Auditoría de oxígenoterapia de pacientes hospitalizados en establecimientos del Servicio de Salud Talcahuano / Audit on oxygen therapy in hospitalized patients from Public Health Service of Talcahuano, Chile

El oxígeno (O2) es una de las drogas más utilizadas en clínica, su uso no está exento de riesgos. Existen guias internacionales para su uso, pero en nuestro medio no sabemos si se aplican. Nuestro objetivo fue describir la forma en que se utiliza y controla la oxígenoterapia en los 3 hospitales de la red del Servicio de Salud Talcahuano. Aplicamos una encuesta un día de agosto de 2016 a los pacientes hospitalizados en las instituciones de la red que recibían O2 en ese momento. Se recolectaron datos sobre la prescripción, administración y seguimiento de la terapia de O2. De los 381 pacientes auditados, un 13,7% recibía oxígenoterapia. Los diagnósticos más frecuentes fueron de causa respiratoria (46,15%) y cardiológica (25%). La indicación la dio un médico en 88,5% de los casos y en un 3,8% no había registro. En un 17,3% de los pacientes no había fundamento para la indicación. Se indicó una dosis fija en el 75% con una meta de SaO2 en el 50%, siendo naricera y máscara de Venturi los métodos de administración más frecuentes monitorizándose con oximetría de pulso en los hospitales menos complejos y gasometría arterial en el hospital terciario. La duración media de la oxígenoterapia fue de 7,8 días. Habiendo un buen fundamento y control de la oxígenoterapia aún no se indican metas a obtener. No hay un buen registro de la indicación ni de los cambios realizados. Creemos útil la realización periódica de este tipo de control para optimizar su uso evitando los potenciales efectos adversos en los pacientes.

Abstract Oxygen is a commonly used drug in clinics and its use must be judicious. There are guidelines for oxygen therapy but we ignore if these are respected in our country. We conducted an audit of oxygen therapy by applying a survey to 381 patients in the three hospitals of Talcahuano Public Health Service. The day of the audit 13.7% of the hospitalized patients were on oxygen, most of them with respiratory (46.15%) or cardiovascular (25%) diseases. Indication of O2 administration was given by a physician in 88.5% and there was not registry in 3.8% of the cases. There was not foundation for supplying O2 in 13.3% of patients. A fixed dose was indicated in 75% of cases and 50% had an oximetry value as a target. Oxygen was administered in most of the cases by nasal prongs and Venturi masks. Monitoring was based on pulse oximetry in the less complex hospitals and on arterial blood gases in the tertiary hospital. 100% of patients at urgency ward were receiving a different dose from that indicated at their admission time and none of them had a registry of the new dose. Mean duration of therapy was 7.8 days. We believe our results might represent what is going on with oxygen therapy in our country; having a good foundation and monitoring, we still don t use targets and there is a bad system of registry. We think that it would be advisably to carry out audits on oxygen therapy at national level on regular basis.

Composición de ácidos grasos (MUFA y CLA) en tejido muscular de bovino relacionado con la presencia del polimorfismo g.878TC en el gen SCD / Fatty acid composition (MUFA and CLA) in bovine muscle tissue related with the presence of the g.878TC SCD gene polymorphism

El tejido muscular de muchos animales domésticos es fuente de proteínas, grasa y minerales para los seres humanos y está compuesto por una serie de estructuras que le otorgan propiedades nutricionales y bioquímicas. En los ultimos años se ha identificado un polimorfismo de único nucleótido (SNP) en el gen SCD (g.878TC), que influye sobre la composición de ácidos grasos en los bovinos. El objetivo de este estudio fue determinar la presencia del SNP g.878TC en músculo Longissimus dorsi de bovino (Bos taurus) por medio de la técnica PCR-RFLP. Fue utilizada una muestra de 100 novillos de raza Aberdeen Angus criados y sacrificados en la Región de La Araucanía (Chile). La frecuencia genotípica del polimorfismo fue de: 0,33 para TT, 0,43 para TC y 0,24 para el genotipo CC. La frecuencia alélica fue de 0,54 para el alelo T y 0,63 para el alelo C. De acuerdo a la composición de ácidos grasos, se determinó que existe una relación positiva entre el genotipo CC y el contenido de ácidos grasos MUFA y CLA presentes en el músculo Longissimus dorsi de novillos Angus. Por lo tanto, el SNP g.878TC podría ser considerado como un marcador genético para la selección de animales Aberdeen Angus, con una composición de ácidos grasos más saludable...

The muscle tissue of many domestic animals is a source of protein, fat and minerals to humans and consists of a series of structures that give nutritional and biochemical properties. In recent years it has identified a single nucleotide polymorphism (SNP) in the SCD gene (g.878TC), which influences the fatty acid composition in cattle. The aim of this study was to determine the presence of SNP g.878TC in Longissimus dorsi bovine (Bos taurus) using the PCR-RFLP. It was used a sample of 100 Aberdeen Angus steers raised and slaughtered in the region of Araucania (Chile). Polymorphism genotype frequency were: 0.33 for TT, 043 for CT and 0.24 for the CC genotype. The allelic frequency was 0.54 for the T allele and 0.63 for allele C. According to the fatty acid composition was determined that a positive relationship between genotype CC and the content of MUFA and CLA fatty acids present in the Longissimus dorsi muscle of Angus steers. Therefore, the SNP g.878TC could be considered as a genetic marker for selection of animals Aberdeen Angus, with a fatty acid composition more healthy...

Detección del polimorfismo en el gen del receptor de melatonina (MT1) en la oveja criolla Araucana / Detection of MT1 melatonin receptor gene polymorphism (MT1) in the Araucana creole sheep

La melatonina es una hormona que regula los ciclos circadianos y muchos de los aspectos reproductivos de los mamíferos y es secretada por la glándula pineal en las horas de ausencia de luz. Esta hormona posee receptores de alta afinidad acoplados a proteínas de tipo G, denominados MT1. Un polimorfismo de la secuencia que codifica para estos receptores estaría involucrado en el control de la reproducción estacional de los ovinos. El propósito de este estudio busca determinar la presencia del polimorfismo del receptor MT1 en la oveja criolla Araucana, un ovino local en el que se ha registrado un corto anestro reproductivo. Para poder realizar este trabajo se utilizó la técnica denominada reacción en cadena de la polimerasa para polimorfismo en el tamaño de los fragmentos de restricción PCR-RFLP, para lo cual, se obtuvieron muestras de ADN genómico de 50 ovejas Araucanas, las cuales fueron digeridas con la endonucleasa de restricción Mnl1. Se logró identificar la presencia del polimorfismo del receptor MT1 en la oveja Araucana. Los genotipos se hallaron en una frecuencia de 68 por ciento para el genotipo +/+, 28 por ciento para el genotipo +/- y4 por ciento para el genotipo -/-. Este alto porcentaje de animales con genotipo +/+ podría explicar el corto anestro reproductivo que presenta esta raza.

Melatonin is a hormone that regulates circadian rhythms and many of the reproductive aspects of mammals and is secreted by the pineal gland during the hours of absence of light. This hormone has high affinity receptors coupled to G-like proteins, termed MT1. A polymorphism of the sequence coding for these receptors was involved in the control of seasonal reproduction in sheep. The purpose of this study was to determine the presence of MT1 receptor polymorphism in Araucana creole sheep, a local breed with a short reproductive anestrus. To carry out this work, we used a technique called polymerase chain reaction-restriction fragment lengh polymorphism PCR-RFLP, for which samples were obtained from genomic DNA of 50 Araucana sheep, which were digested with Mnl1 restriction endonuclease. It was possible to identify the presence of MT1 receptor polymorphism in Araucana sheep. The genotypes were found in a genotype frequency of 68 percent for genotype + / +, 28 percent for genotype + / - y4 percent for genotype - / -. This high percentage of animals with genotype + / + could explain the short reproductive anestrus featuring this breed.

Use of morphometric variables for differentiating spanish hound breeds / Uso de variables morfométricas para la diferenciación de razas de sabueso español

The term Podencos refers to a group of dog breeds from Spain and classification in Group 5 of dog breeds by the Fédération Cynologique Internationale (FCI). The aim of this study was to compare traits morphometric breeds of Podencos; Canario, Ibecenco, Andaluz (small, medium and large) and Orito. Ten morphometric variables were measured in 385 animals (245 females and 140 males), head length, muzzle length, height at withers, rump height, body length, head width, rump width, chest depth, chest girth and the shin circumference. Morphostructural variables were more homogeneous in the Podenco Ibicenco and the Podengo Canario, because for many years there were gradually distinctive trait standards for each breed. The discriminate analysis indicated morphostructural differences between all breeds, as reflected in the significant Mahalanobis distance, and confirmed that the hound Orito may be accepted as a different dog population.

El término Podencos se refiere a un grupo de razas de perros originarios de España y clasificados en el grupo 5 de razas caninas por la Federación Cinológica Internacional (FCI). El objetivo del presente trabajo fue comparar caracteristicas morfométricas de las razas caninas de Podencos; Canario, Ibecenco, Andaluz (pequeño, medio y grande) y Orito. Se midieron diez variables morfométricas en 385 animales (245 hembras y 140 machos); longitud de la cabeza, la longitud hocico, altura a la cruz, alzada a la grupa, la longitud del cuerpo, ancho de la cabeza, ancho de la grupa, la profundidad del pecho, la circunferencia del pecho y la circunferencia de la caña. Las variables morfoestructurales fueron más homogéneas en el Podenco Ibicenco y el Podenco Canario, porque por muchos años fueron fijados gradualmente los rasgos distintivos para los estandares de cada raza. El análisis discriminante manifestó diferencias morfoestructurales entre todas las razas, lo que se refleja en la significativa distancia de Mahalanobis, y confirmó que el podenco Orito puede ser aceptado como una población de perros diferentes.

Tiroiditis crónica de Hashimoto: Serie clínica / Hashimoto chronic thyroiditis: Retrospective analysis of 228 patients

Background: Chronic Hashimoto Thyroiditis (CHT) is the main cause of hypothyroidism. Aim: To report a series of patients with CHT. Material and Methods: Retrospective analysis of a series of 27 men aged 38 ± 14 years and 201 women aged 37 ± 16 years, evaluated in the private offces of two of the authors. Results: Fifty six percent of patients only had unspecifc symptoms at the moment of consultation, 50 percent had a family history of thyroid diseases and only 21 percent of women had a previous history of goiter. Eighty one percent of patients had clinical or subclinical hypothyroidism, 62 percent had both antithyroglobulin and antithyroid peroxidase positive antibodies and 13 percent had both antibodies negative. Only 1.4 percent of patients had a normal thyroid ultrasound examination. Patients were treated with levothyroxine at a mean dosage of 75 µg/day and 53 percent achieved an adequate TSH level. Six of ten patients operated due to nodules had a papillary carcinoma. Conclusions: CHT should be sought in the general population, especially those with a family history of thyroid disease. Thyroid ultrasound is seldom normal in patients with CHT. Thyroid substitution should be monitored periodically to achieve adequate TSH levels.

Panhipopituitarismo y diabetes insípida secundarios a hipofisitis linfocitaria en una paciente con trisomia 12p / Panhypopituitarism and diabetes insipidus secondary to a lymphocytic hypophysitis in one patient with trisomy 12p

Lymphocytic hypophysitis (LH) is an uncommon inflammatory disease of the hypophysis. It's female to male ratio of appearance is 9:1. Pregnant women are more affected during the third trimester of pregnancy or postpartum. Clinical and radiological presentation can simulate a hypophyseal adenoma. We report a nonpregnant 13 years old adolescent, with a trisomy 12p, with panhypopituitarism, diabetes insipidus and a selar tumor. It was necessary to differentiate between a germinoma and a LH. The latter was confirmed with the hypophyseal biopsy.

Frecuencia de aneurisma aórtico abdominal en población adulta con factores de riesgo conocidos / Frequency of abdominal aortic aneurysms in adult population with known risk factors

BACKGROUND: The incidence of abdominal aortic aneurysms has increased. Its predisposing factors are smoking, high blood pressure and dislipidemia. Progressive aneurysmal enlargement may lead to its rupture, which is associated to a mortality rate above 80 per cent. AIM: To assess the prevalence of abdominal aortic aneurysms in Chilean subjects with cardiovascular risk factors. SUBJECTS AND METHODS: Through announcements in open media we invited individuals aged over 60 years, who smoked, had hypertension and/or had occlusive arterial disease, to participate in a study that included medical history and physical examination. An aortic ultrasound was performed in all subjects in whom the aorta was not palpable or there was a suspicion of dilatation. Aortic diameter over 3 cm was considered aneurysmal. RESULTS: Three hundred fifty six subjects aged 67.1 +/- 6.7 years, (73.9 per cent males), were evaluated. The study group included 62 per cent hypertensives, 39 per cent with abnormal lipids and 46 per cent smokers. Known coronary heart disease or peripheral arterial diseases were present in 14 per cent and 10 per cent, respectively. Ultrasound was required in 159 subjects. Aneurysms were detected in 21 persons (5.9 per cent), 7.6 per cent in males and 1.1 per cent in females. The mean transverse diameter of the aneurysm was 4.1 cm (3-7.5). Aneurysm was found in 2.3 per cent of subjects younger than 65 years and 8.3 per cent of subjects aged over 65 years. CONCLUSIONS: In this sample the prevalence of abdominal aortic aneurysms was 5.9 per cent, affecting predominantly males, with a notorious increase with advanced age.

Cáncer tiroideo: comunicación de 85 casos / Thyroid cancer: report of 85 cases

Background: Thyroid cancer is the most frequent endocrine cancer with important implications in terms of diagnosis and treatment. Aim: to report a population of patients with thyroid cancer diagnosed by pathological studies of the surgical piece. Patients and methods: Eighty five patients (68 female) with the definitive diagnosis of thyroid cancer were studied. Clinical, imaginological, cytological and pathological findings were analyzed. Results: The age range of patients was 10 to 77 years old. Sixty nine patients had ultrasonographic studies which showed a solid nodule in 84 percent, mixed solid-cystic area in 14.5 percent and a purely cystic nodule in 1.5 percent of the cases. Nineteen patients had non specific calcifications. Fine needle aspiration cytology was negative for malignancy in eight patients (false negative rate of 9.9 percent). The average size of the nodules was of 2.8 ñ 1.6 cm). Six nodules measured less than one cm (microcarcinoma). In the initial surgical procedure, 13 patients had lymph node metastases, 2 of them had a primary tumor of 1 cm and 5 patients had Graves's Disease. Frozen biopsies during operation had 9 false negative results for cancer (10.6 percent). Pathology showed 64 cases of papillary cancer (75 percent), 14 of follicular (16.5 percent), two were Hurthle cell cancer (2.4 percent), three were medullary (3.5 percent), and two anaplastic (2.4 percent). Conclusions: in our experience, thyroid cancer is more common in women, solid lesions predominate in the ultrasonography and calcifications are frequently found. The tumor size is variable and the most frequent pathological type corresponds to differentiated cancers. Using the definitive pathological study as the standard, the diagnostic sensitivity of fine needle cytology was 90.1 percent, and of frozen section 89.4 percent

Crecimiento en niños con diabetes mellitus insulino-dependiente / Growth of children with insulin dependent diabetes mellitus

Objetivo: establecer la talla del niño al momento del diagnóstico de la diabetes mellitus insulina-dependiente (DMID) y determinar si el tratamiento actual promueve un crecimiento normal. En el momento de diagnosticar la afección, el puntaje Z de la talla de 81 niños con DMID (+0.05ñ1.20) no era significativamente diferente que el de un grupo control de 81 niños sanos (-0,26ñ1,04; p<0,06). De los niños diabéticos, 45 (20 hombres y 25 mujeres) fueron seguidos durante 6,8ñ3,4 años. El puntaje Z de la talla de los niños diabéticos fue menor (-0.50ñ1,23) comparado con los controles (+0.15ñ0,77, p<0,031), pero en las niñas (-0,91ñ0,63) no se observó diferencias con el grupo control (-0,73ñ0,63;p=0,53). El puntaje Z de la talla final alcanzado por los niños diabéticos de ambos sexos fue menor que el de la talla inicial de ellos mismos (p<0,02); sin embargo, en promedio la talla disminuyó moderadamente, no menos de 1 DE. Conclusiones: la talla de los niños con diabetes mellitus dependiente de insulina es normal cuando se hace el diagnóstico de la enfermedad. El tratamiento actual se asocia con una repercusión moderada de aquella sobre el crecimiento lo que no alcanza a asumir significado patológico

Nódulo tiroídeo en enfermedad de Basedow Graves y cáncer tiroídeo: experiencia en 6 pacientes / Thyroid nodules in Basedow Graves disease and thyroid cancer: experience in 6 patients

Traditionally, Basedow graves disease was considered a protection against cancer. However, recent reports suggest that cancer occurs with a higher frequency than expected and is more aggressive in this disease. We report six patients with hyperthyroidism due to a Basedow Graves disease that presented a palpable thyroid nodule, which was cold in the scintiscan and solid in the ultrasound examination. Fine needle cytology disclosed cancer in 5 cases (2 with cytological features of greater aggressiveness) and a nodular hyperplasia in one. The diagnosis was confirmed in the surgical piece in all patients. We conclude that Basedow Graves disease and thyroid cancer, which can have an increased aggressiveness, may coexist