Pregnancies through oocyte donation. A mini review of pathways involved in placental dysfunction.

Pregnancies resulting from assisted reproductive techniques (ART) are increasingly prevalent worldwide. While most pregnancies conceived through in-vitro fertilization (IVF) progress without complications, mounting evidence suggests that these pregnancies are at a heightened risk of adverse perinatal outcomes. Specifically, IVF pregnancies involving oocyte donation have garnered attention due to numerous reports indicating an elevated risk profile for pregnancy-related complications within this subgroup of patients. The precise mechanisms contributing to this increased risk of complications remain incompletely understood. Nonetheless, it is likely that they are mediated by an abnormal immune response at the fetal-maternal interface. Additionally, these outcomes may be influenced by baseline patient characteristics, such as the etiology of infertility, absence of corpus luteum, and variations in endometrial preparation protocols, among other factors. This review aims to succinctly summarize the most widely accepted mechanisms that potentially contribute to the onset of placental dysfunction in pregnancies conceived through oocyte donation.

¿Existen realmente las etapas de cambio para actividad física? Hallazgos desde un estudio con una muestra estudiantil universitaria que combina el Modelo Procesual de Acción en Salud con el Modelo Transteórico / Are there really stages of change in physical activity? Findings from a study with a sample of university students that combines the health action process model with the transtheoretical model

Resumen El proceso de cambio hacia la práctica de actividad física todavía no ha sido adecuadamente caracterizado. Uno de los asuntos en discusión es si este proceso puede ser descrito en términos de etapas. Se llevó a cabo un estudio con el objetivo de examinar patrones de continuidad o discontinuidad de variables del Modelo Procesual de Acción en Salud dentro de las etapas propuestas por el Modelo Transteórico, y así valorar en qué medida la evidencia apoya la existencia de etapas. Para ello, se recogieron datos transversales de estudiantes universitarios (N = 490, edad = 22.5 años, DT = 6.57) y se hicieron ANOVA, contrastes planeados y análisis de tendencias polinómicas, siguiendo las recomendaciones de Sutton (2000). Los resultados para varias de las variables fueron compatibles con supuestos sobre la existencia de etapas. Sin embargo, para otras variables, los resultados no apoyan la existencia de etapas. Estos hallazgos proveen información útil para esfuerzos de integración de distintos modelos. Se discute sobre las implicaciones teóricas y prácticas de estos.

Abstract The process of change towards the practice of physical activity has not yet been adequately characterized. One issue under discussion is whether this process can be described in terms of stages. A study was carried out in order to examine patterns of continuity or discontinuity in variables of the Health Action Process Model within the stages proposed by the Transtheoretical Model, and thus assess to what extent the evidence supports the existence of stages. For this, cross-sectional data of university students (N = 490, mean age 22.5 years (SD = 6.57) were collected, and ANOVAs, planned contrasts, and polynomial trend analyses were performed, as recommended by Sutton (2000). The results for several variables were compatible with assumptions about the existence of stages. However, for other variables results did not support the existence of stages. These findings provide useful information for efforts to integrate different models. The theoretical and practical implications are discussed.

Fetal Growth Velocity according to the Mode of Assisted Conception.

INTRODUCTION: Pregnancies conceived through assisted reproductive techniques (ARTs) are on the rise worldwide and have been associated with a higher risk of placental-related disease in the third trimester. METHODS: A cohort was created of singleton pregnancies after assisted reproduction, admitted at our institution for delivery, between January 2020 and August 2022. Fetal growth velocity from the second trimester to delivery was compared against a gestational-age-matched group of pregnancies spontaneously conceived according to the origin of the selected oocyte (i.e., autologous vs. donated). RESULTS: 125 singleton pregnancies conceived through ART were compared to 315 singleton spontaneous conceptions. Overall, after adjusting for possible confounders, multivariate analysis demonstrated that ART pregnancies had a significantly lower estimated fetal weight (EFW) z-velocity from the second trimester to delivery (adjusted mean difference = -0.002; p = 0.035) and a higher frequency of EFW z-velocity in the lowest decile (adjusted OR = 2.32 [95% CI, 1.15-4.68]). Also, when ART pregnancies were compared according to the type of oocyte, those conceived with donated oocytes showed a significantly lower EFW z-velocity from the second trimester to delivery (adjusted mean difference = -0.008; p = 0.001) and a higher frequency of EFW z-velocity in the lowest decile (adjusted OR = 5.33 [95% CI, 1.34-21.5]). CONCLUSIONS: Pregnancies achieved through ART exhibit a pattern of lower growth velocity across the third trimester, especially those conceived with donated oocytes. The former represents a sub-group at the highest risk of placental dysfunction that may warrant closer follow-up.

Association between Fathers' and Mothers' Parenting Styles and the Risk of Overweight/Obesity among Adolescents in San José Province, Costa Rica.

Parenting styles are a risk factor for adolescents overweight/obesity worldwide, but this association is not well understood in the context of Latin America. This study examines the association between the parenting styles of mothers and fathers and the risk of overweight/obesity among Costa Rican adolescents. Data are cross-sectional from a sample of adolescents (13-18 years old) enrolled in ten urban and eight rural schools (n = 18) in the province of San José, Costa Rica, in 2017. Hierarchical logistic regression analyses were performed to assess the likelihood of adolescents being overweight according to the mothers' and fathers' parenting styles. A significant association was found between the risk of adolescent overweight/obesity and the paternal authoritarian style only in rural areas (B = 0.622, SE = 0.317, Wald = 3.864, ExpB = 1.863, p = 0.04), and between said risk and the paternal permissive style only in male adolescents (B = 0.901, SE = 0.435, Wald = 4.286, ExpB = 2.461, p = 0.038). For maternal parenting styles, no associations reached significant levels once logistic regression models were adjusted for the fathers' parenting styles. These findings underscore the importance of further studying the role of fathers' paternal parenting styles on Latin American adolescent weight outcomes. Expanding our understanding of the parenting styles of fathers has important implications for the design and implementation of culturally- and gender-appropriate family interventions.

Gender-based eating norms, the family environment and food intake among Costa Rican adolescents.

OBJECTIVE: To examine the association between family environment variables (parenting styles, family meal atmosphere), gender-based stereotypes and food intake in Latin American adolescents. DESIGN: Structural equation modelling applied to cross-sectional data, 2017. SETTING: Urban and rural sites of San José, Costa Rica. PARTICIPANTS: n 813; 13-18 years old. RESULTS: Data suggest direct associations between gender-based stereotypes and intake of fruits and vegetables (FV) (ß = 0·20, P < 0·05), unhealthy foods (fast food (FF)) (ß = -0·24, P < 0·01) and ultra-processed foods (ß = -0·15, P < 0·05) among urban girls; intake of legumes among rural girls (ß = 0·16, P < 0·05) and intake of sugar-sweetened beverages (SSB) among rural boys (ß = 0·22, P < 0·05). Family meal atmosphere was associated with legume intake (ß = 0·19, P <·05) among rural girls. Authoritative parenting style was associated with FV intake (ß = 0·23, P < 0·05) among urban boys and FF intake (ß = 0·17, P < 0·05) among urban girls. Authoritarian parenting style was associated with FV consumption (ß = 0·19, P < 0·05) among rural boys, and with SSB and FF consumption (ß = 0·21, P < 0·05; ß = 0·14, P < 0·05, respectively) among urban girls. CONCLUSIONS: Findings are the first to describe the complex family environment and gender-based stereotypes within the context of a Latin American country. They emphasise the need for culturally relevant measurements to characterise the sociocultural context in which parent-adolescent dyads socialise and influence food consumption.

Modelling Longitudinal Directional Associations Between Self-regulation, Physical Activity, and Habit: Results from a Cross-lagged Panel Model.

BACKGROUND: The directionality of associations between self-regulatory variables, behavior, and automaticity is seldomly tested. In this study, we aimed to examine a volitional, self-regulatory sequence of variables proposed in the Health Action Process Approach framework (intention → action plans → action control → behavior) and its relationship with the construct of automaticity of the physical activity habit. METHODS: Longitudinal data was collected from high school students (N = 203, Mage = 15.39 (SD = 1.43), 52% women) at three measurement points. First, a confirmatory factor analysis measurement model was used to examine the study variables across measurement points. Next, a cross-lagged panel model was used to test directionality between variables. RESULTS: After adequate fit of the measurement model was confirmed, a mechanism integrating self-regulation with behavior and automaticity was examined. The hypothesized directionality between variables was verified overall by cross-lagged analysis. However, for the intention-action plan association, the inverse relationship was found: plans were associated with subsequent intentions, but intentions did not predict plans. Moreover, automaticity was not associated with subsequent physical activity behavior. CONCLUSIONS: In general, our findings supported the hypothesized longitudinal direction of the associations, confirming that self-regulation may lead to behavior performance and automaticity. Unexpected findings and implications for intervention and future research are discussed.

Re-evaluating the self-report habit index: the cases of physical activity and snacking habits.

Objectives: The Self-Report Habit Index (SRHI) was originally reported as one-dimensional; however, habit has been described as characterised by several features. Moreover, one-dimensional models for the SRHI have demonstrated poor fit. Therefore, we aimed to compare multidimensional models with a one-dimensional model in both snacking and physical activity habits, besides examining further instrument characteristics. Design: A cross-sectional study was conducted with high school and university students (n = 555). Main outcome measure: The SRHI adapted for physical activity and for snaking habits was applied at one time point. Results: Nested models with one factor, two factors and three factors were compared. Next, a hierarchical second-order model was tested, and further validity issues, as well as invariance between habits, were examined. Three-dimensional models represented a better fit for both habits. However, fit was still inadequate in the snacking version. In addition, discriminant validity concerns emerged for the physical activity SRHI. Moreover, invariance between the snacking and the physical activity versions was not confirmed. Conclusions: Considering the SRHI as composed by the dimensions of 'lack of awareness', 'lack of control' and 'history of behavioural repetition' seems to be more accurate. Nevertheless, our findings suggest that further research is needed.

Fibromixoma de septum nasal: Presentación de un caso / Nasal septum fibromyxoma: A case report

Introducción: El fibromixoma es una lesión benigna poco frecuente cuya etiología aún es controversial. Rara vez aparece en cabeza y cuello, en cuyo caso afecta con mayor frecuencia a la mandíbula. Objetivo: Presentar un caso poco frecuente de fibromixoma derivado de septum nasal. Material y métodos: A continuación se describe el caso de un paciente masculino de 50 años con diagnóstico de fibromixoma proveniente del septum nasal, que se presento con epífora como única manifestación clínica; se trató quirúrgicamente con resección total endoscópica. Discusión: Son pocos los casos de fibromixoma documentados que comprometen la región nasosinusal. Conclusiones: Es importante considerar al fibromixoma dentro de los tumores del septum nasal, que a pesar de su naturaleza benigna, son lesiones que requieren resecciones amplias por su comportamiento localmente agresivo.

Introduction: Fibromyxoma is an uncommon benign lesion whose etiology is still controversial. Rarely, it appears in head and neck where the jaw is the region most often affected. Objective: To present a rare case of nasal septum fibromyxoma. Methods: We present the case of a 50 year old male with the diagnosis of fibromyxoma from the nasal septum, who presented with epiphora as the only clinical manifestation. It was treated surgically with complete endoscopic resection. Discussion: There are few cases of fibromyxoma documented that compromise sinonasal region. Conclusions: It is important to consider fibromyxoma within the differential diagnosis of nasal septum tumors, which despite its benign nature, requires extensive resections due to its locally aggressive behavior.

Mal de Pott en paciente con insuficiencia hepática: presentación de un caso de probable tuberculosis espinal y revisión de literatura / Pott's disease on a patient with hepatic insufficiency: case presentation of probable spinal tuberculosis and literature review

Introducción: La Tuberculosis Espinal corresponde a una infección causada por Mycobacteriun tuberculosis localizada en la región vertebral. El tratamiento farmacológico de esta patología no está exento de complicaciones, principalmente dado por la toxicidad hepática. El caso clínico a presentar se centra en el tratamiento farmacológico en un paciente con Insuficiencia Hepática. Presentación del caso: Paciente de 58 años con antecedentes de Insuficiencia Hepática, inició cuadro de 3 meses de evolución caracterizado por dolor lumbar progresivo con escasa a nula respuesta a tratamiento analgésico. Al examen físico destacó dolor axial de columna lumbar, paresia M4 en L5, Lasegue y Tepe (-). Se solicitaron exámenes de imagenología y laboratorio, confirmándose probable diagnóstico de Tuberculosis Espinal. Se inició tratamiento antituberculoso alternativo. Discusión: El tratamiento universalmente aceptado es la asociación de Isoniazida, Rifampicina, Pirazinamida, Etambutol. En relación al caso clínico y a la Insuficiencia Hepática se recomienda no utilizar Pirazinamida y ante riesgo alto reemplazar el uso de Isoniazida por Fluoroquinolona. Además se recomienda medir enzimas hepáticas al inicio del tratamiento y durante su mantención. En caso de encontrarse elevadas, se recomienda iniciar un esquema con mínimo riesgo de toxicidad hepática, asociando Estreptomicina - Etambutol, mientras se normalizan las alteraciones. En el caso clínico presentado el esquema antibiótico considera la asociación de Estreptomicina, Etambutol y Fluoroquinolona. Es importante reconocer la clínica de la Tuberculosis Espinal, con el fin de proporcionar un tratamiento oportuno y eficaz, considerando el riesgo de hepatoxicidad de éste y su indicación en pacientes con diagnóstico de Insuficiencia Hepática.

Introduction: Spinal Tuberculosis corresponds to an infection caused by Mycobacterium tuberculosis located in the vertebral region. The pharmacological treatment of this pathology is not free of complications, mainly due to liver toxicity. The clinical case to be presented focuses on the pharmacological treatment in a patient with Hepatic Insufficiency. Case report: A 58-year-old patient with a history of Hepatic Insufficiency, started a 3-month evolution characterized by progressive lumbar pain with little to no response to analgesic treatment. Physical examination revealed lumbar spine axial pain, M4 paresis in L5, Lasegue and Tepe (-). Imaging and laboratory tests were requested, confirming the probable diagnosis of Spinal Tuberculosis. Alternative antituberculous treatment was started. Discussion: The universally accepted treatment is the association of Isoniazide, Rifampin, Pyrazinamide, Ethambutol. In relation to the clinical case and Hepatic Insufficiency, it is recommended not to use Pyrazinamide and at high risk to replace the use of Isoniazide with Fluoroquinolone. It is also recommended to measure liver enzymes at the start of treatment and during maintenance. In case of being elevated, it is recommended initiate a scheme with minimal risk of liver toxicity, associating Streptomycin - Ethambutol, while the alterations are normalized. In the clinical case presented, the antibiotic scheme considers the association of Streptomycin, Etambutol and Fluoroquinolone. It is important to recognize the clinic of Spinal Tuberculosis, in order to provide timely and effective treatment, considering the risk of hepatoxicity thereof and its indication in patients diagnosed with Hepatic Insufficiency

Enfermedad de Creutzfeldt-Jakob familiar: a propósito de un caso de demencia rápidamente progresiva en Chile / Creutzfeldt-Jakob familial disease: about a rapidly progressive dementia case in Chile

La enfermedad de Creutzfeldt-Jakob (ECJ) corresponde una enfermedad por priones, la cual se manifiesta como demencia rápidamente progresiva. Dentro de sus manifestaciones clínicas puede presentar deterioro cognitivo progresivo y mioclonías, entre otros. El objetivo de este trabajo es dar a conocer la ECJ de variante familiar, mediante la presentación de un caso clínico. Presentación del caso: Paciente de 67 años, con antecedentes de familiares fallecidos por ECJ, previamente autovalente, que consulta por cuadro de 2 meses de evolución, caracterizado por deterioro cognitivo progresivo, desorientación temporo-espacial, mioclonías y apraxia ideomotora principalmente. Dentro del estudio realizado durante su hospitalización, destaca resonancia magnética de cerebro que describe hiperintensidad de señal bilateral simétrica en ganglios basales y cortezas frontales paramedianas. Además de electroencefalograma (EEG) que muestra descargas agudas de morfología trifásica. Esto junto a la clínica y exámenes complementarios permiten plantear una probable ECJ de variante familiar. Discusión: La aproximación diagnóstica a la ECJ es principalmente clínica, siendo el estudio histopatológico mediante biopsia cerebral el GOLD standard. Dentro de los estudios fundamentales que apoyan el diagnóstico de ECJ, se encuentra la resonancia magnética (RM) y EEG característicos. El diagnóstico de la variante familiar de ECJ se basa en el estudio genético del codón 200 y 129. Se expone una enfermedad no conocida de forma completa, de la cual aún no existen métodos diagnostico totalmente certeros, salvo por la biopsia. Es por esto que los aspectos clínicos son de gran relevancia para su sospecha, representando un desafío para el medico actual.

Introduction: Creutzfeldt-Jakob disease (CJD) is a prion disease, which manifests itself as a rapidly progressive dementia. Within its clinical manifestations may present progressive cognitive impairment and myoclonus, among others. The aim of this paper is to present the familal-type CJD by presenting a clinical case. Case Report: 67-year-old patient with a history of relatives who died of CJD, previously autovalent that consults for a 2 months period characterized by progressive cognitive impairment, time and space disorientation, myoclonus and ideomotor apraxia. In the study carried out during his hospitalization, he was studied with a brain magnetic resonance that describes symmetrical bilateral signal hyperintensity in basal ganglia and paramedian frontal cortex. In addition the electroencephalogram (EEG) showed acute discharges of three-phase morphology. These findings together, with the clinical manifestations and complementary tests allowed to raise a probable familial CJD. Discussion: The diagnostic approach to CJD is mainly clinical, with the GOLD standard being the histopathological study using cerebral biopsy. Among the fundamental studies that support the diagnosis of CJD are the characteristic MRI and EEG. The diagnosis of the familial type of CJD is based on a genetic study of codon 200 and 129. This case exposes a disease of which is not yet fully known which there are still no completely accurate diagnostic methods, except for the biopsy. That is why the clinical aspects are of great relevance to suspect it, representing a challenge for the current doctor.

Social-cognitive antecedents of hand washing: Action control bridges the planning-behaviour gap.

OBJECTIVES: To examine motivational and volitional factors for hand washing in young adults, using the Health Action Process Approach (HAPA) as a theoretical framework. DESIGN: In a longitudinal design with two measurement points, six weeks apart, university students (N = 440) completed paper-based questionnaires. MAIN OUTCOME MEASURES: Prior hand washing frequency, self-efficacy, outcome expectancies, intention and action planning were measured at baseline, and coping planning, action control and hand washing frequency were measured at follow-up. RESULTS: A theory-based structural equation model was specified. In line with the HAPA, the motivational factors of self-efficacy and outcome expectancies predicted intention, whereas the volitional factors of planning and action control mediated between intention and changes in hand washing frequency. Action control was confirmed as the most proximal factor on hand washing behaviour, thus representing a bridge of the planning-behaviour gap. CONCLUSIONS: Both motivational and volitional processes are important to consider in the improvement of hand hygiene practices. Moreover, the statistically significant effects for planning and action control illustrate the importance of these key self-regulatory factors in the prediction of hand hygiene. The current study highlights the importance of adopting models that account for motivational and volitional factors to better understand hand washing behaviour.

Effects of Self-Rated Health and Self-Rated Economic Situation on Depressed Mood Via Life Satisfaction Among Older Adults in Costa Rica.

OBJECTIVE: The study examined the relationship of self-rated health and self-rated economic situation with depressed mood, and life satisfaction as mediator of this relationship among older adults in Costa Rica. METHOD: A longitudinal study was conducted with a subsample (N = 1,618) from the Costa Rican Longevity and Healthy Aging Study (CRELES). Self-rated health, self-rated economic situation, depressed mood, and life satisfaction were measured at baseline, and depressed mood was reassessed 18 months later. Putative mechanisms for changes in depressed mood were examined by means of conditional process analysis. RESULTS: Self-rated health was negatively associated to depressed mood. This effect took place via life satisfaction. An interaction showed that better economic situation compensated the effect of a low self-rated health on life satisfaction. DISCUSSION: This study suggests that subjective variables such as self-rated health, economic situation, and life satisfaction should be considered when addressing the onset of depressed mood.

Dolor pélvico ginecológico: caracterización de egresos hospitalarios en Chile, 2001-2012 / Gynecologic pelvic pain: characterization of hospital discharges in Chile, 2001-2012

Introducción: se define dolor pélvico como aquél que se presenta en la región abdominal baja o pélvica, que puede ser agudo o crónico, y representa un frecuente motivo de consulta y hospitalización ginecológica. Mientras la valoración del dolor pélvico agudo está orientada a disminuir el riesgo de morbimortalidad a través de su identificación etiológica oportuna, en el caso del dolor pélvico crónico aún existe controversia respecto de su definición y criterios de inclusión etiológicos. Si bien existen amplias variaciones en las estimaciones de prevalencia de dolor pélvico, existe consenso que el dolor pélvico crónico tiene importantes repercusiones, tanto a nivel individual como del sistema de salud. En Chile no existen estudios que hayan cuantificado la prevalencia de dolor pélvico. Se presenta una descripción demográfica y epidemiológica de los egresos hospitalarios por dolor pélvico de causa ginecológica en Chile, desde los años 2001 al 2012, con el fin de aportar cifras iniciales sobre la magnitud de esta problemática de salud de la mujer. Materiales y métodos: Estudio descriptivo del universo de egresos hospitalarios por dolor pélvico en mujeres de 12 años y más, ocurridos en Chile entre los años 2001 y 2012, a partir de las bases de datos nacionales del Ministerio de Salud de Chile. Se seleccionaron los códigos CIE-10, correspondientes a dolor pélvico y perineal, y dolor relacionado con órganos genitales femeninos y con el ciclo menstrual. A partir de las variables disponibles, se realizó un análisis descriptivo sociodemográfico y epidemiológico, realizando inferencia estadística con nivel de significancia de 5%...

Introduction: pelvic pain is defined as the one presenting in lower abdomen or pelvis, which may be acute or chronic, and it represents a frequent reason for gynecologic consultations and hospitalization. While acute pelvic pain valuation is oriented to diminish morbidity and mortality through its opportune etiological identification, in chronic pelvic pain, there is still controversy about its definition and optimal inclusion criteria. While there are wide variations in prevalence estimates of pelvic pain, there is consensus in that chronic pelvic pain has important effects at an individual and health system level. In Chile there are not studies that quantify pelvic pain prevalence. Our work presents a demographic and epidemiological description of hospital discharges by gynecological pelvic pain in Chile, from 2001 to 2012, in order to provide initial figures on the extent of this health issue in women. Materials and methods: Descriptive study of hospital discharges by pelvic pain in women 12 years old and older in Chile between 2001 and 2012, from the national databases of the Chilean Health Ministry. We selected ICD-10 codes corresponding to pelvic and perineal pain, and pain related to female genitalia and the menstrual cycle. With the available variables, we made a sociodemographic and epidemiological analysis, conducting statistical inference with a significance level of 5%...

Self-efficacy, action control, and social support explain physical activity changes among Costa Rican older adults.

BACKGROUND: Self-efficacy, action control, and social support are considered to influence changes in physical activity levels in older adults. This study examines the relationship among these variables and explores the putative mediating and moderating mechanisms that might account for activity changes. METHODS: A longitudinal study with 54 older adults (≥ 50 years of age) was carried out in Costa Rica. In a moderated mediation analysis, action control was specified as a mediator between self-efficacy and physical activity, whereas social support was specified as a moderator between self-efficacy and action control. Baseline physical activity, age, and sex were specified as covariates. RESULTS: Action control mediated between self-efficacy and physical activity. An interaction between social support and self-efficacy on action control pointed to a synergistic effect at the first stage of the mediating process. CONCLUSIONS: The effect of self-efficacy on physical activity was partly explained by action control, providing evidence of action control as a proximal mediator of physical activity. Moreover, the moderator role of social support was confirmed: high social support appeared to compensate for low levels of self-efficacy.

La investigación en salud en Chile / Health research in Chile

An analysis of health research in Chile is made, considering factors like exaggerated professional training during undergraduate studies and clinical residencies, and displacement of professionals from academic activities to more remunerative positions. Additionally, the limited role of the Ministry of Health in research promotion, evidenced by the almost absent participation of public hospitals in clinical research is discussed. Research investment, among a 0.6 to 0.8 percent of the GNP, is far from developed countries and Chile has not defined relevant health problems where a search effort would have an impact in public health. The marked centralism of the country attempts against regional application to financed projects. The following suggestions are made: to increase the financing for investigation, to reassign resources allowing the access of regional institutions, to financing, to discuss in the Chilean Association of Medical Faculties (ASOFAMECH) the creation of an academic degree by means of a thesis during the professional studies and to give facilities to develop research during clinical residencies. Also, the Ministry of Health should be involved, creating a national agenda or research priorities and increasing its association with Universities. Also training programs for professionals with a special interest in investigation should be devised

Fracturas expuesta: experiencia de 5,207 casos. Presentación de una nueva clasificación / Open fractures: experience of 5,207 cases and the proposal of a new classification

Este es el primero de una serie de informes acerca de fracturas expuestas y se presenta la estadística de 5,207 casos de fracturas expuestas en 5,072 pacientes atendidos de enero de 1991 a diciembre de 1997. Se presenta una nueva clasificaicón de fracturas expuestas que está basada en la clasificación de Gustilo, la cual se modificó porque en nuestro medio no es aplicable a la totalidad de los pacientes. La clasificación consta de cuatro grupos en un total de diez tipos; cada grupo tiene características propias y los tipos están dados por las características de la lesión, y también da una idea del tratamiento y del pronóstico. El porcentaje de infección fue del 4.4 por ciento en general; se presenta el desglose de infección por tipo de exposición, la pseudoartrosis se presentó en 5.8 por ciento, el porcentaje de amputaciones varía según el tipo de exposición. Hemos encontrado que nuestra clasificación tiene una correlación entre el tipo de exposición y el pronóstico

Resección Submucosa del Cornete Inferior con Microdebridador. Técnica de Mínima Invasión / Submucosal inferior turbinate reseccion with microdebrider: Minimal invasive endoscopic technique

Mucho se ha discutido acerca del manejo de la obstrucción nasal crónica secundaria a la hipertrofia crónica de los cornetes. Los procedimientos dirigidos a esta área continúan hoy en día generando controversia. En la mayoría de los casos la dificultad respiratoria nasal es debida a la combinación de varias enfermedades o anormalidades anatómicas y por lo tanto requiere de un tratamiento médico-quirúrgico para su corrección. El presente trabajo muestra un estudio retrospectivo de una nueva técnica endoscópica de mínima invasión con el uso del microdebridador para el tratamiento de la rinitis crónica hipertrófica. Desde Octubre 2 de 1997 hasta Mayo 20 de 1999 se han realizado 93 resecciones submucosas del cornete inferior (RSCI) bajo visión endoscópica en 52 pacientes. La técnica es sencilla, fácil de realizar y con mínimas complicaciones. Los resultados muestran mejoría notable y consistente a largo plazo del síndrome obstructivo nasal secundario a ensanchamiento de los cornetes

Niveles de lípidos y de presión arterial en población mapuche de la Región de la Araucanía, en Chile / Blood pressure and serum lipid levels in Chilean aboriginal populations (Mapuche) living in the Chilean region of Araucania

Background: Chilean aboriginal populations (Mapuche) predominantly live in the region of Araucanía, in the southern part of the country. Their cardiovascular risk factors have not been systematically assessed. Aim: To study the prevalence of cardiovascular risk factors in the Mapuche population. Subjects and methods: Blood pressure, weight, height, dietary habits, fasting serum total cholesterol, HDL cholesterol and triglycerides were measured in 1.948 adults living in 28 Mapuche communities. Results: Thirteen percent of males and 16 percent of females had high blood pressure. Body mass index was 25.5 kg/m2 in males and 28.1 kg/m2 in females. Forty five percent of women and 24 percent of men were classified as obese. Mean serum total cholesterol was 186.7ñ9.6 mg/dl, HDL cholesterol was 58.7ñ30.7 mg/dl, total cholesterol/HDL cholesterol was 3.4ñ2 and triglycerides were 155.2ñ91.2 mg/dl. Twenty eight percent of males and 9.6 percent of females smoked. Conclusions: Mapuche individuals have higher levels of HDL cholesterol, a better total cholesterol/HDL cholesterol ratio and lower frequency of smoking than non aboriginal Chileans subjects