Types of Psychiatric Beds and Mental Health Services in 16 Latin American Countries, 1990-2020.

OBJECTIVE: Latin America has undergone major changes in psychiatric services over the past three decades. The authors aimed to assess the availability of service data and changes in psychiatric services in this region during the 1990-2020 period. METHODS: The authors formed a research network to collect data on psychiatric service indicators gathered between 1990 and 2020 from national registries in Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, Dominican Republic, Ecuador, El Salvador, Guatemala, Honduras, Mexico, Panama, Paraguay, Peru, and Uruguay. Indicators included psychiatric beds in psychiatric and general hospitals overall, for children and adolescents, and for forensic populations; residential beds for substance use treatment; treatment slots in residential facilities and day hospitals; and outpatient facilities. RESULTS: Data availability varied among countries, service indicators, and time points. The median prevalence of psychiatric beds decreased in psychiatric hospitals from 5.1 to 3.0 per 100,000 people (-42%) and in general hospitals from 1.0 to 0.8 (-24%). The median prevalence estimates of specialized psychiatric beds for children and adolescents (0.18) and for forensic populations (0.04) remained unchanged. Increases in prevalence were observed for residential beds for substance use treatment (from 0.40 to 0.57, 43% increase), available treatment slots in residential facilities (0.67 to 0.79, 17%), treatment slots in day hospitals (0.41 to 0.54, 32%), and outpatient facilities (0.39 to 0.93, 138%). CONCLUSIONS: The findings indicate that treatment capacity shifted from inpatient to outpatient and community care. Most countries had a bed shortage for acute psychiatric care, especially for children and adolescents and forensic patients. More comprehensive and standardized mental health service registries are needed.

Trajectories of motor function in children with Duchenne muscular dystrophy: A longitudinal study on a Colombian population.

Duchenne Muscular Dystrophy (DMD) is characterized by an initial increase in motor function followed by a plateau phase and then entering a phase of steady decline. However, motor evolution of DMD have not been evaluated in developing countries. Therefore, this study aims to evaluate the trajectory of motor function in a sample of Colombian children with DMD. We included 119 children with DMD aged 4.8-19.3 years (mean follow-up = 1.7 years). A linear mixed model was used with age as the time scale and adjusted for covariates using a stepwise regression. Participants showed a progressive decline in motor skills from the age of 5 years with a decrease in speed around the age of 11 years (p < 0.001). After age 11, the decline in motor function was observed to continue until age 20 but at a slower rate (ßAge = -9.64. and ßAge2 = 0.18, p < 0.001 for both). Educational inclusion, glucocorticoid treatment and the number of mutated exons were shown to be associated with the motor performance. These findings may indicate that the evolution of DMD maintains similar patterns between high income countries and the Colombian population. They allow us to adapt and develop treatments that impact the population with DMD in Colombia, based in international evidence.

Role of age and sex in the association between BMI and functional limitations in stroke patients: Cross-sectional analysis in three European and US cohorts.

BACKGROUND: A U- or J-shaped association between BMI and different post-stroke outcomes is suggested. Thus, the aim is to evaluate the association between BMI with ADL, IADL and mobility limitations in the ageing post-stroke population at different ages, as well as the differences in this association by sex. METHODS: A total of 5,468 participants with stroke and 21,872 without stroke over 50 years of age were assessed for the number of limitations in basic or instrumental activities of daily living (ADL/IADL) as well as mobility tasks. The association between BMI at the interview (continuous time-dependent variable) and the level of limitations was assessed using a linear mixed model stratified by sex and stroke status. RESULTS: The association between BMI and ADL/IADL and mobility limitations were found to be significant in both men and women regardless of stroke status (p<0.001 for all). The association differs between those who have suffered a stroke and those who have not (p<0.001 for all). In ADL/IADL limitations, men with stroke showed a transition from an inverted J-shape to a U-shape association with age. In women, the BMI showed a less pronounced association between BMI and ADL/IADL limitations compared to men but with similar trends. A effect of sex was observed in the association between BMI and mobility, with women with and without stroke showing a linear association that differed from the inverted J-shaped or U-shaped association of men. CONCLUSION: Our results suggest that BMI is associated with limitations in ADL, IADL and mobility in stroke patients. In addition, this association differs between men and women and is also influenced by age.

Physical capacity tests as a complement in the evaluation of the level of disability in women with fibromyalgia: A cross-sectional study.

INTRODUCTION: The association between motor capacity and the level of disability in patients with fibromyalgia remains underexplored. This study aims to explore the association between physical capacity tests explored in the consultation and the level of disability in women with fibromyalgia. METHODS: There were 484 women diagnosed with fibromyalgia who were evaluated with 7 physical capacity tests: 10-m walk, 2-minute walk, 5-repetition getting up from a chair and sitting (G&S), 30-second chair stand, monopodal balance (right and left), and up-and-go. Functional performance was assessed with the Revised Fibromyalgia Impact Questionnaire (FIQR). Evaluation of the association between the physical capacity tests and the FIQR was initially performed using a principal component analysis (PCA). Subsequently, agglomerative hierarchical clustering (AHC) was performed in order to characterize groups of patients. RESULTS: Results show than FIQR and the tests 10-m walk, 2-minute walk, 5-repetition G&S, 30-second chair stand, and up-and-go test were correlated. The results of the AHC determined 3 groups of patients mainly on one motor dimension with significant differences in both the FIQR and the physical capacity tests retained in the PCA (P < 0.001 for all). CONCLUSION: The application of these physical tests is simple, fast and can be a complement to the FIQR questionnaire when determining the level of disability of patients with fibromyalgia, in addition to providing information on the evolution of the patients when these tests are administered in the clinical consultation.

The role of age, sex, and multimorbidity in 7-year change in prevalence of limitations in adults 60-94 years.

Recent data suggest a temporal trend in decline in functional limitations in older adults but whether this trend extends to the period after the 8th decade of life remains unclear. We examined change in prevalence of limitations in activities and instrumental activities of daily living (ADL and IADL) between 2008 and 2015 among adults of 60-94 years and the role of age, sex, multimorbidity; we also examined changes in severity of limitations. Data were drawn from two nationally representative surveys in 2008 (n = 13,593) and 2015 (n = 13,267). The 6-item scales of ADL and IADL were each categorized first as ≥ 1 limitations, and then to examine severity as 0, 1-2, and ≥ 3 limitations. Weighted logistic and multinomial regressions were used to estimate prevalence of limitations; the difference between surveys were extracted every 5 years between 60 and 90 years. The prevalence of ≥ 1 ADL declined between 2008 and 2015, from age 75 (- 1.2%; 95%CI = - 2.0, - 0.4%) to age 90 (- 8.8%; 95%CI = - 12.7, - 5.0%). This decline was more pronounced in men than women (p-value for interaction = 0.05) and observed primarily in those with multimorbidity (p-value for interaction = 0.06). Up to 2 ADL limitations declined from age 75 (- 1.0; 95%CI = - 1.7, - 0.3) to 90 (- 6.7; 95%CI = - 9.9, - 3.6) and from age 80 (- 0.6; 95%CI = - 1.1, 0.1) to 85 (- 1.2; 95%CI = - 2.2, - 0.1) for ≥ 3 ADL limitations. There was no substantial change in IADL limitations. These data from a high-income country with universal health care show improvement in ADL even after the 8th decade of life despite increase in multimorbidity.

Population genomics of Puccinia graminis f.sp. tritici highlights the role of admixture in the origin of virulent wheat rust races.

Puccinia graminis f.sp. tritici (Pgt) causes stem rust disease in wheat that can result in severe yield losses. The factors driving the evolution of its virulence and adaptation remain poorly characterized. We utilize long-read sequencing to develop a haplotype-resolved genome assembly of a U.S. isolate of Pgt. Using Pgt haplotypes as a reference, we characterize the structural variants (SVs) and single nucleotide polymorphisms in a diverse panel of isolates. SVs impact the repertoire of predicted effectors, secreted proteins involved in host-pathogen interaction, and show evidence of purifying selection. By analyzing global and local genomic ancestry we demonstrate that the origin of 8 out of 12 Pgt clades is linked with either somatic hybridization or sexual recombination between the diverged donor populations. Our study shows that SVs and admixture events appear to play an important role in broadening Pgt virulence and the origin of highly virulent races, creating a resource for studying the evolution of Pgt virulence and preventing future epidemic outbreaks.

Pre-stroke Disability and Long-Term Functional Limitations in Stroke Survivors: Findings From More of 12 Years of Follow-Up Across Three International Surveys of Aging.

Background: Almost 50% of the post-stroke disabled population already have a premorbid disability before stroke. These patients may be offered a different care pathway in the acute and subacute phase than those without pre-morbid disability. Therefore, the aim of this study was to assess the association of the severity of premorbid disability with change of limitations in basic and instrumental activities of daily living (ADL/IADL) 1 year after stroke and over the following decade. Methods: Among 3,432 participants from HRS, SHARE and ELSA cohorts with a first stroke, ADL/IADL limitations were measured at 1-2 years prior to stroke, at 1 year post-stroke, and during the chronic phase. Modified Ranking Scale (P-mRS) was used to categorize the participants by level of premorbid disability (1-2 years pre-stroke). Change in ADL/IADL limitations by P-mRS level (0-1, 2-3, and 4-5) was assessed using a piecewise linear mixed model with a breakpoint set at 1 year post-stroke, stratified by median age groups. Results: Increase in ADL limitations at 1 year post-stroke was less pronounced in P-mRS ≥2 (p < 0.005). After years of relative stability, limitations of ADL increased for all P-mRS levels (p = 0.003). In those aged ≥75 years at stroke event, the increase was similar irrespective of P-mRS (p = 0.090). There were no significant differences in IADL trajectories between P-mRS levels (p ≥ 0.127). Conclusion: These results suggest similar trajectories of functional limitations between P-mRS levels up to 9 years post-stroke, highlighting the possible benefit of including patients with pre-morbid disability to certain treatments during the acute phase.

Psychiatric beds and prison populations in 17 Latin American countries between 1991 and 2017: rates, trends and an inverse relationship between the two indicators.

BACKGROUND: In 1990, Latin American countries committed to psychiatric reforms including psychiatric bed removals. Aim of the study was to quantify changes in psychiatric bed numbers and prison population rates after the initiation of psychiatric reforms in Latin America. METHODS: We searched primary sources to collect numbers of psychiatric beds and prison population rates across Latin America between the years 1991 and 2017. Changes of psychiatric bed numbers were compared against trends of incarceration rates and tested for associations using fixed-effects regression of panel data. Economic variables were used as covariates. Reliable data were obtained from 17 Latin American countries: Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, Ecuador, Honduras, Guatemala, Mexico, Nicaragua, Panama, Paraguay, Peru, El Salvador, Uruguay and Venezuela. RESULTS: The number of psychiatric beds decreased in 15 out of 17 Latin American countries (median -35%) since 1991. Our findings indicate the total removal of 69 415 psychiatric beds. The prison population increased in all countries (median +181%). Panel data regression analyses showed a significant inverse relationship -2.70 (95% CI -4.28 to -1.11; p = 0.002) indicating that prison populations increased more when and where more psychiatric beds were removed. This relationship held up when introducing per capita income and income inequality as covariates -2.37 (95% CI -3.95 to -0.8; p = 0.006). CONCLUSIONS: Important numbers of psychiatric beds have been removed in Latin America. Removals of psychiatric beds were related to increasing incarceration rates. Minimum numbers of psychiatric beds need to be defined and addressed in national policies.

Long-Term Evolution of Functional Limitations in Stroke Survivors Compared With Stroke-Free Controls: Findings From 15 Years of Follow-Up Across 3 International Surveys of Aging.

BACKGROUND AND PURPOSE: In the chronic phase 2 to 5 years poststroke, limitations in activities of daily living (ADL) and instrumental ADL (IADL) initially plateau before steady increasing. However, the impact of age and differences in initial levels of disability on the evolution of these limitations remains unclear. As such, this study aims to evaluate differences in long-term evolution of ADL/IADL limitations between stroke survivors and stroke-free population, and how limitations differ by initial level of disability for stroke survivors. METHODS: Thirty-three thousand six hundred sixty participants (5610 first-ever stroke cases with no recurrence during follow-up and 28 050 stroke-free controls) aged ≥50 from the Health and Retirement Study, Survey of Health, Ageing and Retirement in Europe, and English Longitudinal Study of Ageing were assessed for number of ADL/IADL limitations during the poststroke chronic phase (for cases) and over follow-up years 1996 to 2018 (for controls). Three thousand seven hundred eighteen stroke cases were additionally categorized by disability level using the modified Rankin Scale score of 1 to 2 years poststroke. Evolution of ADL/IADL limitations was assessed in stroke cases and controls and by modified Rankin Scale score (0-1, 2-3, 4-5) using linear mixed models. Models were stratified by age group (50-74 and ≥75 years) and adjusted for baseline characteristics, health behaviors, BMI, and comorbidities. RESULTS: Findings showed relative stability of ADL/IADL limitations during 3 to 6 years poststroke followed by an increase for both populations, which was faster for younger stroke cases, suggesting a differential age-effect (P<0.001). Disability level at 1 to 2 years poststroke influenced the evolution of limitations over time, especially for severe disability (modified Rankin Scale score, 4-5) associated with a reduction in limitations at 5 to 6 years poststroke. CONCLUSIONS: Our findings showed that during the poststroke chronic phase functional limitations first plateau and then increase and the evolution differs by disability severity. These results highlight the importance of adaptive long-term health and social care measures for stroke survivors.

Fantastic Downy Mildew Pathogens and How to Find Them: Advances in Detection and Diagnostics.

Downy mildews affect important crops and cause severe losses in production worldwide. Accurate identification and monitoring of these plant pathogens, especially at early stages of the disease, is fundamental in achieving effective disease control. The rapid development of molecular methods for diagnosis has provided more specific, fast, reliable, sensitive, and portable alternatives for plant pathogen detection and quantification than traditional approaches. In this review, we provide information on the use of molecular markers, serological techniques, and nucleic acid amplification technologies for downy mildew diagnosis, highlighting the benefits and disadvantages of the technologies and target selection. We emphasize the importance of incorporating information on pathogen variability in virulence and fungicide resistance for disease management and how the development and application of diagnostic assays based on standard and promising technologies, including high-throughput sequencing and genomics, are revolutionizing the development of species-specific assays suitable for in-field diagnosis. Our review provides an overview of molecular detection technologies and a practical guide for selecting the best approaches for diagnosis.

1324 prison suicides in 10 countries in South America: incidence, relative risks, and ecological factors.

PURPOSE: Although suicide rates of prison populations and incidence factors have been reported for high-income countries, data from low- and middle-income regions are lacking. The purpose of the study was to estimate suicide rates among prison populations in South America, to examine prison-related factors, and to compare suicide rates between prison and general populations. METHODS: In this observational study, we collected the numbers of suicides in prison, rates of prison occupancy, and incarceration rates from primary sources in South America between 2000 and 2017. We compared suicide rates among prisoners with incidence rates in the general populations by calculating incidence rate ratios. We assessed the effect of gender, year, incarceration rates and occupancy on suicide rates in the prison populations using regression analyses. RESULTS: There were 1324 suicides reported during 4,437,591 person years of imprisonment between 2000 and 2017 in 10 South American countries. The mean suicide rate was 40 (95% CI 16-65) per 100,000 person years for male and female genders combined. The pooled incidence rate ratio of suicide between prison and general populations was 3.9 (95% CI 3.1-5.1) for both genders combined, 2.4 (95% CI 1.9-3.1) for men and a higher ratio in women (13.5, 95% CI 6.9-26.9). High occupancies of prisons were associated with lower incidence of suicide (ß = - 58, 95% CI - 108.5 to - 7.1). CONCLUSIONS: Suicides during imprisonment in South America are an important public health problem. Suicide prevention strategies need to target prison populations.

Healthy behaviors at age 50 years and frailty at older ages in a 20-year follow-up of the UK Whitehall II cohort: A longitudinal study.

BACKGROUND: Frailty is associated with increased risk of various health conditions, disability, and death. Health behaviors are thought to be a potential target for frailty prevention, but the evidence from previous studies is based on older populations with short follow-ups, making results susceptible to reverse causation bias. We examined the associations of healthy behaviors at age 50, singly and in combination, as well as 10-year change in the number of healthy behaviors over midlife with future risk of frailty. METHODS AND FINDINGS: In this prospective cohort study of 6,357 (29.2% women; 91.7% white) participants from the British Whitehall II cohort, healthy behaviors-nonsmoking, moderate alcohol consumption, ≥2.5 hours per week of moderate to vigorous physical activity, and consumption of fruits or vegetables at least twice a day-were measured at age 50, and change in behaviors was measured between 1985 (mean age = 44.4) and 1997 (mean age = 54.8). Fried's frailty phenotype was assessed in clinical examinations in 2002, 2007, 2012, and 2015. Participants were classified as frail if they had ≥3 of the following criteria: slow walking speed, low grip strength, weight loss, exhaustion, and low physical activity. An illness-death model accounting for both competing risk of death and interval censoring was used to examine the association between healthy behaviors and risk of frailty. Over an average follow-up of 20.4 years (standard deviation, 5.9), 445 participants developed frailty. Each healthy behavior at age 50 was associated with lower risk of incident frailty: hazard ratio (HR) after adjustment for other health behaviors and baseline characteristics 0.56 (95% confidence interval [CI] 0.44-0.71; p < 0.001) in nonsmokers, 0.73 (95% CI 0.61-0.88; p < 0.001) for moderate alcohol consumption, 0.66 (95% CI 0.54-0.81; p < 0.001) for ≥2.5 hours of physical activity per week, and 0.76 (95% CI 0.59-0.98; p = 0.03) for consumption of fruits or vegetables at least twice a day. A greater number of healthy behaviors was associated with reduced risk of frailty, with the HR for each additional healthy behavior being 0.69 (95% CI 0.62-0.76; p < 0.001) and the HR for having all versus no healthy behaviors at age 50 being 0.28 (95% CI 0.15-0.52; p < 0.001). Among participants with no or 1 healthy behavior in 1985, those who increased the number of healthy behaviors by 1997 were at a lower risk of frailty (mean follow-up = 16 years) compared with those with no such increase: the HR was 0.64 (95% CI 0.44-0.94; p = 0.02) for change to 2 healthy behaviors and 0.57 (95% CI 0.38-0.87; p < 0.001) for change to 3-4 healthy behaviors in 1997. The primary limitation of this study is potential selection bias during the follow-up due to missing data on frailty components. CONCLUSIONS: Our findings suggest that healthy behaviors at age 50, as well as improvements in behaviors over midlife, are associated with a lower risk of frailty later in life. Their benefit accumulates so that risk of frailty decreases with greater number of healthy behaviors. These results suggest that healthy behaviors in midlife are a good target for frailty prevention.

Tubérculo marginal del hueso cigomático / Marginal tubercle of zygomatic bone

El hueso cigomático, ubicado en la parte superior y lateral de la cara, es un hueso par e irregular con forma cuadrilátera o romboidal. Se describen 2 caras, 4 aristas y 4 ángulos, forma cavidades, permite la inserción muscular y aponeurótica, es parte de la arquitectura facial, distribuye las fuerzas masticatorias y permite el paso del nervio cigomático. Su margen postero-superior presenta una prominencia ósea conocida como tubérculo marginal, en el que se observa la inserción de la fascia temporal. El objetivo de este trabajo fue describir las características particulares de esta prominencia. La muestra correspondió a 30 cráneos de adultos chilenos de ambos sexos. A través de una serie de puntos óseos, se describió la presencia, ubicación, tamaño, forma, cortical y trabeculado del tejido óseo del tubérculo marginal. Para realizar las mediciones se utilizaron cámara digital, compas de precisión y cáliper digital. El análisis radiográfico requirió tomografía computarizada de alta resolución. Los resultados mostraron que el tubérculo marginal del hueso cigomático es una prominencia constante, ubicada en el tercio medio del proceso frontal del hueso y que la mayoría de los individuos mostraron una forma semilunar. Su altura fluctúa entre 3 y 4 mm, siendo más pronunciada en hombres que en mujeres. El grosor de la corteza ósea es directamente proporcional a la prominencia del tubérculo, mientras que el trabeculado esponjoso está inversamente relacionado con este último. El análisis de estos resultados parece indicar que las fuerzas biomecánicas ejercidas por la musculatura masticatoria y transmitidas por la fascia temporal, determinan la morfología externa e interna de esta prominencia y del propio hueso cigomático. Concluimos, declarando la necesidad de revisar el conocimiento anatómico a la luz de las nuevas técnicas de imagen e integración disciplinar.

The zygomatic bone, located in the upper and lateral area of the face, is an even and irregular quadrilateral or rhomboid shaped bone. It presents 2 faces, 4 margins and 4 angles. It forms cavities, allows muscular and aponeurotic insertion, is part of the facial architecture, distributes masticatory forces and allows the passage of the zygomatic nerve. Its postero-superior margin presents a bony prominence known as a marginal tubercle, in which the insertion of the temporal fascia is observed. The objective of this work was to describe the particular characteristics of this prominence. The sample corresponded to 30 skulls of Chilean adults of both sexes. Through a series of bone points, the presence, location, size, shape, cortical and trabeculate of the bone tissue of the marginal tubercle was described. A digital camera, precision compass and digital caliper were used to perform the measurements. The radiographic analysis required high-resolution computed tomography. The results showed that the marginal tubercle of the zygomatic bone is a constant prominence, located in the middle third of the frontal process of the bone and that most individuals showed a semilunar shape. Its height fluctuated between 3 and 4 mm, being more pronounced in men than in women. The thickness of the bone cortex was directly proportional to the prominence of the tuber, while the spongy trabeculate was inversely related to the latter. The analysis of these results seems to indicate that the biomechanical forces exerted by the masticatory musculature and transmitted by the temporal fascia, determine the external and internal morphology of this prominence, and of the zygomatic bone itself. In conclusion, it is recommended to review anatomical knowledge in the light of new imaging techniques and disciplinary integration.

Bibliografía anatómica utilizada en la formación de médicos en Chile entre 1758 y 1840 / Anatomical bibliography used in the training of physicians in Chile between 1758 and 1840

El estudio de la enseñanza de la medicina, desde una perspectiva histórica, es importante para explicar el desarrollo de esta profesión. Considerando el valor de los libros en el currículo universitario su estudio permite comprender la influencia sociopolítica del momento histórico. El objetivo de este trabajo fue determinar y analizar la primera bibliografía utilizada en la formación de médicos en Chile entre 1758 y 1840 (desde la fundación de la Universidad de San Felipe a la muerte del Dr. Pedro Morán). A través de una investigación histórica se logró encontrar los ocho libros de textos utilizados durante este periodo. De ellos, se realizó un análisis descriptivo que abarcó la identificación del autor, el título de la obra, el año, idioma y lugar de publicación. Además, se clasificaron según extensión y enfoque. También se realizó un análisis cuantitativo para determinar la cantidad de información que presentan estos libros en comparación con la literatura moderna. Los resultados se ordenaron en tablas y gráficos para su posterior análisis. Los textos encontrados fueron principalmente editados en España y en idioma español (62,5 %), aunque una parte importante fueron editados en Francia y en francés (37,5 %). Mayoritariamente se utilizó bibliografía de autores franceses (50 %), aunque también se incluyeron libros de autores españoles (37,5 %) y alemanes (12,5 %). Con respecto a la extensión de los textos, tanto los libros de mediana y gran extensión estuvieron representados de igual forma (37,5 %) y los compendios representaron un porcentaje menor (12,5 %). Este trabajo es un aporte a la comprensión del origen de la formación de médicos en Chile y ayuda a comprender el nacimiento de la identidad profesional, que ha sido de gran influencia en la historia político - social de Chile, describiendo la bibliografía que marco el nacimiento de la Historia de la Anatomía en nuestro país.

The study of the teaching of medicine, from a historical perspective, is important to explain the development of this profession. Considering the value of books in the university curriculum, its study allows us to understand the socio-political influence of the historical moment. The objective of this work was to determine and analyze the first bibliography used in the training of doctors in Chile between 1758 and 1840 (from the foundation of the University of San Felipe to the death of Dr. Pedro Morán).Through a historical investigation it was possible to find the eight textbooks used during this period. Of these, a descriptive analysis was carried out that included the identification of the author, the title of the work, the year, language and place of publication. In addition, they were classified according to extension and focus. A quantitative analysis was also carried out to determine the amount of information presented in these books compared to modern literature. The results were arranged in tables and graphs for later analysis. The texts found were mainly published in Spain and in Spanish (62.5 %), although an important part was published in France and in French (37.5 %). The bibliography of French authors was used mainly (50 %), although books by Spanish authors (37.5 %) and Germans (12.5 %) were also included. With respect to the extension of the texts, both the medium and large extension books were represented in the same way (37.5 %) and the compendiums represented a smaller percentage (12.5 %). This work is a contribution to the understanding of the origin of the training of doctors in Chile and helps to understand the birth of professional identity, which has been of great influence in the political - social history of Chile, describing the bibliography that marked the birth of the History of Anatomy in our country.

Contribución al Estudio Descriptivo del Foramen y Canal Palatino Mayor / Contribution to the Descriptive Study of the Foramen and Greater Palatine Canal

RESUMEN: El foramen y canal palatino mayor (FPM y CPM) comunican boca con fosa pterigopalatina. El conocimiento adecuado de su morfología, permite el abordaje anestésico del nervio maxilar. En el vivo, el FPM está recubierto por una mucosa gruesa, debido a esto los puntos de referencia óseos y dentarios son importantes para ubicar el sitio de punción. Se ha descrito gran variabilidad en cuanto a la etnia, posición, forma, diámetros, longitudes y permeabilidad. Este estudio tuvo como objetivo describir éstas características en cráneos de adultos chilenos. Se utilizaron 31 cráneos de ambos sexos. En los paladares se determinó; forma, largo, profundidad y ancho. En los FPM se consideró su forma, diámetros y localización. En los CPM se registró su permeabilidad y su coincidencia con la forma del FPM. Los registros se realizaron con cámara digital, compás de precisión, caliper digital, compas tridimensional de Korkhaus y sonda metálica. Los resultados muestran un predominio de la forma cuadrada del paladar por sobre las formas triangular y redondeada. Las mediciones de su largo, ancho y profundidad indican diferencias por sexo y por etnia. La forma del FPM no muestra diferencia por sexo, primando la forma ovalada por sobre la fusiforme y la redondeada. La posición de este mismo foramen tampoco muestra diferencias sexuales, primando la posición frente al tercer molar superior, seguida por la posición frente al espacio entre segundo y tercer molar superior y por último frente al 2do molar superior. Las dimensiones del FPM son mayores en individuos masculinos. Los CPM se observaron en su totalidad permeables y los FPM no siempre coincidieron en forma con la sección transversal del CPM. Estos resultados y su comparación con la literatura indican variaciones importantes, lo que impide establecer directrices objetivas a la técnica anestésica que utiliza esta vía anatómica.

ABSTRACT: The greater palatine foramen and canal (GPF and GPC) communicate with the pterygopalatine fossa. The adequate knowledge of its morphology allows the anesthetic approach of the maxillary nerve. In vivo, the GPF is covered by a thick mucosa, therefore, the bone and dental reference points are important to locate the puncture site. Great variability has been described in terms of ethnicity, position, shape, diameters, lengths and permeability. The objective of this study was to describe these characteristics in skulls of Chilean adults. 31 skulls of both sexes were used. In the palates shape, length, depth and width were determined. In the GPF its shape, diameters and location were considered. In the GPC, their permeability and their coincidence with the shape of the GPF were recorded. The records were made with digital camera, precision compass, digital caliper, Korkhaus three-dimensional compass and metallic probe. The results show a predominance of the square shape of the palate over the triangular and rounded forms. The measurements of its length, width and depth indicate differences by sex and ethnicity. The shape of the GPF shows no difference by sex, with the oval shape prevailing over the fusiform and the rounded. The position of this same foramen also shows no sexual differences, with the position prevailing against the upper third molar, followed by the position in front of the space between the upper second and third molars and finally against the upper 2-molar. The dimensions of GPF are greater in male individuals. The GPC were found to be entirely permeable and the GPF did not always coincide in form with the cross section of the GPC. These results and their comparison with the literature indicate important variations, which prevents establishing objective guidelines for the anesthetic technique used in these cases.

Relación entre el patrón dactiloscópico epidérmico y dérmico / Relationship between the epidermal and the dermal dactyloscopic pattern

El método más utilizado en identificación humana es el dactiloscópico, que registra, analiza y coteja los tipos fundamentales y puntos característicos de las figuras presentes en el dactilograma, determinando el grado de coincidencia, entre un patrón de identidad dubitada y uno de identidad indubitada. Debido a los procesos que afectan la piel de cadáveres, como la putrefacción entre otros, se utilizan las técnicas necropapiloscópicas que ocupan los patrones dérmicos para la identificación humana. El objetivo del presente trabajo es comparar registros epidérmicos con dérmicos, y validar científicamente, este método de identificación (epidérmico - dérmico). Para ello se utilizaron 32 dedos de cadáveres de individuos chilenos, de ambos sexos y de entre 40 y 80 años. Para obtener el registro físico artificial epidérmico y dérmico se utilizó la técnica de obtención de impresiones necrodactilares y se comparó a través de la técnica de cotejo dactiloscópico. Estos procedimientos fueron realizados por peritos criminalísticos de Carabineros de Chile. Se logró evidenciar diferencias importantes entre epidermis y dermis en cuanto a cantidad y calidad de puntos característicos y presencia de líneas seniles. En relación a tipos fundamentales, se evidenció que en dermis es difícil la observación de tipos fundamentales (borrosos) pero no se encontró ningún dígito que presentara tipo fundamental diferente entre epidermis y dermis. También se constataron diferencias por sexo y edad. Finalmente se pudo evidenciar, que existe una relación morfológica semejante entre registros físicos artificiales de patrones papiloscópicos epidérmicos con dérmicos provenientes del mismo individuo. Esto permite utilizar los registros dérmicos para la identificación humana positiva. Los resultados de este trabajo son importantes al aportar evidencia científica para la identificación humana en base al patrón dactiloscópico dérmico.

The most used method in human identification is the dactyloscopy, which registers, analyzes and collates the fundamental types and characteristic points of figures present in the dactylogram determining the degree of coincidence, between a pattern of identity that is dubious, and one that is indubious. Due to the processes that affect the skin of corpses, such as putrefaction, the necropapiloscopy techniques that occupy the dermal patterns for human identification are used. The objective of the present work is to compare epidermal with dermal records and validate scientifically, this method of identification (epidermal - dermal). For this purpose, 32 cadaveric fingers of Chilean individuals, of both sexes and between 40 and 80 years were used. In order to obtain the epidermal and dermal artificial physical record, the technique of obtaining necrodactyle impressions was used and compared through of the technique of dactyloscopic comparison. These procedures were carried out by criminalistic experts of Carabineros de Chile. It was possible to show important differences between epidermis and dermis in terms of quantity and quality of characteristic points and presence of senile lines. In relation to fundamental types, it was evidenced that in the dermis it is difficult to observe fundamental types (blurred) but no digit was found that presented a different of fundamental type between epidermis and dermis. There were also differences by sex and age. Finally, it was possible to demonstrate that there is a similar morphological relationship between artificial physical records of epidermal papiloscopic patterns with dermal patterns from the same individual. This allows the use of dermal records for positive human identification. The results of this work are important in providing scientific evidence for human identification based on the dermal fingerprint pattern.

Foramen venoso órbito cavernoso: foramen de Warwick / Cavernous orbital venous foramen: Warwick´s foramen

El foramen de Warwick o foramen venoso órbito cavernoso, es un foramen inconstante del ala mayor del esfenoides, situado entre la fisura orbitaria superior y el foramen rotundo. Comunica la órbita con la fosa craneal media y/o con la fosa pterigopalatina y permitiría el paso de la vena oftálmica inferior. La presencia del foramen venoso órbito cavernoso varía entre el 0,38 % y el 0,74 %. Se describe con forma redondeada o crescéntica (semilunar), unilateral o bilateral. El objetivo de este trabajo fue evidenciar la presencia y las características de foramen venoso órbito cavernoso en cráneos secos de individuos adultos chilenos de ambos sexos. Se analizaron 138 cráneos de individuos adultos y de ambos sexos, en búsqueda del foramen venoso órbito cavernoso para determinar la frecuencia, localización, forma, tamaño, orientación y distancias con respecto a la fisura orbitaria superior y el foramen rotundo. Los forámenes encontrados fueron fotografiados, explorados y medidos. La presencia del foramen venoso órbito cavernoso fue del 2,17 % de la muestra, encontrándose en forma unilateral (1,45 %) y bilateral (0,17 %). Con forma redondeada en 3 casos y semilunar en 1 caso. Con orientación hacia la órbita (2 casos) y hacia la fosa pterigopalatina (2 casos). También se evidenció que cuando está presente el foramen venoso órbito cavernoso, la separación entre la fisura orbitaria superior y el foramen rotundo es mayor que en su ausencia. Nuestro estudio demuestra la presencia del foramen venoso órbito cavernoso en la población chilena, con una frecuencia más alta que la observada en otras poblaciones. La localización, orientación y formas coinciden con la literatura, pero difiere en el tamaño (en forámenes redondeados). También pudimos determinar que la fisura orbitaria superior y el foramen rotundo tienden a encontrarse más cercanos en ausencia del foramen venoso órbito cavernoso y por lo tanto más distante cuando esta estructura está presente. Este hecho no está descrito en la literatura. Los resultados de este estudio son importantes para la anatomía, oftalmología, traumatología, imagenología, cirugía e identificación humana. Finalmente y en virtud de la TAI, proponemos llamar a este foramen, foramen venoso órbito cavernoso.

The Warwick's foramen or cavernous orbital venous foramen, is an inconstant foramen from the greater wing of the sphenoid bone, located between the superior orbital fissure and the rotundum foramen. It connects the orbit with the middle cranial fossa and/or with the pterygopalatine fossa and allows for the passage of the inferior ophthalmic vein. The presence of the cavernous orbital venous foramen varies between 0.38 % and 0.74 % in human skulls. It is described as having a rounded or crescentic (semilunar), unilateral or bilateral shape. The objective of the present work was to demonstrate the presence and characteristics of the cavernous orbital venous foramen in dry skulls of Chilean adult individuals of both sexes. One hundred and thirty-eight adult skulls of both sexes were analyzed in search of the cavernous orbital venous foramen to determine the frequency, location, shape, size, orientation and distances with respect to the superior orbital fissure and the rotund foramen. Found foramina were photographed, explored and measured. The cavernous orbital venous foramen was present in 2.17 % of the sample, and was both unilateral (1.45 %) and bilateral (0.17 %). It had a rounded and lunate shape in 3 and 1 cases, respectively. Moreover, it was orientated towards the orbit (2 cases) and towards the pterygopalatine fossa (2 cases). It was also evidenced that when the cavernous orbital venous foramen is present, the separation between the superior orbital fissure and the rotund foramen is greater than in its absence. Our study demonstrates the presence of the cavernous orbital venous foramen in the Chilean population, with a higher frequency than described previously. The location, orientation and observed forms agree with the literature, but differ in size (in rounded shape foramen). We could also determine that the superior orbital fissure and the rotundum foramen tend to be closer in the absence of the cavernous orbital venous foramen and, therefore, are more distant when this structure is present. This fact is not described in the literature. The results of this study are important for anatomy, ophthalmology, traumatology, imaging, surgery and human identification. Finally, and by virtue of the International Anatomical Terminology (IAT), we propose to call this structure the cavernous orbital venous foramen.

Variation in the AvrSr35 gene determines Sr35 resistance against wheat stem rust race Ug99.

Puccinia graminis f. sp. tritici (Pgt) causes wheat stem rust, a devastating fungal disease. The Sr35 resistance gene confers immunity against this pathogen's most virulent races, including Ug99. We used comparative whole-genome sequencing of chemically mutagenized and natural Pgt isolates to identify a fungal gene named AvrSr35 that is required for Sr35 avirulence. The AvrSr35 gene encodes a secreted protein capable of interacting with Sr35 and triggering the immune response. We show that the origin of Pgt isolates virulent on Sr35 is associated with the nonfunctionalization of the AvrSr35 gene by the insertion of a mobile element. The discovery of AvrSr35 provides a new tool for Pgt surveillance, identification of host susceptibility targets, and characterization of the molecular determinants of immunity in wheat.

Foramen meningo orbitario / Meningo orbital foramen

El foramen meningo orbitario (FMO), ubicado en el ala mayor del esfenoides y cercano al extremo lateral de la fisura orbitaria superior (FOS), comunica órbita con fosa craneal media, permitiendo el paso de una anastomosis entre las arterias oftálmica y meníngea media. Su prevalencia varía del 6 al 82,9 % y puede presentarse en forma unilateral o bilateral, único o múltiple y de forma circular, ovoidal o de ranura. Nuestro objetivo fue evidenciar la presencia del FMO, describiendo sus características morfológicas, en cráneos secos de individuos adultos chilenos de ambos sexos. Se utilizaron 54 cráneos con ambas órbitas. Se consideró; presencia, unilateralidad o bilateralidad, cantidad de forámenes por órbita, forma, ubicación en relación al plano horizontal determinado por el extremo lateral de la FOS, distancia al extremo lateral de la FOS, diámetro y diferencias sexuales. Las mediciones se realizaron con sonda de nylon, compás de puntas secas y cáliper digital. Un 46,29 % de la muestra presentó FMO, con mayor presencia en individuos femeninos. En un 28 % se presentó unilateral y en un 72 % bilateral. Predominó la forma circular (79,07 %) sobre la ovoidal (18 %) y sobre la forma de ranura (2,33 %). El FMO se observó en un 90,69 % sobre el plano horizontal que determina el extremo lateral de la FOS y en un 9,31 % en el mismo plano. La distancia del FMO al extremo lateral de la FOS fue de 6,58 mm y el diámetro del FMO correspondió a 1,22 mm. Nuestros resultados coinciden con la literatura, respecto a su presencia, a la comunicación que permite, a su ubicación, a su forma y tamaño. Se pudo constatar semejanzas y algunas diferencias menores con cráneos indios, asiáticos y pakistaníes. También pudimos evidenciar diferencias por sexo. El conocimiento acabado del FMO tiene importancia en anatomía, antropología, oftalmología, traumatología, imagenología, cirugía e identificación humana.

The meningo orbital foramen (MOF) is located in the major wing of the sphenoid and near the lateral end of the superior orbital fissure (SOF), communicating orbit with the middle cranial fossa and allowing the passage of an anastomosis between the ophthalmic and middle meningeal arteries. Its prevalence varies from 6 to 82.9 % and may occur unilaterally or bilaterally, single or multiple, and may have a circular, ovoid or groove form. The aim of this study is to evidence the existence of MOF, describing its morphological characteristics in dry skulls of Chilean adults of both sexes. The present study analyzed 54 skulls containing both orbits, considering the following criteria: Existence, unilaterality or bilaterality, number of foramens by orbit, shape, location in relation to the horizontalbaselinedetermined by the lateral end of the SOF, distance to the lateral end of the SOF and diameter and variations by sex. Measurements were made with nylonprobe,compass dry point and digital caliper. Of the sample, 46.29 % presented MOF with a greater prevalence in female samples. In 28 % of the cases it was unilateral and in the other 72 % bilateral. The circular shape was predominant in 79.07 %, followed by the ovoidal 18 % and thegrooveform 2.33 %. The MOF was observed in 90.69 % on the horizontalbaselinethat determines the lateral end of the SOF and in 9.31 % in the samebaseline. The average distance from the MOF to the lateral end of the SOF was 6.58 mm and the diameter of the MOF corresponded to 1.22 mm. Our results are consistentwith similar studies. There were some minor differences observed in Indian, Asian andPakistani skulls as well as some anatomical differences by sex. A better understanding of MOF plays an important role in anatomy, anthropology, ophthalmology, traumatology, medical imaging, surgery and human identification.

Divergent and convergent modes of interaction between wheat and Puccinia graminis f. sp. tritici isolates revealed by the comparative gene co-expression network and genome analyses.

BACKGROUND: Two opposing evolutionary constraints exert pressure on plant pathogens: one to diversify virulence factors in order to evade plant defenses, and the other to retain virulence factors critical for maintaining a compatible interaction with the plant host. To better understand how the diversified arsenals of fungal genes promote interaction with the same compatible wheat line, we performed a comparative genomic analysis of two North American isolates of Puccinia graminis f. sp. tritici (Pgt). RESULTS: The patterns of inter-isolate divergence in the secreted candidate effector genes were compared with the levels of conservation and divergence of plant-pathogen gene co-expression networks (GCN) developed for each isolate. Comprative genomic analyses revealed substantial level of interisolate divergence in effector gene complement and sequence divergence. Gene Ontology (GO) analyses of the conserved and unique parts of the isolate-specific GCNs identified a number of conserved host pathways targeted by both isolates. Interestingly, the degree of inter-isolate sub-network conservation varied widely for the different host pathways and was positively associated with the proportion of conserved effector candidates associated with each sub-network. While different Pgt isolates tended to exploit similar wheat pathways for infection, the mode of plant-pathogen interaction varied for different pathways with some pathways being associated with the conserved set of effectors and others being linked with the diverged or isolate-specific effectors. CONCLUSIONS: Our data suggest that at the intra-species level pathogen populations likely maintain divergent sets of effectors capable of targeting the same plant host pathways. This functional redundancy may play an important role in the dynamic of the "arms-race" between host and pathogen serving as the basis for diverse virulence strategies and creating conditions where mutations in certain effector groups will not have a major effect on the pathogen's ability to infect the host.