (PR = 0.52; 95% CI = 0.45-0.61; p < .001) from the pre-folic acid fortification period. During 2010-2015, the NTD prevalence was 9.5/10,000 births, which was higher, but not statistically significantly different from 2001 to 2009 prevalence of 8.6/10,000 (PR = 1.11; 95% CI = 0.96-1.30, p = .17). CONCLUSIONS: Decreasing the concentration of folic acid fortification was not associated with a statistically significant change in the prevalence of NTDs. Mandatory folic acid fortification continues to be a safe and highly effective policy to prevent NTDs. Future studies should evaluate the prevalence of NTDs across Chile and adherence to folic acid fortification mandates.

Hydrochemical characterization, spatial distribution, and geochemical controls on arsenic and boron in waters from arid Arica and Parinacota, northern Chile.

The livelihood of inhabitants from rural agricultural valleys in the arid Arica and Parinacota Region, northernmost Chile, strongly depends on water from high altitude rainfall and runoff to lower elevation areas. However, elevated arsenic, boron, and other potentially harmful elements compromise water quality, especially in rural areas. Samples (n = 90) of surface, underground, cold, geothermal springs, and treated and raw tap water were studied to assess water quality and to determine the main geochemical controls on water composition, origin, and geochemical evolution along dominant flowpaths. Water from major river basins across the region (Lluta, San Jose, Codpa-Chaca, Camarones and Altiplanicas) were collected for hydrogeochemical analysis of a suite of major and trace elements, δD and δ18O. Our new dataset was supplemented by hydrochemical data (n > 1500 data points) from secondary sources. Results show that 72% of the collected samples had As >10 µg/L (WHO drinking water provisional guideline) and affected 44% of the studied waters used for drinking (n = 32). Based on Chilean irrigation guidelines, elevated salinity (EC > 0.75 mS/cm) affected 80% of sampled waters, which were also impacted by high B (89% > 0.75 mg/L), and As (31% > 50 µg/L). Water composition was strongly controlled by geothermal water and freshwater mixing in high altitude areas. Magnitude and fate of As and B concentration was determined by the geothermal input type. Highest As (~21 mg/L) was associated with circum-neutral Na-Cl waters in Camarones basin, while lower As (~5 mg/L) with acid SO4 waters in Lluta basin. Additionally, evaporative concentration and sediment-water interactions were shown to control the level of As in surface and groundwaters downstream. This works provides a comprehensive analysis and a conceptual model of geochemical controls on regional water compositions, contributing to better understanding the geochemical processes underpinning the water quality challenges in northern Chile.

Young adult outcomes associated with lower cognitive functioning in childhood related to iron-fortified formula in infancy.

Objective: This study examined how the lower cognitive skills in children who consumed iron-fortified formula in infancy relate to outcomes in young adulthood.Methods: Participants were 443 Chilean young adults (M age = 21.2y, 55% female) who took part in a randomized controlled iron-deficiency anemia preventive trial during infancy (6-12 m). Slightly over half of participants (n = 237) received iron-fortified formula (12.7 mg/L) and 206 received a low-iron formula (2.3 mg/L). Spatial memory, IQ, and visual-motor integration were measured at age 10, and neurocognition, emotion regulation, educational level, and attainment of adult developmental milestones were assessed at age 21.Results: Consumption of iron-fortified formula in infancy was associated with poorer performance on neurocognitive tests in childhood, and these effects related to poorer neurocognitive, emotional, and educational outcomes in young adulthood. Dosage effects associated with consumption of iron-fortified formula were found for lower educational attainment and, marginally, slower mental processing. Those who received iron-fortified formula and had low age 10 cognitive abilities performed most poorly on neurocognitive tests at age 21.Conclusion: Findings suggest that the long-term development of infants who consume iron-fortified formula may be adversely affected.Clinical Trials number: NCT01166451.

Holistic rehabilitation for children with cancer: The Chilean model.

The increasingly positive outcomes of childhood cancer treatments are among the most inspiring stories in modern medicine. Many of the children and adolescents surviving cancer will have a healthy life; however, many others will suffer from physical, cognitive, psychological, and social sequelae. During treatment, many children experience multiple temporary and permanent side effects which negatively impact their quality of life. Low- and middle-income countries where childhood cancer treatment outcomes are improving are facing the reality of a growing population of teenagers and young adults suffering from long-term disease- and treatment-related consequences. In Chile, 500 children are diagnosed with cancer each year. Treatment is granted for all through public health policies and NGO collaboration. In order to address the complex problems from acute and long-term consequences of disease and treatment, the Oncological Rehabilitation Center Fundación Nuestros Hijos (CROFNH) provides multidisciplinary attention to an extensive variety of rehabilitation needs for children and adolescents with cancer. With its integrated services in the medical treatment of children and adolescents with cancer, the CROFNH helps reduce the impact of treatment-related side effects in children's daily lives, improves quality of life, and aims at contributing to these children becoming independent and functional adults to the maximum of their capacities. The aim of this article is to show the experience of the Chilean Oncological Rehabilitation Centre and its unique multidisciplinary approach. In addition, we discuss the successful telerehabilitation strategy implemented in response to the COVID-19 pandemic in order to secure continuity of treatment.

¿Qué es la Medicina del Estilo de Vida y por qué la necesitamos? / What is Lifestyle Medicine and why do we need it?

Medicina del Estilo de Vida (MEV), se define como la práctica basada en la evidencia, de asistir a individuos y familias en la adopción y mantención de conductas que mejoran la salud y calidad de vida, tales como alimentación saludable, realización de actividad física periódica, sueño reparador, manejo del estrés, cese del uso de sustancias tóxicas y una sólida red de apoyo social. Esta disciplina de la medicina, ha demostrado ser efectiva en la prevención, manejo y a veces reversión de las patologías que conllevan la mayor morbimortalidad global, tales como hipertensión arterial, diabetes mellitus tipo 2, enfermedad coronaria y obesidad. Es más, se estima que el 80% de las enfermedades crónicas no transmisibles podrían prevenirse llevando un estilo de vida más saludable. Ciertas barreras estructurales han hecho que la incorporación de la MEV en las mallas curriculares universitarias y establecimientos de salud sea más lenta de lo esperado, sin embargo, cada vez son más las instituciones académicas y prestadoras de salud que adoptan los principios de la MEV, y la aparición de sociedades médicas relacionadas a esta disciplina en casi todos los continentes, están acelerando el paso hacia una medicina más focalizada en tratar las causas de la enfermedad, en lugar de centrarse en lo sintomático

Lifestyle Medicine (LM) is the evidence based practice of assisting individuals and families to adopt and sustain behaviors that can improve health and quality of life. These include healthy diet, participating in regular physical activity, having good quality sleep, managing stress, avoiding risky substance abuse and building strong social connections. LM has demonstrated its effectiveness at preventing, managing and sometimes reversing the diseases that globally carry the biggest morbidity and mortality burden, such as hypertension, type 2 diabetes mellitus, coronary artery disease and obesity. More so, it is estimated that 80% of non-communicable chronic diseases could be avoided by living a healthier lifestyle. Certain structural barriers have made LM's incorporation into the medical curriculum and clinical practice slower than expected, however, more and more academic institutions and healthcare providers are adopting LM's principles. The appearance of medical associations related to this discipline in almost every continent is accelerating the pace towards a medicine that is more centered on the root-causes of disease, rather than focusing on symptoms

Análisis bibliométrico de las tesis de pregrado: caso de carrera de Kinesiología en una universidad chilena / Bibliometric Analysis of Undergraduate Theses: A Chilean University's Physiotherapy Case

RESUMEN Objetivo: Analizar las características metodológicas y de investigación, los antecedentes del sujeto de estudio y de las evaluaciones e intervenciones de las tesis de pregrado de la carrera de kinesiología en una universidad chilena durante los años 2010 - 2018. Materiales y métodos: Se analizaron 91 tesis; para su análisis se utilizó un instrumento validado que se organizó en tres grandes categorías: a) características metodológicas y de investigación, b) antecedentes del sujeto de estudio y c) antecedentes de las evaluaciones e intervenciones, y se registró un total de 38 ítems. Resultados: Se reportó que las tesis mayoritariamente las realizan dos estudiantes tesis-tas, en conjunto con un guía con grado licenciado, presentan un alcance descriptivo, diseño no experimental, temporalidad transversal, con muestras pequeñas, no probabilísticas, por conveniencia, utilizando cuestionarios y/o encuestas para medir parámetros de actividad y condición físicas principalmente en las áreas respiratoria y traumatológica. Las tesis cumplen con la estructura de un reporte científico, aun cuando un gran porcentaje de ellas tiene referencias poco actualizadas y no incluyen datos de aprobación del comité de ética. Los sujetos de estudio principalmente eran jóvenes y adultos pertenecientes a centros educativos de enseñanza básica, media, universitaria o a una red de atención de salud pública que presentaban algún diagnóstico médico de enfermedad cardiometabólica. Conclusión: Este estudio reveló información valiosa respecto a cómo se ha llevado a cabo la formación investigativa de esta carrera de la salud, identificó áreas de conocimiento, poblaciones y condiciones de salud poco exploradas y los tratamientos usados frecuentemente.

ABSTRACT Objective: To analyze the methodological and research characteristics, records of the participants, and the evaluations and interventions of undergraduate theses of students in the Physiotherapy program in a Chilean university between 2010-2018. Materials and methodology: 91 theses were analyzed, using a validated instrument organized in three categories: methodological and research characteristics, records of the participants, and records of the evaluations and interventions. The said instrument consisted of a total of 38 items. Results: We reported that most theses were written by two candidates each and a thesis advisor with a bachelor's degree. The theses have a descriptive scope, a non-experimental design, and a cross-sectional design with small non-probabilistic purposeful samples. Moreover, the instruments used in the theses are mainly questionnaires and surveys to measure physical condition and activity parameters, mainly in respiratory and orthopedic areas. The theses follow the structure of a scientific report, even when a big percentage of them present outdated references and do not include data regarding approval from the ethics committee. The participants in the studies were mainly young people and adults who belonged to different elementary schools, secondary schools, and universities or people who presented cardiometabolic disease and belonged to a public health establishment. Conclusion: The study revealed important information regarding how research training in the program has been carried out, identifying areas for growth, and barely explored populations and health conditions, as well as frequently used treatments

Experiencia en trasplante pulmonar pediátrico en Chile / Experience with pediatric lung transplantation in Chile

El trasplante de pulmón (TP) es una opción para pacientes pediátricos con enfermedades pulmonares terminales. OBJETIVO: Evaluar resultados y sobrevida de pacientes pediátricos trasplantados de pulmón. MÉTODOS: Análisis retrospectivo de registros clínicos de pacientes TP ≤ 15 años de Clínica Las Condes. Se analizaron datos demográficos, tipo de trasplante, función pulmonar basal y post trasplante, complicaciones precoces y tardías y sobrevida. RESULTADOS: Nueve pacientes < 15 años de edad se han trasplantado. La edad promedio fue 12,7 años. La principal indicación fue fibrosis quística (7 pacientes). El IMC promedio fue de 17,6 y todos estaban con oxígeno domiciliario. El 77% utilizó soporte extracorpóreo intraoperatorio. Las principales complicaciones precoces fueron hemorragia y la disfunción primaria de injerto mientras que las tardías fueron principalmente las infecciones y la disfunción crónica de injerto. Cuatro pacientes han fallecido y la sobrevida a dos años fue de 85%. El trasplante les permitió una reinserción escolar y 3 lograron completar estudios universitarios. CONCLUSIÓN: El trasplante pulmonar es una alternativa para niños con enfermedades pulmonares avanzadas mejorando su sobrevida y calidad de vida.

Lung transplantation (TP) is a treatment option in children with terminal lung diseases. OBJECTIVE: To evaluate the results and survival of pediatrics lung transplant patients. METHODS: Retrospective analysis of clinical records of lung transplantation of patients ≤ 15 years from Clínica Las Condes, Santiago, Chile. Demographic data, type of transplant, baseline and post transplant lung function, early and late complications and survival rate were analyzed. RESULTS: Nine patients ≤ 15 years-old were transplanted. The average age at transplant was 12.7 years. The main indication was cystic fibrosis (7 patients). The average BMI was 17.6 and all the patients were with home oxygen therapy. 77% used extracorporeal intraoperative support. Average baseline FEV1 was 25.2% with progressive improvement in FEV1 of 77% in the first year. The main early complications were hemorrhage and primary graft dysfunction, while late complications were infections and chronic graft dysfunction. Four patients have died and the estimated 2 years survival was 85%. They achieved school reinsertion and three managed to complete university studies. CONCLUSION: Lung transplantation is an alternative for children with advanced lung diseases improving their survival and quality of life.

Folate status in women of childbearing age in the Urban Metropolitan Region of Chile: results from the National Health Survey 2016-2017.

OBJECTIVE: To analyse serum folate levels in women of childbearing age in the Metropolitan Region (MR) of Chile. DESIGN: Cross-sectional design as part of the 2016-2017 National Health Survey (Encuesta Nacional de Salud, ENS 2016-2017), using a household-based multistage stratified random sample. Serum folate levels measured by electrochemiluminescence immunoassay in fasting venous blood samples were classified as deficient (<4·4 ng/ml), normal (4·4-20 ng/ml) or supraphysiological (>20 ng/ml). SETTING: The MR of Chile. PARTICIPANTS: Women of reproductive age (15-49 years, n 222) from the MR participated in the ENS 2016-2017. RESULTS: The mean, median and range of serum folate were 14·2 (se 0·4), 13·9 and 2·1-32·2 ng/ml, respectively. Folate deficiency was detected in 0·9 % of women, while 7·0 % had supraphysiological levels of the vitamin. No significant effects of age, educational level, marital status, parity, smoking status or nutritional status on serum folate levels were detected by univariate or multivariate analyses. Intake of folic acid supplements showed a significant association with serum folate levels, but only 1·2 % of women used supplements. CONCLUSIONS: Folate deficiency in women of reproductive age living in the MR of Chile is almost inexistent according to the ENS 2016-2017, suggesting that the current population-wide mandatory folic acid fortification of flour is an effective and equitable measure to prevent folate deficiency. These results support the option of maintaining current folic acid fortification in Chile, particularly based on the low adherence to supplementation regimes evidenced in other populations.

The effects of a combined intervention (docosahexaenoic acid supplementation and home-based dietary counseling) on metabolic control in obese and overweight pregnant women: the MIGHT study.

BACKGROUND: Lifestyle interventions have shown limited effectiveness in the prevention of gestational diabetes mellitus. The combination of lifestyle interventions with omega-3 polyunsaturated fatty acid supplementation could have a synergetic effect on maternal and offspring outcomes. OBJECTIVE: We evaluated the effects of docosahexaenoic acid supplementation among obese and overweight pregnant women (independently or combined with a dietary counseling intervention) on metabolic control in mothers and their offspring. STUDY DESIGN: This study was a randomized controlled trial with a 2×2 factorial design. The following inclusion criteria were used: <15 weeks of gestation; body mass index ≥25 kg/m2 at the first prenatal visit; singleton pregnancy; and 18 years of age or older. The recruited women (n=1002) were randomly allocated to 1 of the 4 parallel groups: Group 1: dietary counseling plus 800 mg/day of docosahexaenoic acid (n=250); Group 2: routine counseling plus 800 mg/day docosahexaenoic acid (n=252); Group 3: dietary counseling plus 200 mg/day docosahexaenoic acid (n=249); and Group 4: routine counseling plus 200 mg/day docosahexaenoic acid (n=251), considered as the reference group. The dietary intervention comprised 3 sessions, and it was focused on reducing the consumption of foods that most contributed to daily sugar intake. Primary outcomes were gestational diabetes mellitus defined according to the national guidelines; macrosomia (birthweight >4000 g); and neonatal insulin resistance (cord blood Homeostasis Model Assessment for Insulin Resistance ≥2.60), which was assessed in a subsample of 226 newborns. The analysis was by intention to treat and by efficacy. The trial was registered on ClinicalTrials.gov (NCT02574767). RESULTS: The overall incidence of gestational diabetes mellitus was 20.2% (Group 1, 21.0%; Group 2, 20.1%; Group 3, 18.9%; and Group 4, 20.9%). Mean birthweight was 3403.0 g (standard deviation, 575.3), and the incidence of macrosomia was 11.9% (Group 1, 13.2%; Group 2, 10.8%; Group 3, 11.5%; and Group 4, 12.1%). Median cord blood Homeostasis Model Assessment for Insulin Resistance was 0.9 (interquartile range, 0.6-1.7), and 10.2% showed cord blood insulin resistance (Group 1, 12.0%; Group 2, 12.0%; Group 3, 9.7%; and Group 4, 5.1%). No significant differences were found among groups regarding primary outcomes (P<.05). Glucose concentrations in the cord blood samples were lower in those adherents to the docosahexaenoic acid supplementation (P<.05). CONCLUSION: For women who were overweight or obese at the beginning of pregnancy, this combined intervention did not reduce the risk of gestational diabetes in mothers or macrosomia and insulin resistance in neonates.

In vitro screening for growth inhibition activity on cancer cell lines of northern Chile highlands shrubs / Triagem in vitro da atividade de inibição do crescimento em linhagens celulares de câncer em arbustos das montanhas do norte do Chile

ABSTRACT: Cancer is still one of the leading causes of death worldwide. Many chemotherapeutics from plants have been tested in cancer, such as vinblastine and paclitaxel. The north of Chile, Arica & Parinacota region, is characterized by its vegetal biodiversity due to its unique geographical and climatological conditions, offering an unexplored and unique source of naturally-derived compounds. The present research has considered a screening of 26 highland herbs using an in vitro growth inhibition model in a panel of six cancer cell lines from different tissues. 5 of the 26 studied ethanolic extracts shows strong activity at least in one cell line when tested at 10 µg mL-1. We present a group of plants worthy to be evaluated as promissory extracts. This work is part of the systematic attempt to find new candidates to be used in cancer therapies.

RESUMO: O câncer ainda é uma das principais causas de morte no mundo. Muitos quimioterápicos de plantas foram testados em câncer, como vinblastina e paclitaxel. O norte do Chile, região de Arica e Parinacota, caracteriza-se por sua biodiversidade vegetal devido às suas condições geográficas e climatológicas únicas, oferecendo uma fonte inexplorada e única de compostos de origem natural. A presente pesquisa considerou uma triagem de 26 ervas das terras altas usando um modelo de inibição de crescimento in vitro em um painel de seis linhas celulares de câncer de diferentes tecidos. Cinco, dos 26 extratos etanólicos estudados, mostram forte atividade pelo menos em uma linhagem celular quando testados a 10 µg mL-1. Apresentamos um grupo de plantas dignas de serem avaliadas como extratos promissórios. Este trabalho faz parte da tentativa sistemática de encontrar novos candidatos para serem usados ​​em terapias contra o câncer.