Grupos de apoyo de pares para sobrevivientes de intento de suicidio (SOSA): Revisión sistemática

Antecedentes: el intento de suicidio es el principal factor de riesgo de muerte por suicidio. La Organización Mundial de la Salud sugiere grupos de apoyo como intervención para esta población. Objetivo: Este estudio tuvo como objetivo determinar la eficacia de los grupos de apoyo de pares para sobrevivientes de intento de suicidio (SOSA). Método: Revisión sistemática (PROSPERO ID: CRD42022307581). Resultados: En total se identificaron 946 artículos potenciales, se revisaron 81 textos completos y se incluyó un artículo. El artículo informa sobre un estudio piloto abierto con evaluaciones pre y post intervención, sin grupo de control y con alto riesgo de sesgo. Esta es una intervención prometedora, porque los resultados mostraron una disminución de la ideación suicida (d=0,33), y del intento de suicidio (d=0,31). El pequeño número de investigaciones empíricas limita las generalizaciones. Conclusión: El nivel de certeza de la evidencia es bajo (baja certeza), por lo tanto, el grado de recomendación corresponde a evidencia insuficiente (I), para recomendar esta estrategia para las políticas públicas. En este artículo se analizan las razones de estos resultados y los posibles caminos para avanzar en este campo.

Background: Suicide attempt is the main risk factor for death by suicide. The World Health Organization (WHO) suggests support groups as an intervention for this population. Objective: This study aimed to assess the efficacy of peer-support groups for survivors of suicide attempt (SOSA). Method: Systematic review (PROSPERO ID: CRD42022307581). Results: In total, 946 potential articles were identified, 81 full texts were reviewed, and one article was included. The article reported an open-label pilot study with pre- and post-intervention evaluations, without a control group, and with a high risk of bias. This is a promising intervention because the results showed decreased suicidal ideation (d=0.33) and suicide attempt (d=0.31). The small number of empirical investigations limit generalizations. Conclusion: The level of certainty of evidence is low (low certainty); therefore, the grade of recommendation corresponds to insufficient evidence (I) to recommend this strategy for public policies. The reasons for these results and possible paths to advance the field are discussed in this article.

Remisión espontánea de acromegalia y enfermedad de Cushing en adultos mayores: casos clínicos / Spontaneous remission of acromegaly and Cushing's disease in older patients: report of two cases

Pituitary diseases such as acromegaly and Cushing's disease require surgical or medical therapy. In some functioning pituitary tumors, a spontaneous remission of hormonal hypersecretion is observed, mainly associated to apoplexy or pituitary infarction. We report the evolution of two female patients older than 70 years at the time of diagnosis, with multiple comorbidities. In case 1, acromegaly was diagnosed at 74 years of age. Sellar CT scan showed a 10-mm adenoma. During her follow-up, IGF1 levels remained normal. Nine years later, a magnetic resonance (MR) showed a 7-mm adenoma. In case 2, clinical and biochemical diagnosis of Cushing's disease was done being 71 years old. Sellar MR showed a 6-mm adenoma. Three years later, urinary cortisol normalized with no changes in adenoma at MR. Seven years later, she remains without clinical or biochemical signs of hypercortisolism. In both cases, no signs of hemorrhage were observed at MR.

Intervención cognitivo-conductual para trastornos del sueño en adultos mayores / Cognitive-behavioral intervention on senior adults with sleep disorders / Intervenção cognitivo-comportamental para transtornos do sono em idosos

Los trastornos del sueño en el adulto mayor son un problema manifestado con frecuencia, que afecta la calidad de vida y tiene impacto en los costos y el cuidado de salud. La actual forma de manejo de estos problemas se relaciona con prescripciones de fármacos, los cuales tienen efectos secundarios y aumenta su vulnerabilidad. En este contexto, el objetivo de esta investigación es evaluar la efectividad de una intervención cognitivo y conductual, que pretende mejorar el sueño mediante el cambio de los hábitos deficientes, así como el desafío de los pensamientos, las actitudes y las creencias negativas acerca del mismo. El método incluyó intervenciones cognitivo-conductuales grupales, con evaluaciones pre y post intervención. Los resultados indican una media de 9 (Pittsburgh) al inicio del programa y 4.9 al finalizar. Se concluye que la intervención a corto plazo consigue cambios significativos en hábitos e higiene del sueño. Esta investigación orienta a los profesionales de enfermería en la aplicación de estrategias hacia el bienestar del adulto mayor y el desarrollo de la disciplina en el marco del fortalecimiento de cuidados esenciales y fundamentales en procesos vitales.

Sleep disorders among senior adults are a frequent problem which has important impacts on their quality of life, and the costs of healthcare. The current management of these disorders is based on drug prescriptions, which in turn, have secondary effects and also enhance underlying conditions and vulnerabilities. Within this context, the objective of this study was to assess the effectiveness of a cognitive behavioral intervention aimed at improving the quality of sleep of these persons by modifying negative habits, thoughts, and beliefs. The method included group cognitive-behavioral interventions with pre and post assessments. The corresponding results showed a mean of 9 (Pittsburg) at the beginning of the program, and a mean of 4.9 at the end. It was thus concluded that the intervention, in the short term, helped to achieve significant improvements in relation to the sleep hygiene of these persons. This study can orient nursing professionals to establish strategies aimed at the wellbeing of senior adults; all within the vital processes and essential care strengthening framework.

Os transtornos do sono no idoso são um problema manifestado com frequência e que afeta a qualidade de vida e tem impacto nos custos e no cuidado de saúde. A atual forma de manejo destes problemas relaciona-se com prescrições de fármacos, os quais têm efeitos secundários e aumenta sua vulnerabilidade. Neste contexto, o objetivo desta pesquisa é avaliar a efetividade de uma intervenção cognitivo e comportamental, que pretende melhorar o sono mediante a mudança dos hábitos deficientes, assim como o desafio dos pensamentos, as atitudes e as crenças negativas acerca de si próprio. O método incluiu intervenções cognitivo-comportamentais grupais, com avaliações pre e post intervenção. Os resultados indicam uma média de 9 (Pittsburg) ao início do programa e 4.9 para finalizar. Conclui-se que a intervenção a curto prazo consegue câmbios significativos em hábitos e higiene do sono. Esta pesquisa orienta aos profissionais de enfermagem na aplicação de estratégias para o bem-estar do idoso e do desenvolvimento da disciplina no marco do fortalecimento de cuidados essenciais e fundamentais em processos vitais.

Programa de formación de ayudantes de investigación: conocimiento y satisfacción de los estudiantes / Research assistant formation program: students' knowledge and satisfaction / Programa de formação de assistentes de pesquisa: conhecimento e satisfação dos estudantes

Introducción: La inserción de estudiantes de pregrado en actividades de investigación es relevante para fomentar la crítica y aplicación de resultados de investigación. La formación de ayudantes de investigación se plantea como una alternativa válida para que los alumnos se expongan, experimenten y participen activamente en el proceso de investigación. Objetivo: Identificar el nivel de conocimiento y grado de satisfacción de los estudiantes después de participar en un programa de formación de ayudantes de investigación. Método: Estudio de pre y post test en 20 estudiantes de pregrado de Enfermería. Se evaluó el conocimiento alcanzado y la satisfacción de los estudiantes con el programa de formación, el cual considera tres módulos de aprendizaje distribuidos en 180 horas cronológicas. Resultados: El conocimiento de los estudiantes incrementó significativamente con el programa, no se relacionó con el conocimiento que el alumno trae al inicio del mismo, así como tampoco con el semestre que cursa. El grado de satisfacción fue en el 100% de los alumnos muy satisfecho. Discusión: Este artículo reporta un programa de formación de ayudantes de investigación que es posible ser replicado en otras realidades, que incrementa el conocimiento, con un alto grado de satisfacción en los estudiantes. La duración del programa podría considerarse una debilidad. Conclusión: La participación de estudiantes de pregrado en un programa de formación de ayudantes de investigación, puede considerarse una estrategia para involucrar a alumnos en investigación, y que valoren su aporte en la disciplina de enfermería.

Introduction: An early integration of undergraduate students into activities of research can help them develop skills for a critical application of the corresponding findings. The formation of research assistants program is proposed as an experience for students to expose, experiment, and actively participate in diverse researching related activities. Objective: To identify the level of knowledge and degree of satisfaction of students after their participation in a research assistant formation program. Method: This is pre-post-test study involving 20 undergraduate nursing students. Their achieved knowledge and satisfaction in the three-module-180-hours program were assessed. Results: Unrelated to parallel experiences, the students' knowledge increased significantly after the program. All students stated having felt very satisfied. Discussion: This article informs on a program of formation of research assistants which is prone to be extended to other contexts, however its duration could be adjusted. Conclusion: The participation of undergraduate students in a research assistant formation program is a novel strategy to engage students into nursing research.

Introdução: A inserção de estudantes de graduação em atividades de pesquisa é relevante para promover a crítica e aplicação de resultados de pesquisa. A formação de assistentes de pesquisa contempla-se como una alternativa válida para os alunos se exporem, experimentarem e participarem ativamente no processo de pesquisa. Objetivo: Identificar o nível de conhecimento e grau de satisfação dos estudantes depois de participarem em um programa de formação de assistentes de pesquisa. Método: Estudo de pre e post teste de 20 estudantes de graduação de Enfermagem. Avaliou-se o conhecimento atingido e a satisfação dos estudantes com o programa de formação, o qual considera três módulos de aprendizagem distribuídos em 180 horas cronológicas. Resultados: O conhecimento dos estudantes aumentou significativamente com o programa, não se relaciona com o conhecimento que o aluno traz ao início do mesmo, assim como também não, com o semestre que cursa. O grau de satisfação foi do 100% dos alunos: muito satisfeito. Discussão: Este artigo informa um programa de formação de assistentes de pesquisa que é possível ser reproduzido em outras realidades, que aumenta o conhecimento, com um alto grau de satisfação nos estudantes. A duração do programa podia considerar-se uma debilidade. Conclusão: A participação de estudantes de graduação em um programa de formação de assistentes de pesquisa, pode considerar-se uma estratégia para envolver os alunos em pesquisa, e que valorizem seu aporte na disciplina de enfermagem.

Análisis de falsos negativos en la cintigrafía SPECT de paratiroides con sestamibi en pacientes con hiperparatiroidismo primario sometidos a cirugía entre 2008-2015 en hospital universitario / False negative spect parathyroid scintigraphy with sestamibi in patients with primary hyperparathyroidism

Background: 99mTc-sestamibi parathyroid SPECT scintigraphy is a useful tool in the pre-operative study of hyperparathyroidism. False negatives (FN) have been reported in 5.7-14% of the examinations. Aim: To characterize 99mTc-sestamibi FN in cases referred for primary hyperparathyroidism (PHP) to a university hospital. Material and Methods: Descriptive retrospective analysis. We included patients with PHP, studied with SPECT scintigraphy, operated at our center between 2008 and 2015. Clinical and surgical data were recorded; biopsies of the FN were blindly reviewed by one pathologist. Results: One hundred twenty one scintigraphies fulfilled the inclusion criteria. Seven (5.8%) were negative and 114 positive. There was no difference in age, sex and PTH levels between FN and true positive scintigraphies. At surgery, one FN case had two hyperplasic glands and two cases had ectopic glands. Pathology reported adenoma in three cases, hyperplasia in three and carcinoma in one. The largest diameter of the lesion was lower in FN (1.3 and 2.1 cm respectively, p = 0.02) and the proportion of adenomas was higher in true positive cases (29% and 75% respectively; p < 0.01). The interval between scintigraphy and parathyroidectomy was greater in FN with a median of 92 days (range 20 days-3.2 years, p < 0.01). The percentage of oxyphilic cells observed was similar in both groups. Conclusions: FN parathyroid SPECT scintigraphies in PHP are uncommon. They corresponded to lesions under the equipment's resolution limit and resulted in longer time lags between scintigraphy and surgery.

Evaluación de parámetros clínicos y de laboratorio relacionados con el diagnóstico de insulino resistencia / Evaluation of clinical and laboratory parameters related to the diagnosis of insulin resistance

The evaluation of insulin resistance (IR) in clinical practice is based on the determination of fasting insulin (I0) and insulin level after 2 hours in an oral glucose tolerance test (OGT). However, there are not adequate cutoff points to discriminate IR patients. Objectives: to evaluate the reliability of insulin levels in the diagnosis of IR using the intravenous insulin tolerance test (IVITT) as the gold standard. Patients and Method: The OGT and IVITT of patients who participated as cases or controls in research protocols were analyzed. We excluded those cases with fasting glycemia over126 mg/dl. Results: 128 cases, 111 F, 17 M; Age: 40.3 +/- 14.8 years; BMI: 33 +/- 8 kg/m2; Waist circumference, M: 100.3 +/- 9.4 cm, F: 96 +/- 15 cm. According to IVITT (KITT), 103 (80.5 percent) were IR (KITT < 4.5 percent) and 25 (19.5 percent) were non IR (KITT > 4.5 percent). Fasting (G0) and 120 minutes after glucose challenge glycemia (G120), I0 and I120, HOMA and area under the glycemia and insulin curve, were significantly higher in the IR, as the same as, hypertension and acanthosis nigricans features (p < 0.05). According to G120, 45 cases (35.2 percent) had glucose intolerance, 9 (7 percent) diabetes and 74 (57.8 percent) were normals. In addition to G0, only IVITT was significantly different among the 3 groups (p = 0.025), identifying most insulin resistant subjects. The sensitivity and specificity for a cutoff point of I120 at 60 µIU/mL, were 30 percent and 88 percent, respectively. Conclusion: Baseline and 120 minutes post glucose charge insulin levels and HOMA, do not discriminate insulin resistant subjects, especially when there is fasting or post-stimulus hyperglycemia. Therefore, they are not recommended for individual diagnosis or therapeutic decisions

Factores de riesgo cardiovascular en la población Aymara rural del norte de Chile / Prevalence of cardiovascular risk factors in a rural Aymara population from northern Chile

Background: Some rural non-Caucasian ethnic groups have genetic protective factors for the development of chronic non-communicable diseases. Studies performed in Mapuche and Aymara ethnic groups in Chile, found significantly lower prevalence rates. Aymaras are the second most common ethnic population in Chile. Aim: To determine the prevalence of cardiovascular risk factors in a native Aymara ethnic population. Material and Methods: We studied 276 native Aymara people with a median age of 53 years (63% women), registered in the rural clinics of Camiña and Putre. The frequency of hypertension, Type 2 Diabetes Mellitus (DM2), dyslipidemia, overweight, obesity and smoking were determined. Results: The frequency of overweight and obesity was 38% and 38.4% respectively. The prevalence of hypertension and DM2 were 18.5% and 6.9% respectively. Thirty-five percent had elevated total cholesterol, 21% had high LDL cholesterol, 48% had low HDL cholesterol and 45.7% had high triglyceride levels. Two percent smoked. Conclusions: In this group of Aymara individuals, we found a markedly lower prevalence of hypertension and DM2, despite the high prevalence of obesity and dyslipidemia.

Caracterización del perfil epidemiológico de las llamadas alCentro de Información Toxicológica de la Universidad Católica (CITUC), en el año 2010 / Characterization of the epidemiological profile of calls received at the Poison Information Center of the Catholic University (CITUC), in 2010

Objetivo: Describir y caracterizar el perfil epidemiológico de las llamadas recibidas en el año 2010 correspondiente a exposiciones, por el Centro de Información Toxicológica de la Pontificia Universidad Católica de Chile. Método: Se realizó un estudio retrospectivo y descriptivo de las llamadas registradas por el CITUC durante el año 2010. Se analizaron los siguientes datos: número total de llamadas, lugar de la llamada, circunstancia de la exposición, tipo y número de los agentes involucrados, vías de exposición, tiempo desde la exposición, género y edad de los pacientes. Resultados: Se registraron 29.592 llamadas. 45,2 por ciento de las consultas provenían del hogar y 53,2 por ciento de instalaciones médicas. 69,3 por ciento fueron exposiciones accidentales y 27,6 por ciento intencionales. Los medicamentos se presentaron como agente causal de una exposición en 58,4 por ciento de las llamadas, seguidos por los productos de uso doméstico (18,7 por ciento) y plaguicidas (5,8 por ciento). La ingestión fue la vía de exposición que predominó en un 79,3 por ciento del total de casos. 41,0 por ciento del total de las llamadas, se realizaron dentro de la primera hora post-exposición. Las exposiciones en niños menores de 14 años correspondieron a 51,6 por ciento de las llamadas. Conclusiones: Los medicamentos constituyen el principal agente involucrado en intoxicaciones. La principal vía de exposición es la ingesta y el principal grupo de población afectado son los niños menores de 14 años,. Estos indicadores muestran la necesidad imperante de desarrollar campañas de prevención e información avaladas por el Ministerio de Salud, respecto al correcto uso de los medicamentos, como también la introducción del envase resistente ala manipulación de los niños y la educación de la población.

Objective: To describe and to characterize the epidemiologoc profile of the entering pone calls in 2010 belonging to exposures by the Centro de Información Toxicológica de la Pontificia Universidad Católica de Chile. Method: A retrospective and descriptive study of pone calls registered by the CITUC has been made during 2010. The following has been analyzed: total pone calls number, place of the call, exposure circumstances, kind and number ofagents involved, exposure way, time from exposure, gender and age of the patients. Outcomes: 29.592 phone calls were registered. 45,2 percent of the questions came from home and 53,2 percent from medical institutions. 69,3 percent were non intented exposures and 27,6 percent were intented. The drugs were the causal agent of exposures in 58,4 percent of the phone calls, followed by cleaning use products (18,7 percent) and insecticides (5,8 percent). Swallowing was the predominant exposure way with 79,3 percent of the total. 41 percent of total of phone calls, were made in the first hour after exposure. The children under 14 years exposure cases, were were 51,6 percent of total phone calls. Conclusions: Medical drugs are the principal involved agent in intoxications. The main way of exposition is swallowing and the major population group involved is children under 14 years. These indicators shows the need of developing prevention and information campaigns supported by Secretary of Health, oriented to right use of drugs, as well as the use of safety drug boxes for children and population education.

Consumo de tabaco y uso del consejo médico estructurado como estrategia preventiva del tabaquismo en médicos chilenos / The influence of smoking habits of Chilean physicians on the use of the structured medical advice about smoking

Background: Structured medical advice on smoking is the prevention strategy with better cost-effectiveness ratio. Aim: To evaluate smoking among health care providers affect the application of this preventive strategy. Material and Methods: We surveyed 235physicians working in public and private hospitals in different cities over the country, about their smoking habits, their views on smoking as cardiovascular risk factor and the implementation of three key points of the structured medical advice about smoking. Results: Physicians aged less than 44 years had the lower frequency of smoking and the higher frequency of ex-smokers concentrated among those aged 60 years or more. All surveyed physicians agreed that smoking is a cardiovascular risk factor. However, 21% considered that this risk appears only among those that smoke more than three cigarettes per day. Independent of their smoking habits, 18% of physicians not always ask their patients about smoking, 25% do not warn about the risk of smoking and 22% not always give advice about quitting. This last action is carried out with a significantly lower frequency by smoking physicians. Conclusions: To improve physician's compliance with their preventive role in clinical practice, it is essential to consider their own smoking habits, and the information and attitudes that they have towards smoking as a cardiovascular risk factor.

Contenidos de Anatomía en Diseños de Aprendizaje Dispuestos en LAMS e Integrado a Moodle / Anatomy Contents in Learning Designs Displayed in LAMS and Integrated to Moodle

Este trabajo trata la experiencia del uso de LAMS en procesos de aprendizaje e-learning para el área de la salud. Se trabajó con contenidos de anatomía del hígado humano, siguiendo estándares educativos y metodologías necesarias para crear Diseños de Aprendizaje (LD) y recursos educativos de calidad e interoperables. El Instituto de Anatomía, Histología y Patología fue responsable del diseño e implementación de Objetos de Aprendizaje (OAs) en anatomía de hígado (con Macromedia flash), mientras el Instituto de Informática se encargó de abordar la gestión y proceso del recurso pedagógico, integrando un especialista (LAMS y Moodle) para el diseño y gestión de aprendizaje. LAMS fue usado para crear actividades de aprendizaje basado en LD integrado a Moodle, como parte de un curso de estudiantes de medicina. La encuesta de satisfacción aplicada a estos estudiantes mostró, que casi el 70 por ciento de ellos consideró las actividades y objetivos comprensibles y suficientemente detallados, que las evaluaciones fueron coherentes con los contenidos y que existe aprendizaje colaborativo. Así mismo el 67 por ciento aseguró que volvería a usar un plan de lección en esta modalidad y sólo un 33 por ciento lo haría ocasionalmente.

This work relates to the experience of using LAMS in e-learning learning processes in the area of Health Sciences. This work was developed for the target subject matter of Human Liver Anatomy, following educational standards and the necessary methodologies to create Learning Designs (LD) and high-quality, interoperable, educational resources.The Institute of Anatomy, Histology, and Pathology was in charge of the design and implementation of the Learning Objects (LOs) in Liver Anatomy (using Macromedia Flash), while the Informatics Institute was in charge of the administration and processing of the pedagogical resource, integrating a specialist (LAMS and Moodle) for learning design and management. LAMS was used to create learning activities based on a Moodle integrated LD, as part of a medical students course. The satisfaction questionnaire applied tothese students showed that nearly 70 percent of them considered the activities and objectives to be comprehensible and at the right level of detail, the evaluations to be coherent with the subject matter of the course, and in their opinion there was collaborative learning. Likewise, 67 percent assured that they would use a lesson plan in this modality again, and only 33 percent said they would do it occasionally.

Alta frecuencia de anticuerpos anti-tiroperoxidasa (ATPO) positivos en sujetos adultos, sin patología tiroidea conocida, de Santiago de Chile / Frequency of positive anti thyroid peroxidase antibody titers among normal individuals

Background: Anti-thyroid peroxidase antibodies have a pathogenic role in Hashimoto thyroiditis. Between 10 and 19 percent of individuals without thyroid disease, have positive titers of these antibodies. Aim: To study the frequency of positive titers of anti-thyroid peroxidase antibodies in healthy individuals. Material and Methods: A blood sample, to measure anti-thyroid peroxidase antibodies and thyroid stimulating hormone (TSH) by chemoluminiscense assay, was obtained from 67women and 62 men aged 45 ± 14years, without a personal or familiar history of thyroid diseases and normal thyroid palpation. The cutoff point of the manufacturer to consider positive a titer of anti-thyroid peroxidase antibodies was set at 35 IU/ml. Results: Twenty-eight women and 28 men had positive antibody titers (43 percent of the sample). Subjects in the upper tercile of anti-thyroid peroxidase antibody titers had a higher TSH than those in the second tercile, although within normal limits (1.73 ± 0.74 and 1.37 ± 0.59 mlU/L, respectively p = 0.02) Conclusions: Forty three percent of the studied subjects without personal or familial history of thyroid diseases had positive titers of anti-thyroid peroxidase antibodies. Further prospective studies should evaluate whether this observation discloses an increase in thyroid autoimmune disease in a population with increased iodine intake.

Estudio comparativo de los hallazgos electrocardiográficos en colonias india y china en la ciudad de Iquique, Chile / Characteristics of the electrocardiogram in subjects from Indian or Chinese descent living in Iquique, Chile

Introducción: La migración intrínsicamente implica la necesidad de adaptación a nuevos estilos de vida, siendo más radical cuando se trata de países tan lejanos y distintos, como India o China. Las variantes electrocardiográficas en estas culturas están siendo ampliamente estudiadas para entender cuando estos cambios son una anomalía o una adaptación fisiológica normal. Por este motivo se hace imperativo investigar sobre hallazgos electrocardiográficos de una población en constante aumento en nuestra sociedad. Objetivo: Evaluar los hallazgos electrocardiográficos en 2 poblaciones de inmigrantes asiáticos con más de 2 años de residencia en Iquique, Chile. Metodología: Estudio analítico, descriptivo de corte transversal. Análisis de electrocardiograma (ECG) de 12 derivaciones, frecuencia cardíaca, intervalos PR, QTc y conclusiones diagnósticas del trazado. Resultados: El grupo Chino (CHI) de 43 pacientes (37,2 por ciento mujeres), edad de 39,5+13 años. Grupo Indio (IND) de 41 pacientes (48,8 por ciento mujeres) con edad promedio de 38,6+10 años. CHI se encontró un 79,1 por ciento de trazadosalterados con 55,8 por ciento Bloqueo incompleto de Rama Derecha (BIRD), 11,6 por ciento que mostraba signos de Bloqueo completo de Rama Derecha (BCRD), y un 11,6 por ciento presento un QTc alargado. IND el 75,6 por ciento de los pacientes tenía un ECG dentro de los límites normales, los ECG alterados mostraban a un 14,6 por ciento con BIRD y la pesquisa de QTc alargado fue de un 2 por ciento de la población. Conclusión: Existe un alto porcentaje de pacientes chinos con electrocardiogramas alterados y especialmente con bloqueos de rama derecha, lo que hace necesario estudiar las causas y el rol que tendría la occidentalización y las anomalías genéticas en esto.

Background: Immigration implies the adaptation to new life styles and these changes are more complicated when countries are far way as is the case between Chile and both India an China. It is uncertain whether the electrocardiographic differences between these populations reflect adaptation changes or are just differences in normal patterns for each population. Aim: to analyze characteristics of the electrocardiogram in subjects of Indian or Chinese descent living more than 2 years in Iquique, Chile. Method: We analyzed the heart rate (HR), PR interval, and QTc in 12 lead EKGs from subjects of Indian orChinese descent. Results: 43 subjects (37.2 percent women), aged 39.5±13 years were included in the Chinese group (CHI); 41 subjects (48.8 percent women), aged 38.6±10 years were included in the Indian group (IND). 79.1 percent of EKGs in the CHI group were abnormal: incomplete right bundle branch block (RBBB) was present in 55.8 percent 11.6 percent had complete RBBB and 11.6 percent a prolonged QT. On the other hand 75.6 percent of subjects in the IND group had a normal EKG; abnormalities included incomplete RBBB in 14.6 percent and prolonged QT in 2 percent. Conclusion: A high percentage of subjects of Chinese descent living for more than 2 years in Iquique, Chile, exhibit electrocardiographic abnormalities, mainly RBBB. Further study is needed to eucidate whether genetic differences or adaptation to new conditions underlie these characteristics.

Impacto de la occidentalización sobre factores de riesgo cardiovascular en inmigrantes asiáticos residentes en el Norte Grande de Chile / Cardiovascular risk factors in Asian populations migrating to the north of Chile

Antecedentes: Existen pocos estudios clínicos que muestren la relación entre la migración de poblaciones y el aumento en enfermedades cardiovasculares. Objetivo: Comparar factores de riesgo cardiovascular (FRCV) entre colonias chinas (CHI) e indias (IND) residentes en Chile. Metodología: Estudio analítico-descriptivo, transversal. Se analizó a la colonia china (n=43) e india (n=41), incluyendo a los residentes en Chile por más de dos años. Se rnidió: peso, talla, perímetro de cintura (PC), indice de masa corporal (IMC), presión arterial, sedentarismo, hábitos alimentarios, trastornos depresivo y ansiosos, y adicción a! tabaco, además de examen psiquiátrico según DMS-IV Se midieron niveles plasmáticos de triglicéridos, colesterol, hormonas tiroideas, glicemia en ayunas y post-prandial, insulinemia basal y post -sobre carga de glucosa. Análisis Estadístico: T de student, Chi cuadrado. Resultados: Encontramos un peso promedio de 71 +/- 10 en IND v/s 66 +/- 14 kg en CHI, PC 89 +/- 11 v/s 79 +/- 12 cm, IMC 27 +/- 4 v/s 24 4, colesterol total 201 +/- 41 v/s 180 +/-35 mg/dl, colesterol HDL 43 +/- 11 v/s48 +/- 13 mg/dl, Colesterol LDL 125 +/- 33 v/s 107 29 mg/dl, TSH 7.3 +/- 6 v/s 1.8 +/- 1.2 uUl +/-ml, Insulinemia post-prandial 93 +/- 89 v/s 39 +/- 34 Ul/mI, respectivame+/-nte, además de sedentarismo 11 en IND v/s 2 en CHI, hábitos alimentarios sanos 26 v/s 39, beber problema 20 v/s 34, adicción al tabaco 8 v/s 17, Síndrome Metabólico 14 v/s 6, siendo todas estas diferencias significativas. En ambos grupos no se encontraron trastornos depresivos ni ansiosos. Conclusiones: Encontramos un serio impacto del fenómeno migratorio en FRCV de IND, lo que impulse a fomentar cambios en estilos de vida de esa población. Es notable la ausencia de patologías depresivas y ansiosas en ambos grupos.

Background: few clinical studies show a relation between migration and an increase prevalence of cardiovascular diseases. Aim: to study the prevalence of cardiovascular risk factors, including the metabolic syndrome, in Indian and Chinese natives flying in Chile for more than 2 years. Methods: Subjects from either Indian or Chinese origin living in Chile for more than 2 years were evaluated for the presence of cardiovascular risk factors. Wight. height, girth index, body mass index, blood pressure. degree of sedentarism, type of foods and pattern of eating and smoking habits were determined. Plasma lipid, thyroid hormone, fasting and post glucose load (75g) sugar and insulin levels were determined. DSM IV was used to evaluate subjects for the presence of depression or anxiety. Students t test and chi square tests at and alpha level of 5 percent were used to determine statistical significance, as appropriate. Results: Significant differences between the Indian and Chinese groups were, respectively: weight (71.4 vs 66.5, p<0.04); girth index (89.1 vs 79.2, p<0.002); BMI (26.9 vs 23.9 p<0.002); total cholesterol (201.6 vs 180.1 (p<0.05); HOL cholesterol (43.4 vs 47.9, p<0.04); LOL cholesterol (125 vs 107, p<0.004); TSH (7.3 vs 1.8, p<0.036),’ post glucose load insulin level (93.1 vs 39.1, p<0.002). A comparison of the Indian vs the Chinese group also showed relevant differences in presence of sedentarism (11 percent vs 2 percent, p<0.02); healthy eating habits (26 vs 39 percent, p<0.02); excessive alcohol consumption (20 vs 34 percent, p<0.03); tobacco addiction (8 vs 17 percent, p<0. 046) and presence of metabolic syndrome (14 vs 6 percent, p<0. 029). Psycho social problems like presence of depression or anxiety disorders were not detected in any group. Conclusion: The original Indian subjects had a high prevalence of several cardiovascular risk factors, making necessary the promotion of healthy life styles in that population.

Evaluación por inmunohistoquímica de la expresión de hormonas hipofisiarias y del marcador de proliferación celular Ki-67 en tejido de adenomas causantes de acromegalia / Immunohistochemistry for pituitary hormones and Ki-67 in growth hormone producing pituitary adenomas

Background: Growth hormone (GH) producing adenomas, frequently express several hormones. This condition could confer them a higher proliferative capacity. Ki-67 is a nuclear protein antigen that is a marker for proliferative activity. Aim: To measure the immunohistochemical hormone expression in pituitary adenomas, excised from patients with acromegaly. To determine if the pluríhormonal condition of these adenomas is associated with a higher proliferative capacity, assessed through the expression of Ki-67. Material and methods: Forty one paraffin embedded surgical samples of pituitary adenomas from patients with acromegalia were studied. Immunohistochemistry for GH, prolactin (PRL), follicle stimulating hormone (FSH), luteinizing hormone (LH), thyroid stimulating hormone (TSH), adrenocorticotropin (ACTH) and for the expression of Ki-67 was carried out. Results: All samples were positive for GH. Twenty seven had positive staining for PRL, 12 had positive staining for glycoproteic hormones and 11 for PRL and one or more glycoproteic hormones. Mean staining for Ki-67 was Z.6±3.3 percent. There were no differences in the expression of this marker between mono or pluríhormonal tumors. The expression was neither associated with extrasellar extensión. Conclusions: Half of GH producing pituitary adenomas are pluríhormonal. There are no differences in the expression of Ki-67 between mono and plurihormonal adenomas.

Cintigrafía pulmonar por perfusión en niños con daño pulmonar crónico: resultados preliminares de la aplicación de la técnica SPECT / Lung perfusion scintigraphy in children with chronic lung damage: preliminary results of the application of SPECT technique

El objetivo fue describir los hallazgos del SPECT de perfusión pulmonar (SPP) en niños con daño pulmonar crónico. Material y Método: Se revisaron 106 SPP de niños (edad promedio: 3,9± 3,3 años) con daño pulmonar crónico realizados con gammacámara doble cabezal. Los diagnósticos más frecuentes fueron secuela de BNM por adenovirus (ADV) (29 por ciento), daño pulmonar crónico de etiología desconocida (DPED) (21 por ciento), displasia broncopulmonar (DBP) (15 por ciento), y síndrome bronquial obstructivo (SBO) (14 por ciento). El grado de alteración se evaluó utilizando un Score, que consideró extensión y tipo de compromiso y perfusión pulmonar diferencial. El tipo de compromiso y Score fueron correlacionados con diagnóstico y sexo. Resultados: El 91 por ciento (96/106) de los estudios fueron anormales (62 por ciento varones), 52 (54 por ciento) con alteraciones bilaterales, más frecuentes en varones (p:0,019). El grupo ADV mostró principalmente (35 por ciento) un patrón mixto bilateral, el DPED uno unilateral focal (32 por ciento), el SBO uno unilateral difuso (33 por ciento), y la DBP uno normal (25 por ciento). Misceláneas y DPED presentaron los Score más altos (alteraciones severas), y DBP y SBO los más bajos. Conclusión: En esta población el SPP se altera en una alta proporción con algunas características diferenciales según sexo y etiología.

Role of stress and sympathetic innervation in the development of polycystic ovary syndrome

This work attempts to give a review of ovarian innervation, the mechanism of regulation of nerve activity and the role of the sympathetic activity in ovarian pathologies affecting reproductive function. We provide a succinct outline of the findings of our group in this area. The participation of stress as an etiological factor for ovarian pathologies throughout animal models and preliminary data in patients with polycystic ovary syndrome give strong support for a participation of sympathetic nerves in the ovary function both in normal and pathological states.

Espátulas rectas paralelas de Velasco: experiencia del servicio con un nuevo instrumento extractor del feto en el período expulsivo detenido / Velasco spatules: experience of the service with a new fetus extraction instrument

Se presentan las espátulas rectas y paralelas de Velasco (ERV), se describe el instrumento, sus características y se da a conocer una experiencia preliminar en un período de 3 años entre 1997 y 2000 y los resultados obtenidos en nuestro servicio de parto con fetos expulsivos detenidos y alteraciones de sus latidos cardíaco