Evaluación de la terapia de reproducción médicamente asistida en 9 años: estudio de cohorte retrospectivo / Medically assisted reproductive therapy assessment in 9 years: retrospective cohort study

OBJETIVO: Describir las tasas de recién nacidos vivos (RNV) y embarazo de la terapia de reproducción médicamente asistida de baja complejidad del Centro de Reproducción Humana de la Universidad de Valparaíso, Chile. MÉTODO: Estudio retrospectivo de todos los ciclos de estimulación ovárica controlada con inseminación intrauterina (IIU) completados, entre los años 2011 y 2019. Se evaluaron las características clínicas basales y los resultados en IIU homólogas y heterólogas según el ciclo inseminado, la causa de infertilidad, el rango etario y el índice de masa corporal (IMC). El desenlace principal fue la tasa de RNV por ciclo inseminado. RESULTADOS: Se estudiaron 1415 ciclos en 700 parejas. La tasa acumulativa de RNV fue del 19,6%, un 18,3% en IIU homóloga y un 39,0% en IIU heteróloga. La tasa de RNV fue del 10,0% al primer ciclo, del 5,8% al segundo ciclo y del 3,7% al tercer o más ciclos. Al separar por IIU heteróloga, esta aumenta al 24,4% al primer ciclo y al 14,6% al segundo ciclo. La tasa de RNV es significativamente mejor en pacientes menores de 35 años (23,7%) y con IMC < 29 (20,8%). CONCLUSIONES: El tratamiento de baja complejidad en pacientes infértiles es una opción terapéutica vigente con una aceptable tasa de RNV por ciclo inseminado. Los resultados están influenciados por la edad y por el IMC.

OBJECTIVE: To describe the rates of live newborns (LNB) and pregnancy of the low complexity therapy of the Centre for Human Reproduction of Universidad de Valparaíso, Chile. METHOD: Retrospective study of all cycles of controlled ovarian stimulation with intrauterine insemination (IUI) completed between 2011-2019. The baseline clinical characteristics and results in homologous and heterologous IUI were evaluated according to inseminated cycle, cause of infertility, age range and body mass index (BMI). The main outcome was rate of LNB per inseminated cycle. RESULTS: 1415 cycles were studied in 700 couples. The cumulative rate of LNB was 19.6%, 18.3% in homologous IUI and 39.0% in heterologous IUI. The LNB rate was 10.0% at the first cycle, 5.8% at the second cycle, 3.7% at the third or more cycles. When separating by heterologous IUI, it increases to 24.4% in the first cycle and 14.6% in the second cycle. The LNB rate is significantly better in patients under 35 years of age (23.7%) and with a BMI less than 29 (20.8%). CONCLUSIONS: Treatment of low complexity in selected infertile patients is a current therapeutic option with an acceptable rate of LNB per inseminated cycle. The results are influenced by age and BMI.

Alteraciones de Número en Dentición de Pacientes entre 2 y 12 Años de Edad con Disrafias Labio Alvéolo Palatina Atendidos en la Unidad de Odontopediatría del Hospital Regional Antofagasta, Chile / Dentition Number Alterations in Patients between 2 and 12 Years of Age with Cleft Alveolus Palate Examined at the Pediatric Dental Unit of the Regional Hospital Antofagasta, Chile

Se realizó un estudio de las alteraciones de número dientes en 71 pacientes entre 2 y 12 años de edad, portadores de Fisura Labio Alvéolo Palatina del Hospital Regional de Antofagasta, atendidos entre Abril del 2004 y Julio del 2010, utilizando las fichas clínicas, radiografías panorámicas, oclusales o periapicales. Se encontró una prevalencia de agenesias dentarias en un 57,75%, de dientes supernumerarios en un 23,95%. Sólo el 18,4% de los niños no presentó alteraciones de número. En la distribución por sexo, en los niños la fisura labial y fisura labio alvéolo palatina bilateral presentó una mayor frecuencia, mientras que en las niñas las fisuras palatinas y fisuras labio alvéolo palatinas unilaterales fueron más frecuentes. Según el tipo de fisura, la más frecuente fue la fisura labio alvéolo palatina unilateral con un 64,79%. La frecuencia de agenesias en el lado de la fisura fue de un 89,3%. El diente más afectado en las agenesias fue el incisivo lateral con un 78,6% en los niños entre 2 a 6 años, y con un 100% en los niños entre 7 y 12 años. Se observó que el 61,5% de los niños con agenesia tenían 1 diente afectado, el 30,8% mostraron 2 dientes afectados y solo el 7,7% presentó 3 o más dientes afectados.

The present study was carried out to research alterations of teeth in 71 patients, whose ages were between two and twelve years old and who exhibited alveolus cleft lip palate. These patients were treated at The Regional Hospital in Antofagasta around April 2004 and July 2010, therefore, we used the tabs clinics, panoramic radiograph, occlusal and periapical radiographs. A prevalence of tooth agenesis in 57.75% of supernumerary teeth in 23.95% was found and 18.4% of children did not show any modification of number. In connection with the distribution by sex of the cleft lip and cleft lip bilateral alveolar palatine presented a high frequency in boys , and the palate clefts with fissure unilateral alveolus cleft lip were frequently observed in girls. Regarding to the types of cleft lip, the most frequent found was the alveolar cleft lip palate unilateral with 64.70% over the total of the fissures. On the other hand, the frequency of agenesis, related to fissure was 89.3%. The most affected tooth in agenesis was the lateral incisor with 78.6% in children whose ages were from 2 to 6 years old, and 100% in children from 7 to 12.It was also observed that 61.5% of children with agenesis had one affected tooth, 30.8 % had two affected teeth and only 7.7% had three or more affected teeth.

Genotipo y fenotipo de la enzima tiopurina metiltransferasa en población chilena / Phenotype and genotype of thiopurine methyltransferase in Chilean individuals

Background: Thiopurines (azathioprine and 6-mercaptopurine) are highly effective medications but with potential adverse effects. Thiopurine methyltransferase (TMPT) is the key enzyme in their pharmacokinetics and is genetically regulated. A low activity of TPMT is associated with myelotoxicity. The genotype and enzyme activity can vary by ethnicity. Aim: To study the activity and genotype of TPMT in a group of Chilean subjects. Material and Methods: In 200 healthy adult blood donors, TPMT activity was determined by high performance liquid chromatography (HPLC). Deficient, low, normal or high levels were defined when enzymatic activity was < 5, 6-24,25-55 and > 56 nmol/grHb/h, respectively. Genotyping of TPMT (*1, *2, *3A, *3B, *3C) was performed by PCR. Results: Seventy seven women (38.5%) and 123 men (61.5%), with an average age of 34.9 years were studied. Eighteen subjects (9%) had a low enzymatic activity, 178 (89%) had normal activity, 4 (2%) had high activity and no genotype deficient subjects were identified. The wild type genotype (*1) was found in 184 (92%) individuals and 16 (8%) were heterozygous for the variants: *2 (n = 2), *3A (n = 13) and *3C (n = 1). No homozygous subjects for these variants were identified. Wild type genotype had an increased enzymatic activity (40.8 ± 7.2 nmol/gHb/h) compared to heterozygous group (21.2 ± 3 nmol/ gHb/h; p < 0.001). Conclusions: Less than 10% of a Chilean population sample has a low enzymatic activity or allelic variants in the TPMT gene, supporting the use of thiopurines according to international recommendations.