Panel de expertos para la elaboración de un modelo de consentimiento informado de obtención y uso de material audiovisual clínico / Proposal of an informed consent form to obtain audiovisual material from patients

BACKGROUND: An informed consent is mandatory to obtain any clinical audiovisual material from patients. Although there are some documents created for this purpose, there are some barriers for their application, such as the context in which they were created, the language and download availability. AIM: To create a proposal for an informed consent form (ICF) for the capture and different uses for audiovisual material from patients. MATERIAL AND METHODS: A bibliographic search was carried out to obtain different ICFs in Spanish and English, which were subjected to a process of translation, counter-translation and fragmentation. Subsequently, a panel of experts was formed by members of the Chilean Society of Plastic Surgery with extensive experience in social networks. Delphi methodology was applied to reach a consensus about the definitive content of the ICF based on the previously selected fragments. RESULTS: ICFs available for download were identified. The panel was made up of seven Plastic Surgeons and two Delphi rounds were carried out through electronic surveys. At the end of the process, an ICF proposal was obtained for therapeutic, academic or scientific purposes and another for dissemination or education in the mass media. CONCLUSIONS: The proposed ICFs were liberated for their use among health care professionals in Chile, who could use them, provided that they are approved by the local healthcare ethics committees.

Extension of Duplexed Single-Ended Distributed Temperature Sensing Calibration Algorithms and Their Application in Geothermal Systems.

Fiber-optic distributed temperature sensing (DTS) has been widely used since the end of the 20th century, with various industrial, Earth sciences, and research applications. To obtain precise thermal measurements, it is important to extend the currently available DTS calibration methods, considering that environmental and deployment factors can strongly impact these measurements. In this work, a laboratory experiment was performed to assess a currently available duplexed single-ended DTS calibration algorithm and to extend it in case no temperature information is available at the end of the cables, which is extremely important in geothermal applications. The extended calibration algorithms were tested in different boreholes located in the Atacama Desert and in the Central Andes Mountains to estimate the geothermal gradient in these regions. The best algorithm found achieved a root mean square error of 0.31 ± 0.07 °C at the far end of a ~1.1-km cable, which is much smaller than that obtained using the manufacturer algorithm (2.17 ± 0.35 °C). Moreover, temperature differences between single- and double-ended measurements were less than 0.3 °C at the far end of the cable, which results in differences of ~0.5 °C km-1 when determining the geothermal gradient. This improvement in the geothermal gradient is relevant, as it can reduce the drilling depth by at least 700 m in the study area. Future work should investigate new extensions of the algorithms for other DTS configurations and determining the flow rate of the Central Andes Mountains artesian well using the geothermal profile provided by the DTS measurements and the available data of the borehole.

[Proposal of an informed consent form to obtain audiovisual material from patients]. / Panel de expertos para la elaboración de un modelo de consentimiento informado de obtención y uso de material audiovisual clínico.

BACKGROUND: An informed consent is mandatory to obtain any clinical audiovisual material from patients. Although there are some documents created for this purpose, there are some barriers for their application, such as the context in which they were created, the language and download availability. AIM: To create a proposal for an informed consent form (ICF) for the capture and different uses for audiovisual material from patients. MATERIAL AND METHODS: A bibliographic search was carried out to obtain different ICFs in Spanish and English, which were subjected to a process of translation, counter-translation and fragmentation. Subsequently, a panel of experts was formed by members of the Chilean Society of Plastic Surgery with extensive experience in social networks. Delphi methodology was applied to reach a consensus about the definitive content of the ICF based on the previously selected fragments. RESULTS: ICFs available for download were identified. The panel was made up of seven Plastic Surgeons and two Delphi rounds were carried out through electronic surveys. At the end of the process, an ICF proposal was obtained for therapeutic, academic or scientific purposes and another for dissemination or education in the mass media. CONCLUSIONS: The proposed ICFs were liberated for their use among health care professionals in Chile, who could use them, provided that they are approved by the local healthcare ethics committees.

Deciphering groundwater flow-paths in fault-controlled semiarid mountain front zones (Central Chile).

The Mountain-Block Recharge (MBR), also referred to as the hidden recharge, consists of groundwater inflows from the mountain block into adjacent alluvial aquifers. This is a significant recharge process in arid environments, but frequently discarded since it is imperceptible from the ground surface. In fault-controlled Mountain Front Zones (MFZs), the hydrogeological limit between the mountain-block and adjacent alluvial basins is complex and, consequently, the groundwater flow-paths reflect that setting. To cope with the typical low density of boreholes in MFZs hindering a proper assessment of MBR, a combined geoelectrical-gravity approach was proposed to decipher groundwater flow-paths in fault-controlled MFZs. The study took place in the semiarid Western Andean Front separating the Central Depression from the Principal Cordillera at the Aconcagua Basin (Central Chile). Our results, corroborated by field observations and compared with worldwide literature, indicate that: (i) The limit between the two domains consists of N-S-oriented faults with clay-rich core (several tens of meters width low electrical-resistivity subvertical bands) that impede the diffuse MBR. The "hidden recharge" along the Western Andean Front occurs through (ii) focused MBR processes by (ii.a) open and discrete basement faults (mass defect and springs) oblique to the MFZ that cross-cut the N-S-oriented faults, and (ii.b) high-hydraulic transmissivity alluvial corridors in canyons. Alluvial corridors host narrow unconfined mountain aquifers, which are recharged by indirect infiltration along ephemeral streams and focused inflows from oblique basement faults. This study also revealed seepage from irrigation canals highlighting their key role in the recharge of alluvial aquifers in the Central Depression. The proposed combined geophysical approach successfully incorporated (hydro)geological features and geophysical forward/inverse modelling into a robust hydrogeological conceptual model to decipher groundwater flow-paths in fault-controlled MFZs, even in the absence of direct observation points.

Mind the Gap: a Competency-Based Scoping Review of Aesthetic and Reconstructive Reported Simulation Training Models.

BACKGROUND: Simulation training has become an integral part of plastic surgery postgraduate curricula. It facilitates the acquisition of skills in a safe environment that can be later transferred to real-life settings. A variety of models have been described covering some aspects of the specialty better than others. The aim of this study was to identify and classify all the previously reported plastic surgery simulation models and the possible gaps having the Accreditation Council for Graduate Medical Education (ACGME) list of competencies as a guide. METHODS: Through a Delphi process, the complete list of ACGME minimum requirements for certification was analyzed to identify domains amenable for simulation training. A systematic search was conducted in Pubmed looking for all previously reported simulation models in plastic surgery. Predefined inclusion and exclusion criteria and parallel blind review were used to identify eligible models. RESULTS: A total of 81 ACGME competencies were identified. Following a 3-round Delphi process, consensus was reached on 19 reconstructive and 15 aesthetic surgery domains suitable for simulation training. 1667 articles were initially retrieved from Pubmed, of which 66 articles were eligible for inclusion. Descriptive (65%), quasi-experimental (24%) and experimental studies (11%) were found. For the 34 identified ACGME competencies, there were simulation models described for 58.8% of these, mostly covering reconstructive surgery (84.2%) while for aesthetic surgery it was 13.3%. CONCLUSIONS: This scoping review has identified that there are still gaps in ACGME competencies that could benefit from new simulation training models, especially in those related to aesthetic surgery. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Tendencias y perfil de publicación de los cirujanos plásticos de los 22 países miembros de la FILACP, revisión de los últimos 20 años / Publishing trends and profile of plastic surgeons from the 22 countries members of the FILACP, revision of the last 20 years

Introducción y Objetivo: La publicación científica es una actividad académica fundamental, constituyendo una fuente de conocimiento y actualización. El objetivo de este trabajo es conocer el perfil y la tendencia de publicación de los cirujanos plásticos de las 22 naciones que componen la Federación Ibero Latinoamericana de Cirugía Plástica (FILACP) durante los últimos 20 años. Material y Método: Revisión en Pubmed, Lilacs, Scielo, Central (Cochrane) y Tripdatabase, desde el 1 de enero de 1998 al 1 de enero del 2018 bajo los términos: (Cirugía Plástica OR Plastic Surgery) AND: Chile, Argentina, Bolivia, Perú, Colombia, Brasil, Venezuela, Ecuador, Uruguay, Paraguay, Panamá, Costa Rica, Nicaragua, Guatemala, Honduras, El Salvador, México, República Dominicana, Cuba, Puerto Rico, España y Portugal, cada país por separado. Consideramos todos los trabajos que incluyeran entre sus autores al menos un cirujano plástico de su respectivo país y analizamos: pertenencia a su Sociedad Nacional de Cirugía Plástica (SNCP), participación de residentes, centro o campo clínico, tema, grupo etario objetivo, año de publicación y revista. Resultados: Revisamos 6387 publicaciones; 3000 artículos cumplieron criterios de inclusión. Los países con mayor número de publicaciones fueron Brasil (998), España (989) y México (310), seguidos de Portugal (167), Argentina (162), Chile (125) y Colombia (95). En global, el 89.3% de los autores eran miembros de su respectiva SNCP. Predominó como temática lo reconstructivo (47.6%), los estudios en adultos (73.2%) y los centros universitarios (58.2%). Las principales revistas de publicación corresponden a Cirugía Plástica Ibero-Latinoamericana y Plastic and Reconstructive Surgery. Conclusiones: Existe un aumento sostenido en la publicación científica por parte de los cirujanos plásticos de los países de la FILACP, en especial en la última década. Llama la atención la poca participación de residentes (8.4%), lo cual creemos corresponde a un reporte insuficiente de su calidad de residentes entre los autores

Background and Objective: Scientific publication is a fundamental academic activity, constituting a source of update and knowledge. The objective of this article was to find out about the publishing profile and trend of plastic surgeons from the 22 countries that conform the Ibero Latin American Federation of Plastic Surgery (FILACP) during the last 20 years. Methods: Literature Review in Pubmed, Lilacs, Scielo, Central (Cochrane) and Tripdatabase, from January 1, 1998 to January 1, 2018 under the terms: (Plastic Surgery OR Cirugía Plástica) AND: Chile, Argentina, Bolivia, Peru, Colombia, Brazil, Venezuela, Ecuador, Uruguay, Paraguay, Panama, Costa Rica, Nicaragua, Guatemala, Honduras, El Salvador, Mexico, Dominican Republic, Cuba, Puerto Rico, Spain and Portugal, each country separately. Articles with at least one plastic surgeon from the respective country between the authors were included and analyzed by: membership of their National Plastic Surgery Society, resident participation, center, subject, objective age group, year of publication and journal. Results: 6387 publications were reviewed; 3000 articles met inclusion criteria. The countries with the highest number of publications were Brazil (998), Spain (989) and Mexico (310), followed by Portugal (167), Argentina (162), Chile (125) and Colombia (95). Overall, 89.3% of the authors were members of their corresponding National Plastic Surgery Societies. Reconstructive themed papers predominated (47.6%), as well as studies in Adults (73.2%) and Academic centers (58.2%). The main publication journals were Cirugía Plástica Ibero-Latinoamericana and Plastic and Reconstructive Surgery. Conclusions: There is a sustained increase in scientific publication by plastic surgeons from the countries of the FILACP, especially in the last deca- de. The low participation of residents draws attention (8.4%), however we believe it corresponds to an insufficient report about their role as residents among the authors

Impacto que producen las terapias complementarias en usuarios pediátricos con enfermedades oncológicas y la participación de los profesionales de enfermería en su uso, en algunos hospitales e instituciones de Santiago de Chile, en el periodo diciembre 2014 a enero 2015 / Impact of complementary therapies in pediatric users with oncological diseases and the participation of nursing professionals in their use, in some hospitals and institutions in Santiago, Chile, from December 2014 to January 2015

Los niños con enfermedades oncológicas en tratamiento convencional se ven afectados tanto emocional como físicamente por la medicina tradicional y, considerando, que la OMS ha realizado publicaciones en que se invita a los países a implementar el uso de terapias complementarias, y que el Ministerio de Salud del Gobierno de Chile ha reconocido a la acupuntura, naturopatía y homeopatía como profesiones auxiliares de salud, se realizó una investigación descriptiva, basada en la metodología cuantitativa y tomando como referencia la Teoría de los Seres Unitarios planteada por Martha Rogers, con el propósito de conocer el impacto que producen las terapias complementarias en la tolerancia al tratamiento convencional, y la participación del Profesional de Enfermería en su uso. El proceso de recolección de datos fue durante el mes de diciembre de 2014 a enero de 2015, en los Hospitales Dr. Exequiel González Cortés y Dr. Roberto del Río, en el Hospital Clínico de la Universidad Católica de Chile, en la Clínica Dávila y en la Fundación Nuestros Hijos, sede San Miguel. Se encuestó a 120 cuidadores de niños con enfermedades oncológicas, quienes voluntariamente respondieron un cuestionario autoadministrado. Al cuantificar el uso de terapias complementarias, se determinó que 56 niños (47%), utilizan este tipo de terapias y que a su vez, más de la mitad de quienes la utilizan, hacen uso de más de un tipo de éstas. Al determinar el impacto de las terapias complementarias en la tolerancia al tratamiento convencional el resultado fue de carácter positivo, con un porcentaje que fluctúa entre un 75% y un 97%. Finalmente, al establecer el grado de participación de los Profesionales de Enfermería en el uso de terapias complementarias, se evidenció que su participación es baja (18%).

[Bioethics in Latin America: legal perspective]. / La Bioética en Latinoamérica: perspectiva jurídica.

The jurist's work is to detect the legal guiding principles, analize them and to anticipate what kind of acceptance they will have. The legislator must be prudent if the subject studied is changeable as it happens with the norms applied in Bioethics. This detection process is more delicate if the guiding principles that have to be detected are valid for such an extensive region, as it is Latin America, where the legislation of the different countries that form it would adopt them. The two problems that will be studied here are: a) if it is advisable or not to raise some Bioethic basic principles to the constitutional level. b) which are the main principles that have been adopted by the juridical legislations of Latin America and who, in some way, guide the legal regulation.

La Bioética en Latinoamérica; perspectiva jurídica / Bioethics in Latinoamerica: juridical view

El trabajo del jurista consiste en detectar los principios legales rectores, analizarlos y anticipar la aceptación que tendrán. El legislador debe ser prudente si el sujeto de estudio es mutable, como ocurre con las normas aplicables a la bioética. Este proceso de búsqueda es más delicado si los principios rectores a encontrar deben ser válidos para una región tan vasta como es Latinoamérica, donde los diferentes países que la conforman se regirán por ellos. Los 2 problemas que se estudiarán son: a) Si es aconsejable o no elevar algunos principios básicos de bioética a rango constitucional. b) Cuáles son los principios básicos adoptados por las legislaciones jurídicas de Latinoamérica y quiénes, en cierta manera, guían la regulación legal (AU)

No disponible

Hacia una integración supranacional de los principios rectores sobre el genoma humana: (una visión personal desde la perspectiva latinoamericana) / Towards a supranational integration of the governing principles on the human genome: (a personal vision from the Latin American perspective)

El objetivo del autor es preguntarse como se han integrado a nivel supranacional (especialmente en Latinoamérica) los principios rectoreso que se refieren al genoma humano, entendiendo por tales los valores éticos y las normas juridicas que en ellos se fundamentan. Especial importancia adquieren aqui los principios contenidos en la Declaración Universal de la UNESCO sobre el Genoma Humano y los Derechos Humanos.Advirtiendo que las normas juridicas pueden resultar ineficaces para solucionar algunos problemas biogenéticos, el autor aborda primeramente el concepto de ôgenoma humano: patrimonio comun de la humanidado. Y luego, cree encontrar una caracteristica comun en todas las Conferencias, Reuniones o Encuentros que hantenido lugar en América Latina en torno a los problemas del genoma humano: la exigencia de un trato igualitario, para los pueblos sobredesarrollados y para los pueblos infradesarrollados, frente a los beneficios que traerán los descubrimientos en torno al genoma humano.El autor analiza los siguientes principios rectores:a) El principio de la dignidad e inviolabilidadde la persona a través del respeto irrestricto de los derechos humanos.b) El principio de la no-comercializaci¢n del cuerpo humano.c) El principio de la no discriminación.d) El principio de la confidencialidade) El principio del consentimiento libre e informado.