Chile's public healthcare sector hypertension control rates before and during the pandemic and HEARTS implementation.

Hypertension (arterial blood pressure ≥ 140/90 mmHg) is a risk factor for cardiovascular diseases, with the greatest burden of attributable deaths in Chile, having a national prevalence of 27.6%. In 2018, the implementation of HEARTS begun in primary health care centers of the Public Health System, with the aim of achieving increase in control rates, by raising the proportion of hypertensive individuals who meet blood pressure goals (< 140/90 mmHg for individuals 15-79 years old and of 150/90 mmHg for individuals 80 years and older), and thus contributing to reduce cardiovascular morbidity and mortality associated with this condition. This is a descriptive study that follows average treatment and control rates from the Public Health System between 2017-2021 obtained from health centers statistics reports during HEARTS implementation. Treatment and control rates remained at 57% and 39% respectively between 2017-2019. Between 2020 and 2021, in the context of the SARS-CoV-2 pandemic, treatment and control rates decreased very significantly, reaching 46% and 26%, respectively, in December 2021, even though the number of centers reporting the implementation of HEARTS increased from 227 to 387 in this same period. Prior to the pandemic, during the last quarter of 2019, a decrease in cardiovascular health controls was already observed as a result of social protests. In light of the results, the technical pillars of the HEARTS Initiative have an important role in helping to recover the population control rates reached in 2019 and increasing the speed to achieve better hypertension control rates.

La hipertensión arterial (presión arterial ≥ 140/90 mmHg) es un factor de riesgo para las enfermedades cardiovasculares, que tienen la mayor carga de muertes atribuibles en Chile. En este país, la hipertensión tiene una prevalencia nacional del 27,6%. En el 2018 se inició la aplicación del paquete técnico HEARTS en los centros de atención primaria de salud del sistema público de salud de Chile, con el objetivo de lograr un aumento de las tasas de control, al elevar la proporción de personas hipertensas que cumplen con las metas de presión arterial (< 140/90 mmHg para personas de 15 a 79 años y de 150/90 mmHg para personas de 80 años o más) y así contribuir a reducir la morbilidad y la mortalidad cardiovascular asociadas a esta enfermedad. En este estudio descriptivo se realiza un seguimiento de las tasas promedio de tratamiento y control del sistema público de salud entre el 2017 y el 2021 obtenidas de los informes estadísticos de los centros de salud durante la aplicación de la iniciativa HEARTS. Las tasas de tratamiento y control se mantuvieron en 57% y 39%, respectivamente, en el período entre el 2017 y el 2019. Entre el 2020 y el 2021, en el contexto de la pandemia de SARS-CoV-2, las tasas de tratamiento y control disminuyeron de manera muy significativa, y se ubicaron en 46% y 26%, respectivamente, en diciembre del 2021, a pesar de que el número de centros que notificaron la aplicación de HEARTS aumentó de 227 a 387 en el mismo período. Antes de la pandemia, en el último trimestre del 2019, ya se había observado una disminución en los controles de salud cardiovascular debido a las protestas sociales. En vista de estos resultados, los pilares técnicos de la iniciativa HEARTS desempeñan un papel importante para ayudar a recuperar las tasas de control que se habían alcanzado en el 2019 y acelerar la consecución de mejores tasas de control de la hipertensión.

A hipertensão (pressão arterial ≥ 140/90 mmHg) é um fator de risco para doenças cardiovasculares, com a maior carga de mortes atribuíveis no Chile, onde a prevalência nacional é de 27,6%. Em 2018, teve início a implementação da iniciativa HEARTS em centros de atenção primária à saúde do sistema de saúde pública, com o objetivo de elevar as taxas de controle, pelo aumento da proporção de indivíduos hipertensos que alcançam as metas de pressão arterial (< 140/90 mmHg para pessoas de 15-79 anos e de 150/90 mmHg para pessoas a partir de 80 anos), e, assim, contribuir para a redução da morbimortalidade cardiovascular associada a essa condição. Este é um estudo descritivo que acompanha as taxas médias de tratamento e controle no sistema de saúde pública entre 2017 e 2021, obtidas de relatórios estatísticos dos centros de saúde durante a implementação da iniciativa HEARTS. Entre 2017 e 2019, as taxas de tratamento e de controle foram, respectivamente, de 57% e 39%. Entre 2020 e 2021, no contexto da pandemia causada pelo SARS-CoV-2, houve uma diminuição muito significativa das taxas de tratamento e de controle, que chegaram, respectivamente, a 46% e 26% em dezembro de 2021, embora o número de centros que informaram ter implementado o pacote HEARTS tenha aumentado de 227 para 387 no mesmo período. Antes da pandemia, durante o último trimestre de 2019, já se observava uma diminuição dos controles da saúde cardiovascular em consequência de uma onda de protestos sociais. Os resultados mostram que os pilares técnicos da iniciativa HEARTS são importantes para ajudar a recuperar as taxas de controle na população alcançadas em 2019 e aumentar a velocidade para atingir melhores taxas de controle da hipertensão.

[Profile of Blood pressure measurement devices purchased in Chile 2018-2020Perfil de compra de dispositivos para aferição da pressão arterial, Chile, 2018-2020.] / Perfil de compra de dispositivos de medición de presión arterial, Chile 2018-2020.

Objective: To describe the types of blood pressure measurement devices marketed through the Mercado Público platform between 2018 and 2020. Methods: This is a descriptive study based on transactions on the Mercado Público platform for the purchase of blood pressure measurement devices in the 2018-2020 period. A search was made for any validation granted by international organizations for automatic devices. The results are expressed as absolute and relative frequencies. Results: Between 2018 and 2020, purchases of automatic devices increased from 15% to 75%, while purchases of mercury-based devices dropped from 40.9% to 7.5%, and aneroid devices fell from 38.7% to 15.8%. Of the 772 automatic devices, 52.6% were validated for accuracy. Conclusions: Given that Chile is committed to the HEARTS Initiative in the Americas, and that prevention and control of hypertension is critical to reducing mortality from noncommunicable diseases, it is crucial to ensure accurate blood pressure measurement. This document provides relevant information on transactions and the purchase profile of blood pressure measurement devices on the Mercado Público platform. A growing trend was observed in the purchase of validated automatic equipment during the evaluation period.

Objetivo: Descrever os tipos de dispositivos de aferição da pressão arterial comercializados por meio da plataforma Mercado Público, entre 2018 e 2020. Métodos: Estudo descritivo das transações realizadas por meio do Mercado Público, no período de 2018 a 2020, para a compra de dispositivos de aferição da pressão arterial. No caso de dispositivos automáticos, foi verificado se possuíam validação concedida por organizações internacionais. Os resultados são apresentados na forma de frequências absolutas e relativas. Resultados: Entre 2018 e 2020, a aquisição de dispositivos automáticos aumentou de 15% para 75%. Houve uma redução de 40,9% para 7,5% na compra de esfigmomanômetros de mercúrio e de 38,7% para 15,8% na compra de esfigmomanômetros aneroides. Dos 772 dispositivos automáticos, 52,6% tinham exatidão validada. Conclusões: Considerando que o Chile está comprometido com a Iniciativa HEARTS nas Américas e que a prevenção e o controle da hipertensão arterial sistêmica é fundamental para reduzir a mortalidade por doenças não transmissíveis, é essencial garantir a aferição exata da pressão arterial. Este documento fornece informações relevantes sobre as transações realizadas e o perfil de compra de dispositivos de aferição da pressão arterial por meio da plataforma Mercado Público, mostrando uma tendência crescente na aquisição de dispositivos automáticos validados durante o período de avaliação.

Extended Reality (XR) for Condition Assessment of Civil Engineering Structures: A Literature Review.

Condition assessment of civil engineering structures has been an active research area due to growing concerns over the safety of aged as well as new civil structures. Utilization of emerging immersive visualization technologies such as Virtual Reality (VR), Augmented Reality (AR), and Mixed Reality (MR) in the architectural, engineering, and construction (AEC) industry has demonstrated that these visualization tools can be paradigm-shifting. Extended Reality (XR), an umbrella term for VR, AR, and MR technologies, has found many diverse use cases in the AEC industry. Despite this exciting trend, there is no review study on the usage of XR technologies for the condition assessment of civil structures. Thus, the present paper aims to fill this gap by presenting a literature review encompassing the utilization of XR technologies for the condition assessment of civil structures. This study aims to provide essential information and guidelines for practitioners and researchers on using XR technologies to maintain the integrity and safety of civil structures.

[The cardiovascular impact of cancer control therapy]. / Impacto cardiovascular secundario a la terapia para el control del cáncer.

Cardiovascular diseases and cancer account for 27 and 25% of mortality in Chile, respectively. In the last decades, survival of people with cancer has improved due to preventive programs, early detection strategies, advances in technology and development of new antineoplastic therapies. Consequently, a progressive number of cancer-surviving patients have been generated, who may develop cardiovascular diseases, secondary to the same cancer therapy. Cardio-Oncology has emerged as the necessary link between both specialties to promote the prevention and early detection of cardiac complications, in patients undergoing oncological therapies. The aim is to curb cardiovascular complications. Also, to acquire knowledge about the mechanisms and effects of drugs that lead to heart damage aiming to develop efficient cardioprotective therapies. In this article we review and propose a didactic organization and classification of the main cardiovascular effects of cancer control therapy. We recognize that there is still a knowledge gap in basic sciences about the mechanisms that underlie these alterations.

[Obesity: risk factor or primary disease?] / Obesidad: ¿Factor de riesgo o enfermedad?

Obesity is a global health problem. Its worldwide prevalence has tripled between 1975 and 2016, reaching a prevalence in Chile of 34.4%, according to the National Health Survey 2016-2017. If this condition corresponds to a risk factor or primary disease is a widely discussed issue. It is recognized as a disease by the American Medical Association and World Health Organization, based on its metabolic and hormonal features, such as dysregulation of appetite, abnormal energy balance and endocrine dysfunction, among others. Its main environmental risk factors are the consumption of ultra-processed foods and sedentariness. Preventive measures at the population level are fundamental, emphasizing promotion and prevention using a transdisciplinary approach. The individual approach in the management of obesity should improve the quality of life, avoid early mortality, reduce cardiovascular risk, and reduce the progression to type 2 diabetes and incidence of cancer. Thus, an adequate management and control of obesity would have a great impact in our society.

In vivo production of fluorine-18 in a chicken egg tumor model of breast cancer for proton therapy range verification.

Range verification of clinical protontherapy systems via positron-emission tomography (PET) is not a mature technology, suffering from two major issues: insufficient signal from low-energy protons in the Bragg peak area and biological washout of PET emitters. The use of contrast agents including 18O, 68Zn or 63Cu, isotopes with a high cross section for low-energy protons in nuclear reactions producing PET emitters, has been proposed to enhance the PET signal in the last millimeters of the proton path. However, it remains a challenge to achieve sufficient concentrations of these isotopes in the target volume. Here we investigate the possibilities of 18O-enriched water (18-W), a potential contrast agent that could be incorporated in large proportions in live tissues by replacing regular water. We hypothesize that 18-W could also mitigate the problem of biological washout, as PET (18F) isotopes created inside live cells would remain trapped in the form of fluoride anions (F-), allowing its signal to be detected even hours after irradiation. To test our hypothesis, we designed an experiment with two main goals: first, prove that 18-W can incorporate enough 18O into a living organism to produce a detectable signal from 18F after proton irradiation, and second, determine the amount of activity that remains trapped inside the cells. The experiment was performed on a chicken embryo chorioallantoic membrane tumor model of head and neck cancer. Seven eggs with visible tumors were infused with 18-W and irradiated with 8-MeV protons (range in water: 0.74 mm), equivalent to clinical protons at the end of particle range. The activity produced after irradiation was detected and quantified in a small-animal PET-CT scanner, and further studied by placing ex-vivo tumours in a gamma radiation detector. In the acquired images, specific activity of 18F (originating from 18-W) could be detected in the tumour area of the alive chicken embryo up to 9 h after irradiation, which confirms that low-energy protons can indeed produce a detectable PET signal if a suitable contrast agent is employed. Moreover, dynamic PET studies in two of the eggs evidenced a minimal effect of biological washout, with 68% retained specific 18F activity at 8 h after irradiation. Furthermore, ex-vivo analysis of 4 irradiated tumours showed that up to 3% of oxygen atoms in the targets were replaced by 18O from infused 18-W, and evidenced an entrapment of 59% for specific activity of 18F after washing, supporting our hypothesis that F- ions remain trapped within the cells. An infusion of 18-W can incorporate 18O in animal tissues by replacing regular water inside cells, producing a PET signal when irradiated with low-energy protons that could be used for range verification in protontherapy. 18F produced inside cells remains entrapped and suffers from minimal biological washout, allowing for a sharper localization with longer PET acquisitions. Further studies must evaluate the feasibility of this technique in dosimetric conditions closer to clinical practice, in order to define potential protocols for its use in patients.

Radiochromic film dosimetry for protons up to 10 MeV with EBT2, EBT3 and unlaminated EBT3 films.

Passive dosimetry with radiochromic films is widely used in proton radiotherapy, both in clinical and scientific environments, thanks to its simplicity, high spatial resolution and dose-rate independence. However, film under-response for low-energy protons, the so-called linear-energy transfer (LET) quenching, must be accounted and corrected for. We perform a meta-analysis on existing film under-response data with EBT, EBT2 and EBT3 GAFchromic™ films and provide a common framework to integrate it, based on the calculation of dose-averaged LET in the active layer of the films. We also report on direct measurements with the 10 MeV proton beam at the Center for Microanalysis of Materials (CMAM) for EBT2, EBT3 and unlaminated EBT3 films, focusing on the 20-80 keVµm-1LET range, where previous data was scarce. Measured film relative efficiency (RE) values are in agreement with previously reported data from the literature. A model on film RE constructed with combined literature and own experimental values in the 5-80 keVµm-1LET range is presented, supporting the hypothesis of a linear decrease of RE with LET, with no remarkable differences between the three types of films analyzed.

Weak and fragmented regulatory frameworks on the accuracy of blood pressure-measuring devices pose a major impediment for the implementation of HEARTS in the Americas.

Global HEARTS is a WHO initiative for cardiovascular disease prevention and control. Accurate blood pressure (BP) measurement is an essential component of the initiative. This study aimed to determine the regulatory frameworks governing the accuracy of BPMDs in countries of the Americas participating in the HEARTS initiative. Quantitative and qualitative analysis of the laws and regulations relevant to ensuring the accuracy of BPMDs were determined from the Ministries of Health/Regulatory Agencies among 13 countries in Latin America and the Caribbean. Analysis included characterizing the scope of regulations (ie, pre-market approval, sales and promotion, labeling, cuff sizes, and procurement), information systems for monitoring the models of BPMDs used in primary health care (PHC), and systems to enforce compliance with regulations. Ten of the 13 countries had medical device laws, but regulations that specifically address BPMDs only existed in three countries. Only one country (Brazil) had regulations for mandatory accuracy validation testing and only two countries regulated internet sales of BPMDs. Labeling and cuff size regulations existed in four and two countries, respectively. Less than half the countries reported having a data repository on the BPMD models being used in PHC facilities (four countries) or sold (five countries). Weak and fragmented regulatory frameworks on the accuracy of BPMDs exist among countries of the Americas. This will adversely affect the accuracy of blood pressure assessment and hence poses a major impediment for successful implementation of HEARTS initiative.

Perfil de compra de dispositivos de medición de presión arterial, Chile 2018-2020 / Profile of Blood pressure measurement devices purchased in Chile 2018-2020 / Perfil de compra de dispositivos para aferição da pressão arterial, Chile, 2018-2020

RESUMEN Objetivo. Describir los tipos de dispositivos de medición de presión arterial comercializados a través de la plataforma Mercado Público entre los años 2018 y 2020. Métodos. Estudio de tipo descriptivo procedente de las transacciones realizadas a través de Mercado Público en el periodo 2018 y 2020, para la adquisición de dispositivos de medición de presión arterial. Para los equipos automáticos, se buscó el estado de validación otorgado por organismos internacionales. Los resultados se presentan en frecuencias absolutas y relativas. Resultados. Entre los años 2018-2020, aumentó la adquisición de dispositivos automáticos de un 15% a un 75%, y se presentó una reducción del 40,9% al 7,5% en equipos mercuriales y de 38,7% al 15,8% en equipos aneroides. De los 772 dispositivos automáticos, el 52,6% contó con validación de precisión. Conclusiones. Considerando que Chile está comprometido con la Iniciativa HEARTS en las Américas, y que la prevención y control de la HTA es fundamental para reducir la mortalidad por enfermedades no trasmisibles, resulta crucial garantizar una medición de presión arterial precisa. El presente documento aporta información relevante respecto de las transacciones realizadas y el perfil de compra de dispositivos de medición de presión arterial a través de la plataforma Mercado Público, observándose una tendencia creciente en la obtención de equipos automáticos validados durante el periodo evaluado.

ABSTRACT Objective. To describe the types of blood pressure measurement devices marketed through the Mercado Público platform between 2018 and 2020. Methods. This is a descriptive study based on transactions on the Mercado Público platform for the purchase of blood pressure measurement devices in the 2018-2020 period. A search was made for any validation granted by international organizations for automatic devices. The results are expressed as absolute and relative frequencies. Results. Between 2018 and 2020, purchases of automatic devices increased from 15% to 75%, while purchases of mercury-based devices dropped from 40.9% to 7.5%, and aneroid devices fell from 38.7% to 15.8%. Of the 772 automatic devices, 52.6% were validated for accuracy. Conclusions. Given that Chile is committed to the HEARTS Initiative in the Americas, and that prevention and control of hypertension is critical to reducing mortality from noncommunicable diseases, it is crucial to ensure accurate blood pressure measurement. This document provides relevant information on transactions and the purchase profile of blood pressure measurement devices on the Mercado Público platform. A growing trend was observed in the purchase of validated automatic equipment during the evaluation period.

RESUMO Objetivo. Descrever os tipos de dispositivos de aferição da pressão arterial comercializados por meio da plataforma Mercado Público, entre 2018 e 2020. Métodos. Estudo descritivo das transações realizadas por meio do Mercado Público, no período de 2018 a 2020, para a compra de dispositivos de aferição da pressão arterial. No caso de dispositivos automáticos, foi verificado se possuíam validação concedida por organizações internacionais. Os resultados são apresentados na forma de frequências absolutas e relativas. Resultados. Entre 2018 e 2020, a aquisição de dispositivos automáticos aumentou de 15% para 75%. Houve uma redução de 40,9% para 7,5% na compra de esfigmomanômetros de mercúrio e de 38,7% para 15,8% na compra de esfigmomanômetros aneroides. Dos 772 dispositivos automáticos, 52,6% tinham exatidão validada. Conclusões. Considerando que o Chile está comprometido com a Iniciativa HEARTS nas Américas e que a prevenção e o controle da hipertensão arterial sistêmica é fundamental para reduzir a mortalidade por doenças não transmissíveis, é essencial garantir a aferição exata da pressão arterial. Este documento fornece informações relevantes sobre as transações realizadas e o perfil de compra de dispositivos de aferição da pressão arterial por meio da plataforma Mercado Público, mostrando uma tendência crescente na aquisição de dispositivos automáticos validados durante o período de avaliação.

Chile's public healthcare sector hypertension control rates before and during the pandemic and HEARTS implementation / Tasas de control de la hipertensión en el sector de salud pública en Chile antes y durante la pandemia y aplicación de la iniciativa HEARTS / Taxas de controle da hipertensão arterial no setor de saúde pública do Chile antes e durante a pandemia e implementação da iniciativa HEARTS

ABSTRACT Hypertension (arterial blood pressure ≥ 140/90 mmHg) is a risk factor for cardiovascular diseases, with the greatest burden of attributable deaths in Chile, having a national prevalence of 27.6%. In 2018, the implementation of HEARTS begun in primary health care centers of the Public Health System, with the aim of achieving increase in control rates, by raising the proportion of hypertensive individuals who meet blood pressure goals (< 140/90 mmHg for individuals 15-79 years old and of 150/90 mmHg for individuals 80 years and older), and thus contributing to reduce cardiovascular morbidity and mortality associated with this condition. This is a descriptive study that follows average treatment and control rates from the Public Health System between 2017-2021 obtained from health centers statistics reports during HEARTS implementation. Treatment and control rates remained at 57% and 39% respectively between 2017-2019. Between 2020 and 2021, in the context of the SARS-CoV-2 pandemic, treatment and control rates decreased very significantly, reaching 46% and 26%, respectively, in December 2021, even though the number of centers reporting the implementation of HEARTS increased from 227 to 387 in this same period. Prior to the pandemic, during the last quarter of 2019, a decrease in cardiovascular health controls was already observed as a result of social protests. In light of the results, the technical pillars of the HEARTS Initiative have an important role in helping to recover the population control rates reached in 2019 and increasing the speed to achieve better hypertension control rates.

RESUMEN La hipertensión arterial (presión arterial ≥ 140/90 mmHg) es un factor de riesgo para las enfermedades cardiovasculares, que tienen la mayor carga de muertes atribuibles en Chile. En este país, la hipertensión tiene una prevalencia nacional del 27,6%. En el 2018 se inició la aplicación del paquete técnico HEARTS en los centros de atención primaria de salud del sistema público de salud de Chile, con el objetivo de lograr un aumento de las tasas de control, al elevar la proporción de personas hipertensas que cumplen con las metas de presión arterial (< 140/90 mmHg para personas de 15 a 79 años y de 150/90 mmHg para personas de 80 años o más) y así contribuir a reducir la morbilidad y la mortalidad cardiovascular asociadas a esta enfermedad. En este estudio descriptivo se realiza un seguimiento de las tasas promedio de tratamiento y control del sistema público de salud entre el 2017 y el 2021 obtenidas de los informes estadísticos de los centros de salud durante la aplicación de la iniciativa HEARTS. Las tasas de tratamiento y control se mantuvieron en 57% y 39%, respectivamente, en el período entre el 2017 y el 2019. Entre el 2020 y el 2021, en el contexto de la pandemia de SARS-CoV-2, las tasas de tratamiento y control disminuyeron de manera muy significativa, y se ubicaron en 46% y 26%, respectivamente, en diciembre del 2021, a pesar de que el número de centros que notificaron la aplicación de HEARTS aumentó de 227 a 387 en el mismo período. Antes de la pandemia, en el último trimestre del 2019, ya se había observado una disminución en los controles de salud cardiovascular debido a las protestas sociales. En vista de estos resultados, los pilares técnicos de la iniciativa HEARTS desempeñan un papel importante para ayudar a recuperar las tasas de control que se habían alcanzado en el 2019 y acelerar la consecución de mejores tasas de control de la hipertensión.

RESUMO A hipertensão (pressão arterial ≥ 140/90 mmHg) é um fator de risco para doenças cardiovasculares, com a maior carga de mortes atribuíveis no Chile, onde a prevalência nacional é de 27,6%. Em 2018, teve início a implementação da iniciativa HEARTS em centros de atenção primária à saúde do sistema de saúde pública, com o objetivo de elevar as taxas de controle, pelo aumento da proporção de indivíduos hipertensos que alcançam as metas de pressão arterial (< 140/90 mmHg para pessoas de 15-79 anos e de 150/90 mmHg para pessoas a partir de 80 anos), e, assim, contribuir para a redução da morbimortalidade cardiovascular associada a essa condição. Este é um estudo descritivo que acompanha as taxas médias de tratamento e controle no sistema de saúde pública entre 2017 e 2021, obtidas de relatórios estatísticos dos centros de saúde durante a implementação da iniciativa HEARTS. Entre 2017 e 2019, as taxas de tratamento e de controle foram, respectivamente, de 57% e 39%. Entre 2020 e 2021, no contexto da pandemia causada pelo SARS-CoV-2, houve uma diminuição muito significativa das taxas de tratamento e de controle, que chegaram, respectivamente, a 46% e 26% em dezembro de 2021, embora o número de centros que informaram ter implementado o pacote HEARTS tenha aumentado de 227 para 387 no mesmo período. Antes da pandemia, durante o último trimestre de 2019, já se observava uma diminuição dos controles da saúde cardiovascular em consequência de uma onda de protestos sociais. Os resultados mostram que os pilares técnicos da iniciativa HEARTS são importantes para ajudar a recuperar as taxas de controle na população alcançadas em 2019 e aumentar a velocidade para atingir melhores taxas de controle da hipertensão.

Perfil de compra de dispositivos de medición de presión arterial, Chile 2018-2020

[RESUMEN]. Objetivo. Describir los tipos de dispositivos de medición de presión arterial comercializados a través de la plataforma Mercado Público entre los años 2018 y 2020. Métodos. Estudio de tipo descriptivo procedente de las transacciones realizadas a través de Mercado Público en el periodo 2018 y 2020, para la adquisición de dispositivos de medición de presión arterial. Para los equi- pos automáticos, se buscó el estado de validación otorgado por organismos internacionales. Los resultados se presentan en frecuencias absolutas y relativas. Resultados. Entre los años 2018-2020, aumentó la adquisición de dispositivos automáticos de un 15% a un 75%, y se presentó una reducción del 40,9% al 7,5% en equipos mercuriales y de 38,7% al 15,8% en equipos aneroides. De los 772 dispositivos automáticos, el 52,6% contó con validación de precisión. Conclusiones. Considerando que Chile está comprometido con la Iniciativa HEARTS en las Américas, y que la prevención y control de la HTA es fundamental para reducir la mortalidad por enfermedades no trasmisibles, resulta crucial garantizar una medición de presión arterial precisa. El presente documento aporta información relevante respecto de las transacciones realizadas y el perfil de compra de dispositivos de medición de presión arterial a través de la plataforma Mercado Público, observándose una tendencia creciente en la obtención de equipos automáticos validados durante el periodo evaluado.

[ABSTRACT]. Objective. To describe the types of blood pressure measurement devices marketed through the Mercado Público platform between 2018 and 2020. Methods. This is a descriptive study based on transactions on the Mercado Público platform for the purchase of blood pressure measurement devices in the 2018-2020 period. A search was made for any validation granted by international organizations for automatic devices. The results are expressed as absolute and rela- tive frequencies. Results. Between 2018 and 2020, purchases of automatic devices increased from 15% to 75%, while pur- chases of mercury-based devices dropped from 40.9% to 7.5%, and aneroid devices fell from 38.7% to 15.8%. Of the 772 automatic devices, 52.6% were validated for accuracy. Conclusions. Given that Chile is committed to the HEARTS Initiative in the Americas, and that prevention and control of hypertension is critical to reducing mortality from noncommunicable diseases, it is crucial to ensure accurate blood pressure measurement. This document provides relevant information on transactions and the purchase profile of blood pressure measurement devices on the Mercado Público platform. A growing trend was observed in the purchase of validated automatic equipment during the evaluation period.

[RESUMO]. Objetivo. Descrever os tipos de dispositivos de aferição da pressão arterial comercializados por meio da plataforma Mercado Público, entre 2018 e 2020. Métodos. Estudo descritivo das transações realizadas por meio do Mercado Público, no período de 2018 a 2020, para a compra de dispositivos de aferição da pressão arterial. No caso de dispositivos automáticos, foi verificado se possuíam validação concedida por organizações internacionais. Os resultados são apresenta- dos na forma de frequências absolutas e relativas. Resultados. Entre 2018 e 2020, a aquisição de dispositivos automáticos aumentou de 15% para 75%. Houve uma redução de 40,9% para 7,5% na compra de esfigmomanômetros de mercúrio e de 38,7% para 15,8% na compra de esfigmomanômetros aneroides. Dos 772 dispositivos automáticos, 52,6% tinham exatidão validada. Conclusões. Considerando que o Chile está comprometido com a Iniciativa HEARTS nas Américas e que a prevenção e o controle da hipertensão arterial sistêmica é fundamental para reduzir a mortalidade por doenças não transmissíveis, é essencial garantir a aferição exata da pressão arterial. Este documento fornece informações relevantes sobre as transações realizadas e o perfil de compra de dispositivos de aferição da pressão arterial por meio da plataforma Mercado Público, mostrando uma tendência crescente na aquisição de dispositivos automáticos validados durante o período de avaliação.

Chile’s public healthcare sector hypertension control rates before and during the pandemic and HEARTS implementation

[ABSTRACT]. Hypertension (arterial blood pressure ≥ 140/90 mmHg) is a risk factor for cardiovascular diseases, with the greatest burden of attributable deaths in Chile, having a national prevalence of 27.6%. In 2018, the implemen- tation of HEARTS begun in primary health care centers of the Public Health System, with the aim of achieving increase in control rates, by raising the proportion of hypertensive individuals who meet blood pressure goals (< 140/90 mmHg for individuals 15–79 years old and of 150/90 mmHg for individuals 80 years and older), and thus contributing to reduce cardiovascular morbidity and mortality associated with this condition. This is a descriptive study that follows average treatment and control rates from the Public Health System between 2017–2021 obtained from health centers statistics reports during HEARTS implementation. Treatment and control rates remained at 57% and 39% respectively between 2017-2019. Between 2020 and 2021, in the context of the SARS-CoV-2 pandemic, treatment and control rates decreased very significantly, reaching 46% and 26%, respectively, in December 2021, even though the number of centers reporting the implementation of HEARTS increased from 227 to 387 in this same period. Prior to the pandemic, during the last quarter of 2019, a decrease in cardiovascular health controls was already observed as a result of social protests. In light of the results, the technical pillars of the HEARTS Initiative have an important role in helping to recover the population control rates reached in 2019 and increasing the speed to achieve better hypertension control rates.

[RESUMEN]. La hipertensión arterial (presión arterial ≥ 140/90 mmHg) es un factor de riesgo para las enfermedades car- diovasculares, que tienen la mayor carga de muertes atribuibles en Chile. En este país, la hipertensión tiene una prevalencia nacional del 27,6%. En el 2018 se inició la aplicación del paquete técnico HEARTS en los centros de atención primaria de salud del sistema público de salud de Chile, con el objetivo de lograr un aumento de las tasas de control, al elevar la proporción de personas hipertensas que cumplen con las metas de presión arterial (< 140/90 mmHg para personas de 15 a 79 años y de 150/90 mmHg para personas de 80 años o más) y así contribuir a reducir la morbilidad y la mortalidad cardiovascular asociadas a esta enfer- medad. En este estudio descriptivo se realiza un seguimiento de las tasas promedio de tratamiento y control del sistema público de salud entre el 2017 y el 2021 obtenidas de los informes estadísticos de los centros de salud durante la aplicación de la iniciativa HEARTS. Las tasas de tratamiento y control se mantuvieron en 57% y 39%, respectivamente, en el período entre el 2017 y el 2019. Entre el 2020 y el 2021, en el contexto de la pandemia de SARS-CoV-2, las tasas de tratamiento y control disminuyeron de manera muy significativa, y se ubicaron en 46% y 26%, respectivamente, en diciembre del 2021, a pesar de que el número de centros que notificaron la aplicación de HEARTS aumentó de 227 a 387 en el mismo período. Antes de la pandemia, en el último trimestre del 2019, ya se había observado una disminución en los controles de salud cardiovascular debido a las protestas sociales. En vista de estos resultados, los pilares técnicos de la iniciativa HEARTS desempeñan un papel importante para ayudar a recuperar las tasas de control que se habían alcanzado en el 2019 y acelerar la consecución de mejores tasas de control de la hipertensión.

[RESUMO]. A hipertensão (pressão arterial ≥ 140/90 mmHg) é um fator de risco para doenças cardiovasculares, com a maior carga de mortes atribuíveis no Chile, onde a prevalência nacional é de 27,6%. Em 2018, teve início a implementação da iniciativa HEARTS em centros de atenção primária à saúde do sistema de saúde pública, com o objetivo de elevar as taxas de controle, pelo aumento da proporção de indivíduos hipertensos que alcançam as metas de pressão arterial (< 140/90 mmHg para pessoas de 15-79 anos e de 150/90 mmHg para pessoas a partir de 80 anos), e, assim, contribuir para a redução da morbimortalidade cardiovascular associada a essa condição. Este é um estudo descritivo que acompanha as taxas médias de tratamento e controle no sistema de saúde pública entre 2017 e 2021, obtidas de relatórios estatísticos dos centros de saúde durante a implementação da iniciativa HEARTS. Entre 2017 e 2019, as taxas de tratamento e de controle foram, respectivamente, de 57% e 39%. Entre 2020 e 2021, no contexto da pandemia causada pelo SARS-CoV-2, houve uma diminuição muito significativa das taxas de tratamento e de controle, que chegaram, respectivamente, a 46% e 26% em dezembro de 2021, embora o número de centros que informaram ter implementado o pacote HEARTS tenha aumentado de 227 para 387 no mesmo período. Antes da pandemia, durante o último trimestre de 2019, já se observava uma diminuição dos controles da saúde cardiovascular em consequência de uma onda de protestos sociais. Os resultados mostram que os pilares técnicos da ini- ciativa HEARTS são importantes para ajudar a recuperar as taxas de controle na população alcançadas em 2019 e aumentar a velocidade para atingir melhores taxas de controle da hipertensão.

Impacto cardiovascular secundario a la terapia para el control del cáncer / The cardiovascular impact of cancer control therapy

Cardiovascular diseases and cancer account for 27 and 25% of mortality in Chile, respectively. In the last decades, survival of people with cancer has improved due to preventive programs, early detection strategies, advances in technology and development of new antineoplastic therapies. Consequently, a progressive number of cancer-surviving patients have been generated, who may develop cardiovascular diseases, secondary to the same cancer therapy. Cardio-Oncology has emerged as the necessary link between both specialties to promote the prevention and early detection of cardiac complications, in patients undergoing oncological therapies. The aim is to curb cardiovascular complications. Also, to acquire knowledge about the mechanisms and effects of drugs that lead to heart damage aiming to develop efficient cardioprotective therapies. In this article we review and propose a didactic organization and classification of the main cardiovascular effects of cancer control therapy. We recognize that there is still a knowledge gap in basic sciences about the mechanisms that underlie these alterations.

Obesidad: ¿Factor de riesgo o enfermedad? / Obesity: risk factor or primary disease?

Obesity is a global health problem. Its worldwide prevalence has tripled between 1975 and 2016, reaching a prevalence in Chile of 34.4%, according to the National Health Survey 2016-2017. If this condition corresponds to a risk factor or primary disease is a widely discussed issue. It is recognized as a disease by the American Medical Association and World Health Organization, based on its metabolic and hormonal features, such as dysregulation of appetite, abnormal energy balance and endocrine dysfunction, among others. Its main environmental risk factors are the consumption of ultra-processed foods and sedentariness. Preventive measures at the population level are fundamental, emphasizing promotion and prevention using a transdisciplinary approach. The individual approach in the management of obesity should improve the quality of life, avoid early mortality, reduce cardiovascular risk, and reduce the progression to type 2 diabetes and incidence of cancer. Thus, an adequate management and control of obesity would have a great impact in our society.

Louisiana: a model for advancing regional e-Research through cyberinfrastructure.

Louisiana researchers and universities are leading a concentrated, collaborative effort to advance statewide e-Research through a new cyberinfrastructure: computing systems, data storage systems, advanced instruments and data repositories, visualization environments and people, all linked together by software programs and high-performance networks. This effort has led to a set of interlinked projects that have started making a significant difference in the state, and has created an environment that encourages increased collaboration, leading to new e-Research. This paper describes the overall effort, the new projects and environment and the results to date.

Integration of metabolic networks and gene expression in virtual reality.

MOTIVATION: Metabolic networks combine metabolism and regulation. These complex networks are difficult to understand and visualize due to the amount and diverse types of information that need to be represented. For example, pathway information gives indications of interactions. Experimental data, such as transcriptomics, proteomics and metabolomics data, give snapshots of the system state. Stereoscopic virtual environments provide a true three-dimensional representation of metabolic networks, which can be intuitively manipulated, and may help to manage the data complexity. RESULTS: MetNet3D, a 3D virtual reality system, allows a user to explore gene expression and metabolic pathway data simultaneously. Normalized gene expression data are processed in R and visualized as a 3D plot. Users can find a particular gene of interest or a cluster of genes that behave similarly and see how these genes function in metabolic networks from MetNetDB, a database of Arabidopsis metabolic networks, using animated network graphs. Interactive virtual reality, with its enhanced ability to display more information, makes such integration more effective by abstracting key relationships. AVAILABILITY: MetNet3D and some sample datasets are available at http://www.vrac.iastate.edu/research/sites/metnet/Download/Download.htm. SUPPLEMENTARY INFORMATION: Color snapshots and movies are available at http://www.vrac.iastate.edu/research/sites/metnet/Bioinformatics/SupplementaryInformation.htm.