Histerectomía total vía abdominal: revisión de la literatura / Total abdominal hysterectomy: a literature review

Hysterectomy is the most common gynecological surgery in non-pregnant women. There are different surgical approaches for total hysterectomy, abdominal, vaginal, laparoscopic and robotic routes. The choice is determined by different factors such as uterine size, malformations, surgical risks, skill of the surgeon, expected postoperative quality of life, and monetary costs. The surgical technique is well described in the literature, however, there are certain anatomical and functional considerations that must be known before performing the hysterectomy to avoid complications. The most frequent complications are hemorrhage, infections, thromboembolism, urinary and gastrointestinal tract injuries. Majority can be avoided with an adequate procedure and management of pre-existing comorbidities. (AU)

Anatomical and histological characterization of the digestive canal of the golden kingklip (Genypterus blacodes) / Caracterización anatómica e histológica del canal digestivo del congrio dorado (Genypterus blacodes)

Given the importance of the Golden kingklip (Genypterus blacodes) as an alternative to the production of salmonid species for worldwide diversification of aquaculture this study researched the morpho-histology of the digestive canal, providing a uniform nomenclature and basic information to support their nutritional management in captive conditions. The objective was to describe the normal morphology of the digestive canal. Twelve wild specimens were collected and dissected. Samples of the esophagus, stomach, liver, pyloric blind and intestines were obtained. An anatomical and histological description was performed. The digestive canal presented a short tubular esophagus, a slightly dilated, J-shaped stomach and thick walls. The stomach had a cardiac region that ended in a pyloric sphincter from which the intestine of thin walls. The intestine presented an anterior, middle and posterior segment. The anterior region of the first segment of the middle intestine presented 4-5 pairs of pyloric cecum. The middle intestine represented approximately 30 % of the total length of the digestive canal, with a smaller diameter compared to the first segment. The posterior intestine was separated from the middle intestine by a thick and powerful sphincter. The liver was large and elongated, and located in the peritoneal cavity located to the left plane and ventral to the swim bladder. The gallbladder was located lateral to the hepatic anterior wolf. The bile duct led to the duodenal region of the anterior intestine. Ventrally, the rectum ended in the anus, located in front of the anal fin. In general, the histological structures were variable according to the segment studied, a mucous tunic was recognized that presented a simple columnar epithelium, a lamina propria composed of loose connective tissue, a muscular layer of the mucosa composed of smooth muscle tissue and a submucosal layer composed of loose connective tissue, a circular and longitudinal stratum of muscular tunic, which had striated musculature and an adventitial tunic composed of a simple squamous epithelium. In conclusion, Golden kingklip (Genypterus blacodes) presents a digestive system typical of a carnivorous benthic fish adapted to feed on fish and crustaceans.

Dada la importancia del Congrio colorado (Genypterus blacodes) como alternativa a la producción de especies salmonídeas para la diversificación mundial de la acuicultura, el objetivo del presente estudio es describir la morfología normal del canal digestivo de esta especie, proporcionando una nomenclatura uniforme e información básica para apoyar su manejo nutricional en condiciones de cautiverio. Doce especímenes silvestres fueron colectados y disecados. Se obtuvo muestras del esófago, estómago, hígado, ciego pilórico e intestinos. Se realizó una descripción anatómica e histológica. El canal digestivo presentó un esófago tubular corto, un estómago ligeramente dilatado, con forma de J y paredes gruesas. El estómago presentaba una región cardíaca que terminaba en un esfínter pilórico desde el cual el intestino de paredes delgadas. El intestino presentaba un segmento anterior, medio y posterior. La región anterior del primer segmento del intestino medio presentó 4-5 pares de ciegos pilóricos. El intestino medio representó aproximadamente el 30 % de la longitud total del canal digestivo, con un diámetro menor en comparación con el primer segmento. El intestino posterior estaba separado del intestino medio por un esfínter grueso y poderoso. El hígado era grande y alargado, y ubicado en la cavidad peritoneal ubicado al plano izquierdo y ventral a la vejiga natatoria. La vesícula biliar se ubicó lateral al lobo anterior hepático. El ducto biliar desembocó en la región duodenal del intestino anterior. Ventralmente, el recto terminó en el ano, ubicado frente a la aleta anal. En general, las estructuras histológicas fueron variables según el segmento estudiado, se reconoció una túnica mucosa que presentaba un epitelio columnar simple, una lámina propia de la mucosa compuesta por tejido conectivo laxo, una capa muscular de la mucosa compuesta por músculo liso tejido y una capa submucosa compuesta de tejido conectivo laxo, un estrato circular y longitudinal de túnica muscular, que tenía musculatura estriada y una túnica adventicia compuesta por un epitelio plano simple. En conclusión, Congrio colorado (Genypterus blacodes) presenta un sistema digestivo típico de un pez bentónico carnívoro adaptado para alimentarse de peces y crustáceos.

Freezing dog semen using -80 °C ultra-freezer: Sperm function and in vivo fertility.

Long term storage of canine frozen semen is conventionally performed in liquid nitrogen (LN2). However, previous works in freezing canine semen using a -80 °C ultra-freezer (-80°C-UF) showed no differences on sperm quality after thawing. The main objective of this study was to compare the effects of the freezing techniques using LN2 or -80°C-UF on sperm function and in vivo fertility of frozen-thawed dog semen. The sperm-rich fraction of the ejaculate was collected separately from five Chihuahua breed, and each one divided into two aliquots, and frozen and stored in LN2 or -80°C-UF. Sperm function was analyzed for motility and viability, acrosome integrity, mitochondrial function and phosphatidylserine translocation by flow cytometry before and after cryopreservation. A total of 10 bitches were intravaginal inseminated (IVAI; LN2 frozen-thawed semen = 5 and -80°C-UF frozen-thawed semen = 5). Pregnancy status was confirmed 30 d after IVAI by transabdominal ultrasonography and live born puppies at term were recorded. Sperm function parameters were affected for both freezing protocols. Differences (P < 0.05) were found between freezing and storage methods in most of the parameters of sperm function analyzed, except in the phosphatidylserine translocation. The percentages of pregnancies were not different between the two freezing and storage protocols used. Semen freezing and storage using -80 °C UF is an effective technique for long-term preservation of canine spermatozoa.

Envejecimiento poblacional y unidades de climaterio / Population aging and climacteric units

La población chilena viene experimentando un proceso de envejecimiento acelerado, extremadamente complejo, que acarrea grandes desafíos para el sujeto que lo vive, como para la sociedad en su conjunto, uno de los cuales es la problemática que plantean las mujeres en etapa de climaterio. El Plan Nacional de Salud para los Objetivos Sanitarios al 2020, recoge la preocupación por el climaterio y establece como metas para la mujer climatérica, disminuir a menos de un 15% aquellas mujeres que presenten un deterioro importante en su calidad de vida, aumentar a un 30% las mujeres que se realicen controles de climaterio e indicar terapia de reemplazo hormonal al menos al 70% de las mujeres que presenten calidad de vida alterada a nivel de los establecimientos públicos. Se considera que con el uso correcto de intervenciones clínicas es posible revertir el deterioro de la calidad de vida de mujeres entre 45 y 64 años, en especial si es centrado en equipos multidisciplinarios que otorguen una atención personalizada y se focalizan en un manejo integral de la problemática que plantea el climaterio y la menopausia. Para lograr lo anterior es necesario contar con una red que permita evaluar la calidad de vida de la población, aumentar la cobertura y la calidad de atención por síntomas climatéricos y la difusión a nivel poblacional de contenidos relacionados a esta etapa. Si bien la implementación de unidades de climaterio a nivel primario se recoge adecuadamente en la Orientaciones del Ministerio de Salud, el diseño e implementación de unidades de climaterio a nivel secundario y terciario, donde será necesario derivar un gran número de mujeres por sus antecedentes o su patología actual, podría facilitarse si se tienen en cuenta algunas consideraciones basadas en el adecuado uso de las herramientas que ofrece la gestión clínica aplicada.

The Chilean population is undergoing an accelerated, extremely complex aging process, which presents great challenges for both the subject who lives it and the society as a whole, one of which is the problem posed by women in the climacteric stage. The National Health Plan for Health Objectives as of 2020, reflects the concern for the climacteric and establishes as goals for climacteric women, to reduce to less than 15% those women who present a significant deterioration in their quality of life, increase to a 30% women who perform climacteric controls, and indicate hormone replacement therapy to at least 70% of women who present altered quality of life at the level of public establishments. It is considered that with the correct use of clinical interventions it is possible to revert the deterioration of the quality of life of women between 45 and 64 years old, especially if it is focused on multidisciplinary teams that provide a personalized attention and focus on a comprehensive management of the problem posed by climacteric and menopause. To achieve this, it is necessary to have a network to evaluate the quality of life of the population, increase coverage and quality of care due to climacteric symptoms and the promotion at population level of contents related to this stage. Although the implementation of climacteric units at the primary level is adequately reflected in the Ministry of Health Guidelines, the design and implementation of climacteric units at secondary and tertiary level, where it will be necessary to refer a large number of women due to their background or their pathology, could be facilitated if some considerations are taken into account based on the proper use of the tools offered by applied clinical management.

Histomorphometrics and quantitative unbiased stereology in canine uteri treated with medroxyprogesterone acetate.

This article describes the effects of MPA use on the canine uterus using stereological methods. Entire reproductive tracts were removed from normal healthy canine bitches (Canis lupus familiaris) and grouped as: nulliparous (n = 11), multiparous (n = 11) and MPA-treated (n = 11; nulliparous; two treatments; 5 mg/kg). 1 cm samples were cut from the corpus, horn and uterine tube and fixed in 10% formaldehyde. Sections of each were mounted on slides and stained with hematoxylin-eosin. We assessed the fraction area for components of endometrium and myometrium and VV (volume density) and SV (surface density) of the gland and stroma using the M36 test system provided by the STEPanizer Stereological Tool. No gross histological differences were observed between study groups in the uterine tube, uterine corpus and horn. The wall of the uterine corpus and horn in MPA-treated bitches was characterized as being thicker than in the other groups. A cross-section of the uterine corpus revealed no differences between components of uterine wall in the corpus and horn; however, differences were observed in the volume density [VV; %] in variables such as: VV[str.vasc/uterus] (nulliparous vs. multiparous; p = 0.0019) and VV[str.supravasc/uterus] (multiparous vs. nulliparous and MPA; p = 0.0035). In the endometrial gland, differences were detected in SV[gland/endom] (multiparous vs. MPA, p = 0.0442). In the uterine horn, differences were only observed in the variable VV[lumen.gland/endom] (multiparous vs. MPA; p = 0.0019). This study shows quantitative changes in the architecture of the endometrium and myometrium in all the uterine segments, mainly morphological endometrial gland changes of the uterine corpus, increasing the surface area per unit of volume; however, these changes usually do not differ quantitatively from those observed in the uterus of multiparous bitches.

Effects of topical capsaicin combined with moderate exercise on insulin resistance, body weight and oxidative stress in hypoestrogenic obese rats.

BACKGROUND: Hypoestrogenic (HE) women are one of the most vulnerable groups for the development of obesity and its complications. Capsaicin and exercise have demonstrated to reduce body weight and to improve insulin sensitivity in different animal models, but it is unknown whether their combination could be useful in HE obese females. METHODS: We investigated whether topical capsaicin, exercise or their combination had better therapeutic effects in an obesity-hypoestrogenism model. Ovariectomized Wistar rats were given a 30% sucrose solution (HE-Obese (HEOb)) or purified water (HE) during 28 weeks ad libitum; four experimental groups per each condition. After shaving the abdominal skin, cold cream vehicle was applied to the Sedentary groups (Sed) and capsaicin cream 0.075% (0.6 mg kg-1 per day) to the Capsaicin groups (Cap). Exercise (Ex) groups ran on a treadmill every day for 20 min at speeds from 9 to 18 m per min increased every 10 days; combination groups (Cap+Ex) were given topical capsaicin 90 min before exercise. The treatments were performed for 6 weeks, and caloric intake and body weight were monitored. At the end of the experimental protocol, glucose tolerance tests were performed, the animals were killed by decapitation; blood and organs were obtained to perform oxidative profile, histology, biochemical analyses and Western blot. RESULTS: In HEOb rats, the combined therapy reduced caloric intake, body weight and abdominal fat in a higher proportion than the individual treatments; it also decreased insulin resistance (IR), oxidative stress and pancreatic islet size. It was the only treatment that significantly increased p-AMPK levels in the soleus muscle. In HE rats, topical capsaicin was the only treatment that reduced glucose intolerance and improved the oxidative profile in a higher proportion than the combined therapy or Ex alone. CONCLUSIONS: Capsaicin per se or its combination with moderate exercise could be a useful therapy against complications linked to obesity-IR in HE females.

Tratamiento del síndrome genitourinario de la menopausia mediante láser fraccionado CO2: una opción terapéutica emergente / Treatment of genitourinary syndrome of menopause by CO2 fractional laser: an emerging therapeutic option

Estudios recientes han demostrado que el láser fraccionado es una opción terapéutica no hormonal efectiva, sencilla, bien tolerada y sin efectos adversos, para el tratamiento del Síndrome Genitourinario de la Menopausia. La reacción térmica originada produce la restauración del epitelio vaginal, un proceso de neocolagénesis y una mayor vascularización que favorece la llegada de nutrientes, reestableciéndose la estructura de la mucosa, su grosor y trofismo funcional, mejorando por tanto la sintomatología. No obstante, se precisan estudios a largo plazo, controlados, frente a estrógenos locales y otros tratamientos no hormonales para validar la duración de los efectos y la seguridad de las sucesivas aplicaciones. El objetivo de este trabajo es revisar la evidencia relacionada con esta terapia emergente.

Recent reported studies have demonstrated that non-invasive fractional laser is a valid, safe, effective and well tolerated therapeutic option, without adverse events to treat the Menopause Genitourinary Syndrome. The heat shock effect induces the increase of vaginal epithelium thickness, the new glycogen content and the vascular changes, improving the vaginal epithelium structure, functionality and menopausal symptoms. Nevertheless, duration of treatment effects and safety of repeated session are not clear enough. Further controlled long-term follow-up research on laser versus local estrogens and other non-hormonal therapies are needed. The objective of this paper is to review the scientific evidence related to this emergent treatment.

Diseño e implementación de una unidad de medicina materno fetal / Design and implementation of a unit of maternal fetal medicine

Uno de los grandes desafíos de la obstetricia actual, es transitar desde una maternidad tradicional a una maternidad diseñada e implementada como una unidad de gestión clínica. Si bien la determinación del riesgo de las pacientes obstétricas se mantiene en el tiempo, adaptándose a los nuevos conocimientos y la capacidad de intervención, la estructura y funcionamiento de las maternidades está cambiando, desarrollándose la medicina materno fetal y la medicina fetal, para abordar patologías obstétricas y materno fetales, o patologías fetales o feto placentarias primarias o patologías médicas que puedan complicar la gestación y en forma indirecta al feto. De ahí la importancia de utilizar una metodología que permita transformar nuestras maternidad en unidades de gestión clínica, que puedan responder efectiva, eficaz y eficiente a la problemática actual en el campo obstétrico. En gestión clínica aplicada, se han utilizado distintos modelos para realizar esta transformación. Uno de ellos, el modelo AMPHOS, nos ha parecido conveniente para el diseño e implementación de unidades de medicina materno-fetal. El modelo AMPHOS cuenta con 7 módulos, los 2 primeros de resorte de la dirección de los establecimientos, en especial de la mejoría de sus procesos. Los módulos siguientes se refieren al desarrollo de las unidades de medicina materno-fetal, mientras que el módulo 7 y final representa la vinculación de la institución con su respectiva unidad de medicina materno-fetal, que a través de dirección por objetivos y la firma de compromisos de gestión, pudiera operacionalizar los acuerdos para lograr su desarrollo.

One of the great challenges of the present obstetrics, is turn from a traditional maternity hospital to a maternity designed and implemented as a clinical management unit. While determining the risk of obstetric patients is maintained over time, adapting to new knowledge and intervention capacity, the structure and operation of maternity wards is changing, developing maternal-fetal medicine and fetal medicine, to address obstetrical and maternal-fetal pathologies or fetal pathologies or primary fetal placental pathologies or medical conditions that may complicate gestation and the fetus in a indirect way. Hence the importance of using a methodology to transform our maternity in management clinical units that can respond effectively, efficiently and effectively to the current problems in the obstetrical field. In applied clinical management, different models have been used to perform this transformation. One of them, the AMPHOS model, it seemed suitable for design and implementation on maternal fetal medicine units. The AMPHOS model has 7 modules, the first 2 spring the direction of the establishments, especially improving their processes. The following modules refer to the development of maternal fetal medicine units, while module 7 and final, represents the binding of the institution with their respective medical maternal-fetal unit, that through management by objectives and management firm commitments, could operationalize the agreements to achieve its development.

Rol de enfermería en educación para la salud de los menonitas desde el interaccionismo simbólico / The role of nursing in the health education of the Mennonites from the symbolic interactionism approach / O papel da enfermagem na educação para a saúde dos menonitas desde o interacionismo simbólico

Este trabajo deriva de una investigación cualitativa etnográfica cuyo objeto de estudio es la educación para la salud de personas pertenecientes a la cultura menonita, así como la descripción de sus percepciones y creencias acerca del proceso salud-enfermedad. A partir del conocimiento que se obtuvo en el análisis de los datos surge la necesidad de indagar la relación entre los usuarios menonitas y el personal de enfermería en los centros de salud de la comunidad mestiza en Cuauhtémoc, Chihuahua, México. Objetivo: Develar la importancia de enfermería como agente educador para la salud cuando existe un acercamiento a culturas diferentes a la propia, se considera la interacción enfermera-paciente-familia como núcleo central conforme al modelo enfermero de Joan Riehl Sisca. Método: Estudio con enfoque cualitativo fenomenológico. La recolección de datos fue a través de entrevistas a profundidad a enfermeras y el análisis de los diarios de campo de estudiantes de enfermería en su práctica clínica en el hospital de ginecoobstetricia de la ciudad, generándose categorías que permitieron describir sus percepciones cuando deben atender a pacientes de cultura diferente a la propia. Los criterios de validación se hicieron a través de la triangulación de los datos obtenidos de confiabilidad y confirmabilidad. Resultados: Se presentan los datos analizados a partir de dos categorías: 1) desconocimiento de la cultura menonita, 2) deseo de brindar cuidado holístico. Conclusiones: Los estudiantes y personal de enfermería refieren que cuando logran la comprensión de la cosmovisión menonita obtienen un alto grado de satisfacción por el cuidado que brindan y descubren un sentido de autoeficacia elevado.

This work derives from an ethnographic qualitative research; and its object of study is the health education to persons belonging to the Mennonite culture, as well as these persons' beliefs and perceptions on the health-illness process. From the data analysis, a need surges to explore the relationship between the Mennonite users and the nursing staff at the health centers of the Coloured community in Cuauhtemoc, Chihuahua, México. Objective: To show the importance of nursing as a health education agent for different cultures. The interaction nurse-patient-family as proposed from the Joan Riehl Sisca nursing model is considered as the central core. Method: Study with a phenomenological qualitative focus. Data were obtained by means of in-depth interviews to nurses and the analysis of the field diaries of nursing students in their clinical practice at the gynecology and obstetrics city hospital. The categories found allowed a description of the participants' perceptions about treating patients from a different culture. The validation criteria were conformed by triangulation of the reliability and confirmability data. Results: The analyzed data are shown through two categories: 1) lack of knowledge of the Mennonite culture, and 2) desire to offer holistic care. Conclusions: Students and nursing staff referred that when they achieve an understanding of the Mennonite cosmos-vision, they get a high degree of satisfaction for the offered care, and they discover a sense of high self-efficacy.

Este trabalho procede de uma pesquisa qualitativa etnográfica cujo objeto de estudo é a educação para a saúde de pessoas pertencentes à cultura menonita, bem como a descrição das suas percepções e crenças relativas ao processo de saúde-doença. A partir do conhecimento que se obteve na análise de dados, aparece a necessidade de procurar a relação entre os usuários menonitas e o pessoal de enfermagem nos centros de saúde da comunidade mestiça em Cuauhtémoc, Chihuahua, México. Objetivo: Revelar a importância da enfermagem como agente educador para a saúde quando existe uma aproximação de culturas diferentes à própria, considera-se a interação enfermeira-paciente-família como núcleo central conforme ao modelo da enfermagem de Joan Riehl Sisca. Método: Estudo com abordagem qualitativa fenomenológica, a coleta de dados se deu através de entrevistas em profundidade com enfermeiras e com a análise dos diários de campo de estudantes de enfermagem na sua prática clínica no hospital de gineco obstetrícia da cidade, produziram-se categorias que permitiram descobrir as percepções sobre quando devem atender aos pacientes de cultura diferente à própria. Os critérios de validação realizaram-se através da triangulação dos dados obtidos de confiabilidade e confirmação. Resultados: Presentam-se os dados analisados a partir de duas categorias: 1) desconhecimento da cultura menonita, 2) desejo de oferecer cuidado holístico. Conclusões: Os estudantes e o pessoal de enfermagem atribuem que no caso de atingir a compreensão da cosmovisão menonita, eles obtêm um alto grau de satisfação pelo cuidado que oferecem e descobrem um sentido de auto-eficácia elevado.

Dual roles for Wnt signalling during the formation of the vertebrate neuromuscular junction.

Wnt proteins play prominent roles in different aspects of neuronal development culminating with the formation of complex neuronal circuits. Here, we discuss new studies addressing the function of Wnt signalling at the peripheral neuromuscular junction (NMJ). In both, invertebrate and vertebrate organisms, Wnt signalling promotes and also inhibits the assembly of the neuromuscular synapse. Here, we focus our attention on recent studies at the vertebrate NMJ that demonstrate that some Wnt proteins collaborate with the Agrin-MuSK signalling to induce post-synaptic differentiation. In contrast, Wnts that activate the Wnt/ß-catenin signalling inhibit post-synaptic differentiation. The dual function of different Wnts might finely modulate the proper apposition of the pre- and post-synaptic terminals during NMJ formation and growth.

Una propuesta educativa en enfermería transcultural: el caso de la cultura menonita / Transcultural nursing educational proposal: the case of mennonite culture

La necesidad de afrontar las barreras culturales, primeramente de lenguaje, el cual se entiende como sistema de comunicación que nos permite expresar conceptos entre los usuarios de la cultura menonita y los estudiantes del programa de la licenciatura en enfermería de la Universidad Autónoma de Ciudad Juárez, Unidad Multidisciplinaria en Cuauhtémoc, nos lleva a una propuesta educativa del cuidado enfermero. El objetivo es introducir al estudiante como futuro prestador del cuidado humano a la cultura menonita, asentada en la región desde 1922 y cuya lengua materna es el alemán bajo, con tradiciones y costumbres respecto a la salud muy arraigadas. Según datos del Hospital General Javier Ramírez, Topete de la ciudad de Cuauhtémoc, actualmente el porcentaje de menonitas que acuden a los servicios de salud se estima en un 73% del total de la población de la etnia, por lo cual se hace necesaria la interacción enfermera-paciente para una comprensión significativa de la situación sanitaria de la población primaria a través del lenguaje. Se toma como eje la teoría de la Diversidad y Universalidad de los Cuidados Culturales de Madeleine Leininger, cuyo propósito es que la enfermería trascienda la interculturalidad hacia la práctica, utilizando los conceptos antropológicos y médicos, aplicados en un diccionario de salud de la cultura de los menonitas, para establecer la relación humana, la comunicación y la comprensión de significados de salud para avanzar hacia la enfermería transcultural. Se asume que la existencia del cuidado cultural en el sistema de salud, fortalece el papel del enfermero(a) en la práctica asistencial. De ahí la importancia de esta propuesta educativa.

The need of trespassing the cultural barriers, in the first place that of the language, understanding language as a communication system that allows to express concepts, between the users of the Mennonite culture and the nursing degree students, of the Universidad Autónoma de Ciudad Juárez, Unidad Multidisciplinaria en Cuauhtémoc City, leads us to an educational purpose in the nurse care. Our aim is to introduce the student as a future provider of human care, to the Mennonite culture, that lives in the region since 1922. Their language is the low german. They have very strong health traditions and uses . The General Hospital Javier Ramirez Topete of Cuauhtémoc City has given us the data that almost the 73% of the Mennonite population use the Mexican community health services. That is why it is very necessary the interaction through the language. We are taking as a base the Diversity and Universality theory of the Cultural Care of Madeleine Leninger, whose purpose is that the nursing care goes beyond the interculturality , using the medical anthropological concepts applied in a health dictionary of the Mennonite culture, to the human relationship, the communication and the comprehension of health meanings an so arrive to the cross-cultural nursery . We assume that the existence of the cultural care in the health system strengthens the nurse role in the assistential practices. That is why this educational purpose is so important.

[Strategies for dealing with cholera disease. A public health perspective of the Chilean experience]. / Estrategias para el enfrentamiento del cólera. La experiencia chilena desde una perspectiva de salud pública.

During the latest Latin American epidemic of cholera (1991), more than 70,000 cases were identified and over 6,000 deaths occurred. Cholera started in Peru and expanded to the rest of Latin American countries, including Chile. Compared to Peru, the epidemic in Chile had minor consequences due to the strategies adopted by the National System of Health Services, together with other public institutions. These strategies included the establishment of a National Committee for Cholera, strategic planning of health services, strengthening of epidemiologic surveillance systems and of clinical and environmental laboratories, education of the population, and preventive strategies, among others. Maintenance of environmental health measures and the population's collaboration are essential to avoid future emergence of this disease.

Estrategias para el enfrentamiento del cólera: La experiencia chilena desde una perspectiva de salud pública / Strategies for dealing with cholera disease: A public health perspective of the Chilean experience

Más de 700.000 casos y alrededor de 6.000 muertes se produjeron en la última epidemia de cólera registrada en América Latina, ocurrida en 1991. Esta se inició en el Perú y se propagó de país en país, afectando a la mayor parte de la región, incluyendo Chile. Comparado al Perú, la epidemia en Chile tuvo consecuencias menores debido a las medidas adoptadas por el Sistema Nacional de Servicios de Salud, en conjunto con otras entidades del Estado. Dentro de estas medidas destacan el establecimiento del Consejo Nacional de Salud, la planificación estratégica de los Servicios de Salud, el fortalecimiento de los Sistemas de Vigilancia Epidemiológica y de Laboratorios Clínicos y Ambientales, la educación de la población y las estrategias de prevención. La mantención de las medidas de sanidad ambiental y la colaboración de la población son fundamentales para evitar la aparición futura de la enfermedad.

During the latest Latin American epidemic of cholera (1991), more than 70,000 cases were identified and over 6,000 deaths occurred. Cholera started in Peru and expanded to the rest of Latin American countries, including Chile. Compared to Peru, the epidemic in Chile had minor consequences due to the strategies adopted by the National System of Health Services, together with other public institutions. These strategies included the establishment of a National Committee for Cholera, strategic planning of health services, strengthening of epidemiologic surveillance systems and of clinical and environmental laboratories, education of the population, and preventive strategies, among others. Maintenance of environmental health measures and the population’s collaboration are essential to avoid future emergence of this disease.