Caracterización de la conducta suicida en población general de la Región de Coquimbo (Chile) entre 2018 y 2020 / Characterization of suicidal behavior in Coquimbo, Chile, between 2018 and 2020

Introducción La conducta suicida es un problema de salud pública mundial. La Organización Mundial de la Salud estimó en 700 000 los fallecimientos por suicidio para el año 2021. Objetivo El propósito fue estimar la prevalencia de la conducta suicida y describir sus factores relacionados en la Región de Coquimbo, Chile, entre los años 2018 y 2020. Métodos Se analizaron 2190 notificaciones por intentos suicidas del sistema de vigilancia epidemiológica regional, que correspondieron a 1781 personas; junto con 217 informes de personas fallecidas por suicidio del Servicio Médico Legal. Resultados La tasa global de suicidio para la región en el período fue de 9,79 fallecimientos por 100 000 habitantes. Se estandarizaron las tasas del año 2018 según la información disponible, con método directo para la tasa regional (9,55 por 100 000 habitantes) e indirecto para las comunas. Las comunas rurales presentaron mayores tasas que las urbanas. Las mujeres mostraron mayor riesgo de intentos (: 1,28; intervalo de confianza 95%: de 1,23 a 1,33) y menor riesgo de suicidio (0,086; de 0,06 a 0,13) que los hombres. Las personas jóvenes presentaron mayor riesgo de intentos y menor riesgo de suicidio, comparado con personas mayores. Destaca el aumento de la tasa de suicidio en personas mayores (de 70 a 79 años) durante el año 2020. El nivel educacional básico es una variable de riesgo para suicidio (2,21; de 1,15 a 4,23), comparado con educación universitaria. Los intentos de suicidio previos y patología psiquiátrica son factores de riesgo. Conclusiones La prevalencia de suicidio y los factores relacionados son similares a lo reportado en otros estudios e informes nacionales, destacando la ruralidad y mayor riesgo en varones de edad adulta avanzada. A diferencia de los suicidios, los intentos son más frecuentes en mujeres y personas jóvenes. Antecedentes de problemas de salud mental, intentos previos y violencia en la familia son factores de riesgo para ambas conductas. Conocer el comportamiento de la conducta suicida en la población es fundamental para su prevención.

Introduction Suicidal behavior is a public health problem worldwide. The World Health Organization estimated 700 000 deaths for the year 2021. Objective This study aimed to estimate the prevalence of suicidal behavior and describe its related factors in the Coquimbo Region, Chile, between 2018 and 2020. Methods 2190 suicide attempt notifications from the regional epidemiological surveillance system were analyzed, corresponding to 1781 people, along with 217 reports from the Forensic Medical Service of people who died by suicide. Results The overall suicide rate for the region during that period was 9.79 deaths per 100 000 inhabitants. The 2018 rates were standardized according to available information, with direct methods for the regional rate (9.55 per 100 000 inhabitants) and indirect methods for the communes. Rural communes presented higher rates than urban ones. Women showed a higher risk of attempts (OR 1.28; 95% CI 1.23 to 1.33) and a lower risk of suicide compared to men (0.086; 0.06 to 0.13). Young people had a higher risk of suicide attempts and a lower risk of suicide compared to older people. The increased suicide rates in older people (70 to 79 years) during 2020 are noteworthy. Basic education level is a risk variable for suicide (2.21; from 1.15 to 4.23), compared to having higher education. Previous suicide attempts and psychiatric pathology are risk factors. Conclusions Suicide prevalence and related factors are similar to those reported in other studies and national reports, highlighting rurality and higher risk in older male adults. In contrast to suicides, attempts are more frequent in women and young people. A history of mental health problems, previous attempts, and family violence are risk factors for both outcomes. Knowing the patterns of suicidal behavior in the population is fundamental for its prevention.

Urinary incontinence in Chilean women: a prevalence study of the health profile and associated factors / Incontinencia urinaria en mujeres chilenas: estudio de prevalencia de perfil de salud y de factores asociados

PURPOSE: This research seeks to determine the prevalence of urinary incontinence in adult women in La Serena, Chile, exploring its association with known risk factors. METHODS: We conducted a cross-sectional, descriptive study with an analytical component. A validated questionnaire was applied to 371 women who consented, were aged 30 or older, and were users of primary health care centers. RESULTS: The prevalence obtained was 45.01%, associated with four main factors: hard work (odds ratio: 2.29; 95% confidence interval: 1.45 to 3.62), constipation (odds ratio: 1.99; 95% confidence interval: 1.21 to 2.76), type 2 diabetes (odds ratio: 1.88; 95% confidence interval: 1.16 to 3.06) and obesity (odds ratio: 1.09; 95% confidence interval: 1.05 to 1.14). CONCLUSIONS: Given the high prevalence of urinary incontinence, its association with prevalent health problems, and its known impact on women's quality of life, the authors suggest that strategies be implemented to deal with this health problem at the primary care level.

OBJETIVO: Determinar la prevalencia de incontinencia urinaria en mujeres adultas de la ciudad de La Serena, explorando la asociación con factores de riesgo conocidos. MÉTODOS: Estudio descriptivo transversal, con componente analítico. Se aplicó un cuestionario validado a 371 mujeres mayores de 30 años y usuarias de centros de atención primaria, que dieron su consentimiento. RESULTADOS: Se obtuvo una prevalencia de 45,01%, asociándose con trabajo pesado (Odds ratio: 2,29; intervalo de confianza 95%: 1,45 a 3,62); estreñimiento (Odds ratio: 1,99; intervalo de confianza 95%: 1,21 a 2,76); diabetes mellitus tipo 2 (Odds ratio: 1,88; intervalo de confianza 95%: 1,16 a 3,06) y obesidad (Odds ratio: 1,09; intervalo de confianza 95%: 1,05 a 1,14). CONCLUSIONES: Dada la alta prevalencia de incontinencia urinaria, su asociación con problemas de salud prevalentes y el impacto conocido en la calidad de vida de las mujeres, los autores sugieren la implementación de estrategias que aborden este problema en el nivel de atención primaria.

Epidemiología de la sífilis con enfoque territorial: caso del Hospital de La Serena, años 2015-2017 / Epidemiological features of syphilis diagnosed at a clinic of sexually transmitted diseases

Background: Syphilis continues to be a common sexually transmitted disease. Aim: To describe the epidemiologic features of patients with syphilis consulting in a Chilean sexually transmitted diseases clinic. Material and Methods: Review of medical records of patients with positive serology for syphilis, who attended a unit of sexually transmitted diseases between 2015 and 2017. Results: Of 266 cases, 61% were male and 74% were aged between 20 and 49 years. The highest incidence was observed in males aged between 20 and 30 years. Eighty five percent of cases were diagnosed in latent phases, 10% of the cases had a co-infection with HIV and 18%, a history of other sexually transmitted disease. The rate of coinfection was significantly higher in men than in women (78 and 28%, respectively; p < 0.01). Only 6.4% reported always using a condom. Men used it with higher frequency than women (72 and 28% respectively; p < 0.01). A low adherence to treatment and faulty follow-up and treatment of sexual contacts was observed. Twenty five percent of women diagnosed with syphilis were pregnant and 27% of them had a premature birth, with one neonatal death. Conclusions: A high incidence of syphilis was observed, especially in men of younger ages. The diagnosis is delayed, the treatment of sexual contacts and the use of condoms are uncommon. Although the treatment of pregnant women is appropriated, some perinatal complications are observed.

Incidencia de cáncer en la Región de Coquimbo, estimada según resultados de biopsias, años 2006 al 2015 / Incidence of cancer in the coquimbo region, estimated using biopsy results: 2006 to 2015

INTRODUCCIÓN: A pesar de que los cánceres producen alta carga de enfermedad en Chile, se carece de un registro poblacional de cáncer nacional. El objetivo de estudio fue estimar la incidencia de los veinte principales tipos de cáncer en la Región de Coquimbo. MATERIAL Y MÉTODOS: Con datos del registro de la Unidad Anatomía Patológica del Hospital de Coquimbo, que procesa totalidad de las biopsias procedentes de los establecimientos públicos de la región; se estimó la incidencia de estas patologías. Se caracterizaron los cánceres según tipo, sexo y grupos de edad. Se calculó tasas de incidencia de los quinquenios 2006-2010 y 2011-2015, utilizando como denominador la población beneficiaria del Fondo Nacional de Salud. Finalmente se realizó una proyección lineal de la incidencia hasta el año 2025. RESULTADOS: Las mujeres presentaron una mayor tasa bruta de incidencia que los hombres. La incidencia aumenta, en ambos sexos, conforme aumenta la edad. Los cánceres más incidentes en mujeres fueron de mama, de piel no melanoma y de cuello uterino, y entre los hombres, fueron los cánceres de piel no melanoma, de próstata y gástrico. DISCUSIÓN: Dada la elevada frecuencia relativa de cánceres de tiroides, testículo, cuello de útero y mama en edades jóvenes, se sugiere orientar estrategias preventivas hacia estos grupos de edad. Así mismo, se debiera establecer programas integrales para los cánceres más frecuentes (piel no melanoma, próstata, colon). De no existir políticas públicas enfocadas a prevenir los cánceres, se proyecta un crecimiento lineal de hasta un 22% en la incidencia al año 2025. (AU)

INTRODUCTION: Though cancers produce a high disease burden in Chile, there is no national population-based cancer registry. The present study aimed to estimate the incidence of the twenty main types of cancers in the Coquimbo Region. MATERIAL AND METHODS: Data from the registry of the Unit of Pathological Anatomy of Coquimbo Hospital, which processes all biopsies from public facilities in the region, were used; this allowed for the estimation of the incidence of these pathologies. The different types of cancers were characterized according to the sex and age groups of the affected individuals. For the calculation of incidence rates over two five-year periods, 2006-2010 and 2011-2015, the beneficiary population of the national public health insurance system (FONASA) was used as the denominator. Finally, a linear projection of the incidence rate was calculated until 2025. RESULTS: Women had a higher gross incidence rate of cancer than men. The incidence increases, in both sexes, as age increases. The most incident cancers in women were breast cancer, non-melanoma skin cancer, and cervical cancer, and among men, they were non-melanoma skin cancer, prostate cancer, and gastric cancers. DISCUSSION: Given the relative high frequency of certain cancers (thyroid, testicular, cervical, and breast) among younger adults, preventive strategies should be oriented towards these age groups. Likewise, comprehensive programs should be established for the most frequent can-cers (non-melanoma skin, prostate, and colon). If no new cancer prevention policies are im-plemented, a linear growth of the incidence rate of up to 22% is projected for the year 2025. (AU)

Mortalidad estandarizada según causas, edad y género en una comuna minera del norte de Chile entre 2006 y 2015 / Standardized mortality according to cauSe of death, age, and gender in a mining community in Northern Chile, 2006-2015

INTRODUCCIÓN: La comuna de Andacollo fue declarada Zona Saturada por material particulado en el año 2009, desconociéndose si dicha contaminación afecta la salud de sus habitantes o aumenta el riesgo de morir de su población. OBJETIVO: Comparar la mortalidad general y por causas cardiovasculares, respiratorias y neoplasias, según edad y género, de la comuna Andacollo con las tasas nacionales, entre 2006 y 2015. MATERIALES Y MÉTODOS: Con registros oficiales de defunciones y población, se calcularon tasas de mortalidad general, por causas específicas y según género. Se estandarizó con ajuste directo por edad las tasas comunales, para compararlas con las del país. RESULTADOS: Las tasas de mortalidad ajustadas de Andacollo tienden a ser, en promedio, 20% superiores a las nacionales, durante toda la década. Esta diferencia está dada principalmente por un mayor riesgo de morir en hombres, que es 35% mayor para neoplasias, 40% más para enfermedades cardiovasculares y 50% mayor para las enfermedades respiratorias. Estas diferencias de riesgo de morir es mucho menor para las mujeres (promedio 9%) y no se observan en la población joven (20-59 años). CONCLUSIONES: Las tasas de mortalidad general y específicas de Andacollo son significativamente superiores a las nacionales, pudiendo descartarse influencia de las condiciones ambientales en el riesgo de morir de su población, dada la heterogencidad presentada en los riesgos de morir por sexo. El exceso de riesgo de fallecer en hombres mayores podría explicarse por exposiciones laborales antiguas.

INTRODUCTION: The Chilean municipality of Andacollo was declared to be a Saturated Zone due to air pollution in 2009. It is unknown if this contamination affects the health of its inha-bitants. OBJECTIVE: To compare the general mortality and specific cardiovascular, respiratory, and neoplastic mortality rates in Andacollo with the national mortality rates between the years 2006 and 2015. MATERIALS AND METHODS: General and specific mortality rates, by gender, were calculated using official death and population registries. The Andacollo mortality rates were directly standardized by age and then compared with the national rates. RESULTS: The adjus-ted mortality rates of Andacollo tend to be, on average, 20% higher than the national ones, throughout the decade. This difference is mainly due to an increased risk of dying among men, which is 35% higher for cancers, 40% higher for cardiovascular diseases, and 50% higher for respiratory diseases. These differences in risk of dying are much lower for women (average 9%) and are not observed in the younger population (20-59 years of age). CONCLUSIONS: An-dacollo's general and specific mortality rates are significantly higher than national ones, and the influence of environmental conditions on the population's risk of dying can be ruled out, given the heterogeneity presented by sex. The excess risk of death among older men could be explained by previous occupational exposures.

Medicina traslacional e innovación en salud: mecanismos y perspectivas / Translational medicine and innovation in health: mechanisms and perspectives

Many new discoveries in Life Sciences cannot be translated into products, services or new applications to improve human health. Translational medicine, defined as "from bench to bedside", refers to the transfer of results or new knowledge achieved in the laboratory into health innovation. We aim to review the state of art of translational medicine, its relationship with innovation processes and the different perspectives to consider. Finally, we contextualize the situation of Research and Development (R&D) in Chile and the main issues of the biotechnology market in the country.