Development of Groundwater Levels Dataset for Chile since 1970.

Access to accurate spatio-temporal groundwater level data is crucial for sustainable water management in Chile. Despite this importance, a lack of unified, quality-controlled datasets have hindered large-scale groundwater studies. Our objective was to establish a comprehensive, reliable nationwide groundwater dataset. We curated over 120,000 records from 640 wells, spanning 1970-2021, provided by the General Water Resources Directorate. One notable enhancement to our dataset is the incorporation of elevation data. This addition allows for a more comprehensive estimation of groundwater elevation. Rigorous data quality analysis was executed through a classification scheme applied to raw groundwater level records. This resource is invaluable for researchers, decision-makers, and stakeholders, offering insights into groundwater trends to support informed, sustainable water management. Our study bridges a crucial gap by providing a dependable dataset for expansive studies, aiding water management strategies in Chile.

Preoperative ultrasound findings as risk factors of recurrence of pelvic organ prolapse after laparoscopic sacrocolpopexy.

INTRODUCTION AND HYPOTHESIS: The objective of this study is to evaluate levator ani muscle avulsion (LAMA) and ballooning as risk factors for recurrence of pelvic organ prolapse (POP) after laparoscopic sacrocolpopexy (SCP). We hypothesize that these ultrasound findings are associated with a higher risk of POP recurrence. METHODS: Retrospective cohort study of patients who underwent laparoscopic SCP between January 2015 and December 2018. Baseline translabial 3D ultrasound of the pelvic floor was performed. Pelvic Floor Distress Inventory (PFDI-20) and the Pelvic Floor Impact Questionnaire (PFIQ-7) were applied. Both univariate and multivariate analyses were carried out. RESULTS: One hundred thirty-four patients were included. On ultrasound, 32% of patients had levator ani muscle avulsion, and 36.5% had ballooning. Mean follow-up time was 16 months. There was a 13.4% anatomic recurrence; five of them (3.7%) also had symptomatic recurrence. After multivariate analysis we found that LAMA and ballooning were not significant: OR 0.99 (95% CI 0.098-10.1; p = 0.99) and OR 1.1 (95% CI 0.99-1.2; p = 0.06), respectively. CONCLUSIONS: LAMA and ballooning on pelvic floor US are not significant risk factors for anatomic POP recurrence after laparoscopic SCP. Laparoscopic SCP has a 13.4% and 3.4% anatomic and symptomatic recurrence rate, respectively, and the majority of patients reported significant improvement in quality of life.

Decreased Influenza Activity During the COVID-19 Pandemic - United States, Australia, Chile, and South Africa, 2020.

After recognition of widespread community transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), by mid- to late February 2020, indicators of influenza activity began to decline in the Northern Hemisphere. These changes were attributed to both artifactual changes related to declines in routine health seeking for respiratory illness as well as real changes in influenza virus circulation because of widespread implementation of measures to mitigate transmission of SARS-CoV-2. Data from clinical laboratories in the United States indicated a 61% decrease in the number of specimens submitted (from a median of 49,696 per week during September 29, 2019-February 29, 2020, to 19,537 during March 1-May 16, 2020) and a 98% decrease in influenza activity as measured by percentage of submitted specimens testing positive (from a median of 19.34% to 0.33%). Interseasonal (i.e., summer) circulation of influenza in the United States (May 17-August 8, 2020) is currently at historical lows (median = 0.20% tests positive in 2020 versus 2.35% in 2019, 1.04% in 2018, and 2.36% in 2017). Influenza data reported to the World Health Organization's (WHO's) FluNet platform from three Southern Hemisphere countries that serve as robust sentinel sites for influenza from Oceania (Australia), South America (Chile), and Southern Africa (South Africa) showed very low influenza activity during June-August 2020, the months that constitute the typical Southern Hemisphere influenza season. In countries or jurisdictions where extensive community mitigation measures are maintained (e.g., face masks, social distancing, school closures, and teleworking), those locations might have little influenza circulation during the upcoming 2020-21 Northern Hemisphere influenza season. The use of community mitigation measures for the COVID-19 pandemic, plus influenza vaccination, are likely to be effective in reducing the incidence and impact of influenza, and some of these mitigation measures could have a role in preventing influenza in future seasons. However, given the novelty of the COVID-19 pandemic and the uncertainty of continued community mitigation measures, it is important to plan for seasonal influenza circulation in the United States this fall and winter. Influenza vaccination of all persons aged ≥6 months remains the best method for influenza prevention and is especially important this season when SARS-CoV-2 and influenza virus might cocirculate (1).

Evaluación por médicos especialistas de curso de urgencias gineco-obstétricas utilizando metodología de simulación clínica / Evaluation by emergency medical specialists gyneco-obstetricians using clinical simulation methodology

Introducción: La simulación clínica es una herramienta de aprendizaje complementaria a los métodos tradicionales en la práctica clínica. Permite desarrollar habilidades y destrezas en escenarios seguros. La división de ginecología y obstetricia de la Universidad Católica (UC) imparte un curso de emergencias obstétricas para especialistas utilizando esta metodología. Presentamos la evaluación de los especialistas que realizaron el curso en el año 2016. Materiales y métodos: se realizó un curso de simulación de escenarios de emergencia en obstetricia, con un total de 16 horas separadas en 2 días. Con simuladores de alta y mediana complejidad. Tutoriados por instructores acreditados por el Institute of medical simulation de la Universidad de Harvard. Al finalizar el curso los participantes respondieron una encuesta escrita de diversos tópicos del curso. Resultados: participaron 93 especialistas. 76 por ciento de los participantes estuvo completamente de acuerdo y 23 por ciento de acuerdo con que la práctica con modelos simulados mejora la destreza relacionada con la realización de los procedimientos propuestos en el curso. El 100 por ciento de ellos indica que recibió retroalimentación considerada como útil durante las sesiones de entrenamiento y consideran que están completamente de acuerdo o de acuerdo con que esta metodología les permite cometer errores en forma segura. Conclusiones: la implementación de la metodología de simulación clínica en la docencia de emergencias obstétricas es muy bien evaluada por los especialistas, ya que entrega retroalimentación académica útil de cada caso y les permite cometer errores sin riesgos para los pacientes con un alto nivel de realismo.(AU)

Introduction: Clinical simulation is a learning tool complementary to traditional methods in clinical practice. It allows the development of skills and abilities in safe scenarios. The department of obstetrics and gynecology at the Catholic University offers an obstetrics emergency course for specialists using this methodology. Below we present the evaluation of the specialists who completed the course in 2016. Methods and Materials: A simulation course of emergency scenarios in obstetrics was carried out, distributed in clinical stations, with high and medium complexity simulators for a total of 16 hours' duration in 2 days. The tutors where instructors accredited by the Institute of medical simulation of Harvard University. At the end of the course the participants answered a written survey including various topics of the course. Results: Ninety-three specialists participated. 76 percent of the participants were in complete agreement and 23 percent agreed that the practice with simulated models improved the skills related to the clinical procedures proposed in the course. One hundred percent of them considered that the feedback received was useful during the training sessions and completely agreed that this methodology allows them to make mistakes in a safe form. Conclusions: The implementation of the methodology of clinical simulation in the teaching of obstetrical emergencies was very well evaluated by the specialists, since it provides useful academic feedback of each case and allows them to make mistakes without risks for the patients with a high level of realism.(AU)

Metabolism and antifungal activity of safrole, dillapiole, and derivatives against botryodiplodia theobromae and colletotrichum acutatum / Metabolismo y actividad antifúngica de safrol, dilapiol, y derivados contra botryodiplodia theobromae y colletotrichum acutatum

The direct in vitro fungitoxicity and metabolism of safrole and dillapiole (isolated from Piper auritum and Piper holtonii, respectively) by Botryodiplodia theobromae and Colletotrichum acutatum were investigated. Higher values of mycelial growth inhibition for both fungi were obtained for dillapiole, as compared with safrole. B. theobromae was able to metabolize both compounds to their respective vicinal diols, reaching 65 percent relative abundance during the biotransformation of dillapiole; while C. acutatum only transformed safrole to various metabolites with relative abundances under 5 percent. According to the low antifungal activity of the major metabolic products (< 5 percent for vicinal diols), a detoxification process was implied. Studies on the influence of some substituents in the aromatic ring of safrole and dillapiole on the antifungal activity against B. theobromae were also carried out. As result, the safrole nitrated derivative, 6-nitrosafrole, showed a fungitoxicity level similar to that displayed by the commercial fungicide Carbendazim® under the conditions used. In light of this, safrole and dillapiole could be suggested as feasible structural templates for developing new antifungal agents.

Se investigó la fungitoxicidad directa in vitro y el metabolismo de safrol y dilapiol (obtenidos desde Piper auritum and Piper holtonii, respectivamente) por Botryodiplodia theobromae y Colletotrichum acutatum. Los valores mayores de inhibición del crecimiento micelial de ambos hongos se obtuvieron para dilapiol, en comparación con safrol. B. theobromae metabolizó ambos compuestos a sus respectivos dioles vecinales, alcanzando abundancias relativas del 65 por ciento durante la biotransformación del dilapiol; mientras que C. acutatum solo transformó safrol en varios metabolitos con abundancias relativas menores al 5 por ciento. De acuerdo con la baja actividad antifúngica de los productos metabólicos mayoritarios (< 5 por ciento para los dioles vecinales), se sugiere un proceso de desintoxicación. Adicionalmente, se evaluó la influencia de algunos sustituyentes en el anillo aromático de safrol y dilapiol sobre la actividad antifúngica contra B. theobromae. Como resultado, el derivado nitrado del safrol, el 6–nitro safrol, presentó un nivel de fungitoxicidad similar al exhibido por el fungicida comercial Carbendazim® bajo las condiciones usadas. A la luz de lo anterior, safrol y dilapiol podrían ser sugeridos como plantillas estructurales adecuadas para el desarrollo de nuevos agentes antifúngicos.

Efficacy and safety of tension-free vaginal tape compared with transobturator tape among obese women with stress urinary incontinence: a retrospective cohort study.

OBJECTIVE: To determine the efficacy and safety of tension-free vaginal tape (TVT) compared with transobturator tape (TOT) in obese women with stress urinary incontinence (SUI). METHODS: We performed a retrospective chart review of patients who underwent insertion of TVT or TOT for stress urinary incontinence between January 2003 and October 2009. Women were excluded if they had had previous surgery for SUI or had a diagnosis of intrinsic sphincter deficiency. RESULTS: One hundred eighty obese women (BMI > 30 kg/m²) with SUI and with follow-up for at least one year were identified (90 had TVT and 90 had TOT). The rates of success on the objective criteria were 91% for the TVT group and 88% for the TOT group (P = 0.46) and 87% versus 80% (P = 0.23) on subjective assessment. CONCLUSION: Our retrospective cohort study demonstrated similar rates of cure for obese women with SUI who underwent insertion of TVT and TOT.

Randomized controlled trial of cystocele plication risks: a pilot study.

OBJECTIVE: We wished to determine the feasibility of a single-centre randomized controlled trial to investigate whether avoiding cystocele plication in women undergoing transvaginal repair of cystocele decreases the need for catheterization beyond the second postoperative day. METHODS: Patients undergoing transvaginal repair of cystocele were randomly assigned to either have or not have plication sutures during their procedure. We assessed the success of recruitment, physician acceptability, and adherence to protocol, and we also assessed the need for catheterization beyond the second postoperative day. RESULTS: Twenty-two women were randomized (a recruitment rate of 85%), and participating surgeons did not feel that one surgical technique was superior to the other. There were no protocol violations after randomization. No cases of postoperative voiding dysfunction were identified. CONCLUSION: A multicentre randomized controlled trial is required to determine the short-term and long-term risks and benefits of avoiding plication sutures in women undergoing transvaginal repair of cystocele. If patients and physicians support the study protocol, conducting such a trial is feasible.

Sindrome plurimetabólica / Metabolic syndrome

A síndrome plurimetabólica é definida por um conjunto de anormalidades metabólicas, caracterizada por resistência celular à açäo periférica da insulina, hiperinsulinemia compensatória, hipertensäo, obesidade intra-abdominal (visceral), dislipidemia caracterizada por níveis séricos diminuídos de lipoproteína de alta densidade (HDL) e elevados de lipoproteína de baixa densidade(LDL) e de muito baixa densidade(VLDL), além de um risco aumentado no desenvolvimento de doenças cardiovasculares e diabetes mellitus tipo 2. Também podem ser observados nos pacientes: alteraçöes na coagulaçäo sangüínea, hiperuricemia, hiperfibrogenemia, microalbuminúria, maior incidência de ovários policisticos, apnéia do sono, depressäo e alguns tumores. O tratamento consiste em medidas näo farmacológicas(dietas especiais e exercícios físicos) e farmacológicas(tiazolidinedionas, biguanidas, inibidores da ECA e bloqueadores de receptores AT1, além do emprego de outros agentes anti-hipertensivos). Este artigo faz uma revisäo sobre os principais aspectos da epidemiologia, patogênese, clínica, formas de tratamento e prevençäo da síndrome plurimetabólica.(au)

Neoplasia maligna de bainha de nervo periférico de origem central: relato de caso e revisão de literatura / Malignant peripheral nerve sheath tumor of central origin: case report and review of the literature

O estudo descreve o caso de um tumor muito raro, neoplasia maligna de bainha de nervo periférico de origem central, antigamente denominado schwanoma maligno de sistema nervoso central. Devido à sua histogênese controversa, prefere-se a primeira denominação. O caso relatado corresponde ao sexto caso descrito na literatura, e ocorreu em um menino de 12 anos. Este é o primeiro caso a ser associado à neurofibromatose tipo 1 (doença de von Recklinghausen). Em outubro de 1999, o paciente procurou auxílio médico queixando-se de cefaléia, náuseas, desvio da comissura labial e comportamento hilárico. Estudos de imagem revelaram massa em lobo frontal esquerdo, assemelhando-se a um meningioma. Foi realizada cirurgia com ressecção completa da lesão. O estudo da patologia revelou neoplasia maligna fusocelular. A seguir foi feito estudo imuno-histoquímico definindo o diagnóstico exato. Iniciada radioterapia em seguida. Trinta dias após o término do tratamento actínico ocorreu recidiva loco-regional em couro cabeludo (implantação cirúrgica), sendo proposta então quimioterapia utilizando o protocolo do Pediatric Oncology Group para sarcomas de alto risco. O tratamento foi finalizado em março de 2001 sem sinais e sintomas clínicos ou imagem à ressonância magnética sugestivos de doença em atividade.