Disponibilidad de médicos y especialistas en Chile / Availability of physicians and specialists in Chile

The availability and planning of Human Resources are important issues in many countries, as it is a key factor to cope with the critical challenges of Health Care Systems. In Chile, the Ministry of Health has undertaken several studies in order to improve knowledge about the medical workforce both in public and private sectors. The aim of this paper is to update and systematize the existing data on physicians and specialists availability in Chile. Several information sources were crossed to obtain new and more precise figures about this topic. According to the Internal Revenue System, 29.996 physicians practice medicine in the country, 43 percent of them hired in public services, part or full time. There is a high concentration of professionals in the central regions of Chile. Being the overall density of physicians of one per 559 inhabitants, the figures in the central region is one per 471 and one per more than 800 in the South and North. Between 2004 and 2008, the public sector increased its physician workforce by more than 80 percent in primary health care and more than 20 percent in the secondary and tertiary levels. This paper presents a method for a more rigorous identification of the categories of general practitioner and specialist respectively, and the results obtained from the databases used.

Timpanoplastía tipo III / Type III tympanoplasty

La timpanoplastía tipo III es una técnica quirúrgica reconstructiva de los mecanismos de conducción del oído medio cuando existe una discontinuidad incudo-estapedial. Según la patología osicular existente, las timpanoplastías tipo III se subdividen en clásica, III A y III B. Se realiza un estudio retrospectivo de 29 cirugías (27 pacientes) correspondientes al período 1993-2003. El abordaje quirúrgico más frecuente fue el retroauricular, y la fascia temporal fue el tejido más utilizado para reparar la membrana timpánica. El defecto osicular encontrado más a menudo fue la erosión de la apófisis larga del yunque, en el 57,7 por ciento de los casos. La osiculoplastía más frecuente fue la maleoloestapediopexia con interposición de yunque (51,9 por ciento). Se obtuvo un éxito anatómico de 88,9 por ciento, y un éxito auditivo de 69,2 por ciento. Las timpanoplastías III A se asociaron, en forma no significativa, a un mayor éxito auditivo que las III B. La conservación de la pared posterior del conducto auditivo externo se asoció significativamente a un mejor resultado auditivo. No se demostró diferencias entre las diferentes alternativas de osiculoplastía en timpanoplastías III A, mientras que en las 3 B, el uso de prótesis sintética (TORP) exhibió un mejor resultado que la utilización de autoinjertos.

Quantification of fecal neutrophils by MPO determination (myeloperoxidase) in patients with invasive diarrhea. Cuantificación de neutrofilos fecales mediante la determinación de MPO (Mieloperoxidasa) en pacientes con diarrea invasiva

Myeloperoxidase (MPO), a specific polymorphonuclear leukocyte enzyme, has been used previously to quantify the number of neutrophils in tissue. MPO activity was found to be linearly related to the number of neutrophil cells. In an attempt to use this method in leukocytes measuring in stool, fecal MPO was solubilized with hexadecyltrimethylammonium bromide and the MPO activity was measured by a dianisidine-H2O2 assay. Stools from 10 normal subjects and 39 patients with diarrhea produced by enteropathogenic bacteria were examined for leukocytes by MPO activity as well as microscopically using methylene blue stain, MPO activity was positive in 36 patients (92

) and leukocytes were present by microscopic observation in 30 (77

). Fecal leukocytes were not found in healthy controls and the MPO activity was undectable. Stool MPO activity had a range of from 1.6 to 2,830.0 x 10(3) UMPO per gram of feces (median 460.0). The number of neutrophils obtained through MPO activity had a range of 6.0 to 13,216.0/ mm3 (median 1,261.0). Fecal MPO activity is a simple biochemical assay for the detection and quantification of fecal leukocytes.

Characterization of yellow and development of instant flours by hydrothermal process / Caracterización de arroz manchado y elaboración de harinas instantaneas por proceso hidrotérmico

Commercial brown and yellow milled rice submitted to inappropriate storage conditions were characterized and utilized to develop instant flours that were used in the preparation of atoles. The grains were classified as long-thin; the average size was 2.13 x 6.79 mm. The milling yields obtained in laboratory with paddy rice were 70 per cent brown rice and 60 per cent milled rice. Brown rice and yellow milled rice had similar amylose contents, 22.5 and 25.6 per cent respectively. Gel consistency was solf with low gelatinization temperature (63-68ºC) for both samples. Field fungi, such as Helminnthosporium oryzae, and storage fungi, such as Aspergillus spp, were present in paddy, yellow milled and commercial rice. The fungus Helminthosporium oryzae, Aspergillus spp, and Penicillum spp were not present in instant flours. Instant flours were prepared by soaking the grain in water, and then steaming, dryng and milling it. The highest values for water absortion index were obtained from yellow milled instant rice flour. the color of yellow milled instant rice flour varied from white ("L") to pale yellow (lesser values of "b"). The lower viscosity of the instant flours indicates the breakdown of polymers and reveals that unintact starch granules were not present in instant flours. Protein and ash contents of brown and milled rice were unaffected by hydrothernal process, and the lipid content showed only little changes. Sensory analyses carried out on the atoles prepared with instant flours considered them acceptable, specially for products made from milled yellow rice