SARS-CoV-2 infection in asymptomatic healthcare workers at a clinic in Chile.

Asymptomatic SARS-CoV-2 infection of healthcare workers (HCWs) has been reported as a key player in the nosocomial spreading of COVID-19. Early detection of infected HCWs can prevent spreading of the virus in hospitals among HCWs and patients. We conducted a cross-sectional study to determine the asymptomatic infection of HCWs in a private clinic in the city of Santiago, Chile. Our study was conducted during a period of 5 weeks at the peak of transmission of SARS-CoV-2 in Chile. Nasopharyngeal samples were obtained from 413 HCWs and tested for the presence of SARS-CoV-2 using RT-qPCR. We found that a 3.14% of HCWs were positive for the presence of SARS-CoV-2 (14/413). Out of these, 7/14 were completely asymptomatic and did not develop symptoms within 3 weeks of testing. Sequencing of viral genomes showed the predominance of the GR clade; however, sequence comparison demonstrated numerous genetic differences among them suggesting community infection as the main focus of transmission among HCWs. Our study demonstrates that the protocols applied to protect HCWs and patients have been effective as no infection clusters due to asymptomatic carriers were found in the clinic. Together, these data suggest that infection with SARS-CoV-2 among HCWs of this health center is not nosocomial.

[Endovascular management of acute complications of type B aortic dissection]. / Manejo endovascular de las complicaciones agudas de la disección aórtica tipo B.

BACKGROUND: Type B aortic dissection is usually managed by intensive care medical therapy and surgery is reserved for treating the complications that can occur during the evolution of a case. AIM: To assess the endovascular management of acute complications of type B aortic dissection and the closure of the intimal defect and aortic false lumen. MATERIAL AND METHODS: Retrospective analysis of 8 consecutive patients aged 40 to 57 years (seven males) treated for acute complications in the initial episode of a type B aortic dissection between August 2006 and July 2008. RESULTS: Six/eight were known hypertensive patients. The indications for surgery were intractable pain in one, hypertension refractory to treatment in two and distal hypoperfusion in five. Five patients required covering of the left subclavian artery ostium, without need for surgical repair. One patient was subjected to renal angioplasty and stenting. Technical success was achieved in all cases, with complete closure of the proximal aortic tear and thoracic aortic false lumen, although 7 of patients had a persistent distal aortic false lumen. One case had a transient lower limb paraparesis. No patient died. CONCLUSIONS: Endovascular treatment is effective in closing the aortic tear as well as the thoracic aortic false lumen in aortic type B dissections with a low complication rate. Due to the high frequency of distal aortic false lumen persistence, it is not a definitive treatment for this condition but it is useful for the acute complications of the initial phase of type B aortic dissection.

[Popliteal artery entrampment: report of one case]. / Atrapamiento de la arteria poplítea: comunicación de un caso.

Popliteal artery entrampment is a rare condition, occurring in young subjects, that causes ischemia of the extremity. The anatomical background is the compression or occlussion of the popliteal artery caused by forced plantar or dorsal flexion. We report a 32 year-old sportsman who presented with gangrene of the right first toe and a history of three months of progressive claudication. The Ankle-Brachial index and pulse volume curve registries showed a severe ischemia below the knee. Angiography showed a medial deviation of the popliteal artery associated to stenosis and aneurysm formation. A CT scan of the contralateral artery was normal. The patient was operated using a posterior approach, performing a reverse saphenous vein bypass graft and excising the popliteal artery. The postoperative period was uneventful.

Maltrato infantil / Child abuse

El maltrato infantil (MI) es un hecho conocido desde la antiguedad, sin embargo sólo en los últimos años se ha tomado real conciencia de éste como una patología de la infancia. En 1962 el tópico de maltrato infantil (MI) ganó la atención médica debido a la publicación del "Síndrome del niño golpeado" de Henry Kempe y cols. cuando por primera vez se conoció como una patología con todos sus aspectos físicos, radiológicos e implicancias legales. Chile, por su parte, se adscribe a los derechos del niño y, por ende, cualquier violación a estos derechos es considerado un maltrato. Desde ese momento se establece la obligación de proteger al niño. El pediatra a través de su labor tanto ambulatoria como hospitalaria tiene la posibilidad y el deber de proteger a los niños. Hacer el diagnóstico de MI es tan crucial como el de cualquier otra patología ya que una intervención oportuna puede prevenir catastróficas consecuencias