Nuevos Recursos Tecnológicos para la Enseñanza de Anatomía Durante la Crisis por Pandemia COVID-19. Desde el B-learn hacia el E-learn en una Nueva Escuela de Medicina de Chile / New Technological Resources for Anatomy Teaching During the COVID-19 Pandemic Crisis. From B-learn to E-Learn at a New Medical School, in Chile

Para iniciar la enseñanza de anatomía la nueva Escuela de Medicina de la Universidad de Tarapacá (UTA) adquirió innovadores recursos tecnológicos según el estado del arte en medios digitales y 3D. La primera cohorte de estudiantes de medicina utilizó estos recursos tecnológicos el año 2016, valoró positivamente la asignatura cursada y su metodología didáctica mediante un enfoque combinado (B-Learn). Estos resultados fueron publicados el año 2018, siendo un exitoso modelo local de enseñanza hasta el año 2019. La pandemia COVID-19 golpeó fuertemente a Chile desde el inicio del año 2020 y las universidades debieron adaptar su modelo de enseñanza. En nuestro caso se realizó impartiendo las asignaturas mediante un enfoque de total aprendizaje en línea a través de internet (E-Learn). Se impartió el primer y segundo semestre de anatomía a 36 estudiantes del primer año de medicina 2020. Además de los recursos tradicionales como textos de estudio y guías de laboratorio, para migrar a un modelo de curso E-Learn totalmente en línea, se utilizaron los recursos digitales y 3D almacenados en la base de datos local de la mesa de disección digital SECTRA® y su plataforma RIS/PACS portal IDS7 SECTRA®, para ser enseñados mediante internet vía Zoom® en tiempo real y vía plataformas Intranet-UTA en conjunto con Moodle® para las tareas y posteriores evaluaciones. La transición desde un modelo B-Learn a uno E-Learn se realizó en forma exitosa gracias a la experiencia conseguida los años anteriores en cuanto a diseño y uso de recursos didácticos, además de la base de datos local con recursos anatómicos previamente almacenados en formato digital. El rendimiento de los alumnos fue sobresaliente durante la pandemia, mostrando la versatilidad y adaptación de los nuevos estudiantes nativos digitales a las emergentes condiciones de aprendizaje.

SUMMARY: To start teaching anatomy, the recently established medical school of the University of Tarapacá (UTA) acquired innovative and state of the art technological resources in digital and 3D media. The first cohort of medical students used these resources in 2016 and positively assessed the subject studied and its didactic methodology through a combined approach (B- Learn). These results were published in 2018, and it was deemed a successful local teaching model until 2019. Since the beginning of 2020 the COVID-19 pandemic impacted Chile particularly hard, and universities had to adapt their teaching model. In our case, we carried it out by teaching the subjects using a comprehensive online learning approach through the Internet (E-Learn). The first and second semester of anatomy were taught to 36 students in the first year of medicine 2020. In addition to traditional resources such as study texts and laboratory guides, to migrate to a fully online E- Learn course model, the digital and 3D resources stored in the local database of the SECTRA® digital dissection table and its RIS/ PACS portal IDS7 SECTRA® platform were used to be taught via the internet through Zoom® in real-time and via Intranet UTA platforms in conjunction with Moodle® for the tasks and subsequent evaluations. The transition from a B-Learn model to an E-Learn model was carried out successfully thanks to the experience gained in previous years in terms of design and use of teaching resources, in addition to the local database with previously stored anatomical resources in digital format. Student performance was outstanding during the pandemic, showing the versatility and adaptation of new digital native students to emerging learning conditions.

Nuevos Recursos Digitales y 3D en la Enseñanza de Anatomía. Experiencia Internacional Reportada en el "Sectra Users Meeting 2019", Karolinska Institutet, Suecia, antes de la Pandemia de COVID-19 / New Digital and 3D Resources in the Teaching of Anatomy. International Experience Reported in the "Sectra Users Meeting 2019", Karolinska Institutet, Sweden, Before the Pandemic COVID-19

El uso de nuevos recursos tecnológicos en la enseñanza de anatomía ha impulsado la necesidad de adaptar el modelo educativo haciéndolo más centrado en el estudiante, dinámico y participativo mediante herramientas digitales y 3D; orientando los conocimientos hacia su aplicación clínica, pero bajo un ajuste curricular que tiende a cursar menos horas presenciales en aula o laboratorio. Este trabajo describe la experiencia local de una nueva Escuela de Medicina en Chile, reportada el año 2018, además y otros trabajos de centros formadores presentados en el "SECTRA Users Meeting 2019 Estocolmo", Karolinska Institutet, Suecia. Este trabajo describe los reportes orales sobre la aplicación de nuevos recursos digitales como; la mesa de disección digital táctil SECTRA® y modelos anatómicos cadavéricos impresos en 3D Erler-Zimmer®, bases de datos sobre anatomía digital, además, su impacto en el desempeño académico, reportado por usuarios de diferentes países, tales como: Australia, Canadá, Chile, China, Colombia, Estados Unidos de Norteamérica (EUA) y Suecia. Los datos fueron recopilados y analizados a partir de la información reportada en las presentaciones orales y resúmenes entregados por los expositores. La gran mayoría de los países expositores declararon el uso combinado de recursos digitales y 3D sumados a los tradicionales para la enseñanza de anatomía. Sólo el representante de EUA declaró usar exclusivamente recursos digitales (en laboratorio y en línea), experiencia correspondiente a una joven e innovadora escuela de medicina. La mayoría de los centros docentes declaró utilizar la mesa de disección digital en una amplia proporción de sus contenidos curriculares, en asociación a plataformas tipo RIS/PACS como IDS7 portal de SECTRA o las utilizadas por el centro formador. El uso de nuevas tecnologías digitales y 3D ha ganado un importante espacio en el currículum de la enseñanza de anatomía, complementando el uso de los recursos tradicionales.

SUMMARY: The use of new technological resources in the teaching of anatomy has promoted the need to adapt the educational model, making it more student-centered, dynamic, and participatory through digital and 3D tools, directing the knowledge towards its clinical application, but under a curricular adjustment that tends to take fewer contact hours in the classroom or laboratory. This work describes the local experience of a new School of Medicine in Chile, reported in 2018, and other work from training centers presented at the "SECTRA Users Meeting 2019 Stockholm", Karolinska Institutet, Sweden. This work describes the oral reports on the application of new digital resources such as; the SECTRA® digital tactile dissection table and Erler- Zimmer® 3D printed cadaveric anatomical models, databases on digital anatomy, in addition, its impact on academic performance, reported by users from different countries, such as Australia, Canada, Chile, China, Colombia, United States of America (USA) and Sweden. The data was collected and analyzed from the information reported in the oral presentations and summaries delivered by the speakers.The vast majority of the exhibiting countries declared the combined use of digital and 3D resources added to the traditional ones for teaching anatomy. Only the representative from the USA stated that they exclusively used digital resources (in the laboratory and online), an experience corresponding to a young and innovative medical school. Most of the educational centers stated that they used the digital dissection table in a large proportion of their curricular contents, in association with RIS/PACS-type platforms such as the IDS7 SECTRA portal or those used by the training center. The use of new digital and 3D technologies has gained an important space in the anatomy teaching curriculum, complementing the use of traditional resources.

A new constraint to model background signals when processing chromatographic-spectral second-order data with multivariate curve resolution.

BACKGROUND: the chemometric processing of second-order chromatographic-spectral data is usually carried out with the aid of multivariate curve resolution-alternating least-squares (MCR-ALS). When baseline contributions occur in the data, the background profile retrieved with MCR-ALS may show abnormal lumps or negative dips at the position of the remaining component peaks. RESULTS: The phenomenon is shown to be due to remaining rotational ambiguity in the obtained profiles, as confirmed by the estimation of the boundaries of the range of feasible bilinear profiles. To avoid the abnormal features in the retrieved profile, a new background interpolation constraint is proposed and described in detail. Both simulated and experimental data are employed to support the need of the new MCR-ALS constraint. In the latter case, the estimated analyte concentrations agreed with those previously reported. SIGNIFICANCE: The developed procedure helps to reduce the extent of rotational ambiguity in the solution and to better interpret the results on physicochemical grounds.

Definición de displasia broncopulmonar propuesta por la Comisión Neo SOCHINEP / Definition of bronchopulmonary dysplasia proposed by the Neo SOCHINEP Commission

La displasia broncopulmonar (DBP) es la enfermedad crónica más frecuente del recién nacido prematuro. Los avances en su prevención y tratamiento han permitido una mayor sobrevida de prematuros más pequeños, pero su incidencia se ha mantenido estable en el tiempo, con una fisiopatología y presentación clínica que abarca un amplio espectro y que difiere de la DBP descrita originalmente hace más de 50 años. Aún existen controversias en su definición, la que se ha establecido en base al tratamiento, específicamente al requerimiento de soporte respiratorio. Las definiciones más utilizadas son el requerimiento de oxígeno por 28 días y a las 36 semanas de edad gestacional corregida (EGC). Recientemente se ha propuesto definirla en base al requerimiento de ventilación mecánica a las 36 semanas de EGC, lo que identificaría a los prematuros con DBP más grave y mayor probabilidad de complicaciones respiratorias y neurológicas en los 2 primeros años de vida. Nuestro objetivo en la comisión de Neo-SOCHINEP es el de recomendar la definición y clasificación que nos parece más adecuada para identificar a los prematuros portadores de DBP, considerando los aspectos fisiopatológicos, del compromiso de la función pulmonar y consecuencias prácticas de la definición en nuestro medio. También proponemos la definición del requerimiento de oxígeno en el prematuro cuando esta en neonatología, las condiciones e interpretación de la saturometría contínua cuando está pronto al alta y el seguimiento de la oxigenoterapia posterior al alta.

Bronchopulmonary dysplasia (BPD) is the most frequent chronic disease of the premature newborn. Advances in its prevention and treatment have allowed a greater survival of smaller preterm infants, but its incidence has remained stable over time, with a pathophysiology and clinical presentation that covers a wide spectrum and differs from the BPD originally described more than 50 years ago. There are still controversies in its definition, which has been established based on the treatment, specifically the requirement of respiratory support. The most used definitions are the oxygen requirement for 28 days and at 36 weeks of postmenstrual age (PMA). It has recently been proposed a definition based on the requirement of mechanical ventilation at 36 weeks of PMA, which would identify premature infants with more severe BPD and a greater probability of respiratory and neurological complications in the first 2 years of life. Our objective in the Neo-SOCHINEP commission is to recommend the definition and classification that we believe is most appropriate to identify premature infants with BPD, considering the pathophysiological aspects, the compromised lung function, and practical consequences of the definition in our medium. We also propose the definition of the oxygen requirement in premature infants when they are in neonatology, the conditions and interpretation of continuous saturation when they are soon discharged, and the follow-up of post-discharge oxygen therapy.

Hepatitis aguda por virus C: reporte de siete casos en centro de referencia en Chile

Hepatitis C virus infection is a major global public health problem. Treatment with direct-acting antivirals is intended to eradicate the chronic form of this infection by 2030. Although uncommon, the acute form of presentation is increasingly recognized, especially in some high-risk populations, such as men who have sex with men without protection. Its virological and serological diagnosis is not standardized, so clinical suspicion is essential. Its early detection allows a timely treatment. We report seven cases of acute HCV hepatitis in a national reference center, its presentation, diagnosis and treatment. We discuss populations at risk and the change in therapeutics with the use of direct-acting antiviral drugs.

[Acute hepatitis C. Report of seven cases]. / Hepatitis aguda por virus C: reporte de siete casos en centro de referencia en Chile.

Hepatitis C virus infection is a major global public health problem. Treatment with direct-acting antivirals is intended to eradicate the chronic form of this infection by 2030. Although uncommon, the acute form of presentation is increasingly recognized, especially in some high-risk populations, such as men who have sex with men without protection. Its virological and serological diagnosis is not standardized, so clinical suspicion is essential. Its early detection allows a timely treatment. We report seven cases of acute HCV hepatitis in a national reference center, its presentation, diagnosis and treatment. We discuss populations at risk and the change in therapeutics with the use of direct-acting antiviral drugs.

Interpretation of matrix chromatographic-spectral data modeling with parallel factor analysis 2 and multivariate curve resolution.

Parallel factor analysis 2 (PARAFAC2) is still being advocated for the processing of second-order chromatographic-spectral data, both for qualitative and quantitative applications. However, neither classical PARAFAC2 nor the newly developed flexible non-negative NN-PARAFAC2 version can adequately model these data in a general situation. In quantitative analysis, considerable bias may result in the estimation of analyte concentrations, due to the fact that both PARAFAC2 models apply an artificial constraint to the retrieved profiles, requiring constant cross-product, i.e., constant overlapping, between all pairs of component elution profiles in all samples. This only occurs under limited conditions. In this report, simulations help to understand, visualize and interpret these PARAFAC2 features. Experimental data are also studied concerning the determination of a fluoroquinolone antibiotic in bovine liver samples by liquid chromatography with multi-wavelength fluorescence detection. Both for simulated and experimental data, the PARAFAC2 versions provide poor analytical results, while correct data processing and reasonable analytical indicators can be achieved using multivariate curve resolution - alternating least-squares (MCR-ALS). For the simulated data sets, root mean square errors/relative errors of prediction were 0.01 concentration units/2% for MCR-ALS, compared to 0.02-0.06 units/4-12% for both PARAFAC2 and NN-PARAFAC2. For the experimental data sets, they were 0.025 µg mL-1/11% for MCR-ALS, 0.09 µg mL-1/40% for PARAFAC2 and 0.16 µg mL-1/71% for NN-PARAFAC2, with average recoveries (standard deviation) of 91(14)%, 185(135)% and 69(35)% respectively.

Excitation-emission fluorescence-kinetic third-order/four-way data: Determination of bisphenol A and nonylphenol in food-contact plastics.

The endocrine disrupting chemicals bisphenol A (BPA) and 4-nonylphenol (NP) were simultaneously quantified through third-order/four-way calibration. Excitation-emission fluorescence matrix-kinetic (EEFM-K) third-order data were generated by measuring the EEFMs of these priority xenoestrogens as a function of reaction time during their Fenton degradation. Third-order/four-way calibration notably improves the sensitivity of the method and provides the required selectivity for quantifying analytes with critically overlapped fluorescence signals. In fact, collinearity between BPA and NP emission spectra prevented their quantification using EEFM second-order data and three-way PARAFAC (parallel factor analysis); however, the addition of a third instrumental mode allowed the correct chemometric modeling with four-way PARAFAC. In this way, the compliance of Kruskal's theorem extended to higher-order data was verified. The method was applied for the determination of the analytes in samples of different plastic materials, which are in contact with food and/or beverages. In these cases, where unmodelled constituents are present, good results for BPA were achieved with four-way PARAFAC, but the predictions for NP using this model were deficient. A better predictive capability for NP in real samples was achieved when either U-PLS/RTL (unfolded partial least-squares combined with residual trilinearization) or MCR-ALS (multivariate curve resolution with alternating least-squares) was applied for data processing, demonstrating the power of these latter models for the resolution of more complex systems.

Multivariate curve resolution strategy for non-quadrilinear type 4 third-order/four way liquid chromatography-excitation-emission fluorescence matrix data.

For the first time, a third-order/four-way system having instrumental modes depending on each other was experimentally generated and it was successfully resolved. Non-quadrilinear type 4 data, constituted by liquid chromatographic elution times (LC) and excitation-emission fluorescence matrices (EEFMs), were on-line measured using conventional equipment. Thus, third-order/four-way data, valuable for giving rise to highly sensitive and selective methods, were obtained minimizing significantly the experimental work and time, in comparison with the reported strategies for the acquisition of LC-EEFM data. The usefulness of MCR-ALS (multivariate curve resolution-alternating least square) for attaining reliable results from data with two mutually dependent instrumental modes, namely elution time and excitation wavelength modes, was established through the simultaneous quantitation of benz[a]anthracene, chrysene, benzo[b]fluoranthene, and benzo[a]pyrene. Limits of detection in the range 1.0-1.4 ng mL-1 were achieved for the target polycyclic aromatic hydrocarbons, allowing their determination in about 9 min per sample in leaves of different types of tea.

On-line generation of third-order liquid chromatography-excitation-emission fluorescence matrix data. Quantitation of heavy-polycyclic aromatic hydrocarbons.

For the first time, third-order liquid chromatography with excitation-emission fluorescence matrix detection (LC-EEFM) data were generated on-line and chemometrically processed for the simultaneous quantitation of the heavy-polycyclic aromatic hydrocarbons fluoranthene, pyrene, benz[a]anthracene, chrysene, benzo[b]fluoranthene, benzo[k]fluoranthene, benzo[a]pyrene, and dibenz[a,h]anthracene. The applied experimental strategy is very simple, and is based on the reduction of the linear flow rate by fitting a larger diameter connecting-tube between the column outlet and the fluorimetric detector. In this way, EEFMs were successfully recorded on-line, without involving a large total analysis time. Because in the studied system quadrilinearity was fulfilled, four-way parallel factor (PARAFAC) analysis was applied for data processing. The second-order advantage, which is an intrinsic property of data of at least second-order, allowed the quantification of the analytes in interfering media. Moreover, resolution of the system with a high degree of collinearity was achieved thanks to the third-order advantage. In addition to a selectivity improvement, third-order/four-way calibration increased the sensitivity, with limits of detection in the range of 0.4-2.9ngmL-1. After a solid-phase extraction procedure with C18 membranes, considerably lower concentrations (between 0.033-2.70ngmL-1) were determined in real waters, with most recoveries in the range 90-106%.

Multivariate curve resolution applied to kinetic-spectroscopic data matrices: Dye determination in foods by means of enzymatic oxidation.

In this work, the combination of chemometric techniques with kinetic-spectroscopic data allowed quantifying two dyes (tartrazine and carminic acid) in complex matrices as mustard, ketchup, asparagus soup powder, pumpkin soup powder, plum jam and orange-strawberry juice. Quantitative analysis was performed without the use of tedious sample pretreatment, due to the achievement of the second-order advantage. The results obtained showed an improvement in simplicity, speed and cost with respect to usual separation techniques, allowing to properly quantifying these dyes obtaining limits of detection below 0.6mgL-1. In addition, to the best of our knowledge, is the first time that kinetic-spectroscopic data are obtained from the action of laccase for analytical purposes.

Excitation-emission fluorescence-kinetic data obtained by Fenton degradation. Determination of heavy-polycyclic aromatic hydrocarbons by four-way parallel factor analysis.

For the first time, a simple and environmentally friendly third-order/four-way calibration was applied for the simultaneous determination of five heavy-polycyclic aromatic hydrocarbons (PAHs) in interfering environments. The kinetic evolution of the Fenton degradation of benzo[a]pyrene, dibenz[a,h]anthracene, benzo[b]fluoranthene, benzo[k]fluoranthene and benz[a]anthracene was followed by recording full excitation-emission fluorescence matrices (EEFMs) of the samples at different reaction times, obtaining third-order EEFM-kinetic (EEFM-K) data. The sensitivity of the method was increased by carrying out the reaction in the presence of methyl-ß-cyclodextrin. The four-way parallel factor (PARAFAC) algorithm, which was used for data processing, exploits the second-order advantage, allowing analyte concentrations to be estimated even in the presence of an uncalibrated fluorescent background. The clear superiority of the applied approach in comparison with second-order/three-way calibration performed with unreacting EEFMs is demonstrated, using two sets of samples with foreign compounds with particular spectral profiles. In one of the latter sets, the existence of a third-order advantage was explored and discussed. The feasibility to directly determine parts-per-trillion concentration levels of PAHs after a very simple solid-phase extraction with C18 membranes is established with natural water samples containing uncalibrated constituents.

Therapeutic alternatives for the treatment of type 1 hepatorenal syndrome: A Delphi technique-based consensus.

AIM: To propose several alternatives treatment of type 1 hepatorenal syndrome (HRS-1) what is the most severe expression of circulatory dysfunction on patients with portal hypertension. METHODS: A group of eleven gastroenterologists and nephrologists performed a structured analysis of available literature. Each expert was designated to review and answer a question. They generated draft statements for evaluation by all the experts. Additional input was obtained from medical community. In order to reach consensus, a modified three-round Delphi technique method was used. According to United States Preventive Services Task Force criteria, the quality of the evidence and level of recommendation supporting each statement was graded. RESULTS: Nine questions were formulated. The available evidence was evaluated considering its quality, number of patients included in the studies and the consistency of its results. The generated questions were answered by the expert panel with a high level of agreement. Thus, a therapeutic algorithm was generated. The role of terlipressin and norepinephrine was confirmed as the pharmacologic treatment of choice. On the other hand the use of the combination of octreotide, midodrine and albumin without vasoconstrictors was discouraged. The role of several other options was also evaluated and the available evidence was explored and discussed. Liver transplantation is considered the definitive treatment for HRS-1. The present consensus is an important effort that intends to organize the available strategies based on the available evidence in the literature, the quality of the evidence and the benefits, adverse effects and availability of the therapeutic tools described. CONCLUSION: Based on the available evidence the expert panel was able to discriminate the most appropriate therapeutic alternatives for the treatment of HRS-1.

Scope of partial least-squares regression applied to the enantiomeric composition determination of ketoprofen from strongly overlapped chromatographic profiles.

Valuable quantitative information could be obtained from strongly overlapped chromatographic profiles of two enantiomers by using proper chemometric methods. Complete separation profiles where the peaks are fully resolved are difficult to achieve in chiral separation methods, and this becomes a particularly severe problem in case that the analyst needs to measure the chiral purity, i.e., when one of the enantiomers is present in the sample in very low concentrations. In this report, we explore the scope of a multivariate chemometric technique based on unfolded partial least-squares regression, as a mathematical tool to solve this quite frequent difficulty. This technique was applied to obtain quantitative results from partially overlapped chromatographic profiles of R- and S-ketoprofen, with different values of enantioresolution factors (from 0.81 down to less than 0.2 resolution units), and also at several different S:R enantiomeric ratios. Enantiomeric purity below 1% was determined with excellent precision even from almost completely overlapped signals. All these assays were tested on the most demanding condition, i.e., when the minor peak elutes immediately after the main peak. The results were validated using univariate calibration of completely resolved profiles and the method applied to the determination of enantiomeric purity of commercial pharmaceuticals.

Programa de evaluación y control del tabaquismo en funcionarios del hospital doctor Gustavo Fricke, Viña del Mar, Chile / Program of evaluation and control of smoking in hospital staff at Hospital Doctor Gustavo Fricke, Viña del Mar, Chile

El tabaquismo, mantiene alta prevalencia a nivel de la población general, lo que se manifiesta también en los funcionarios de la salud en nuestro país. Objetivos: Se planificó un programa antitabaco para los funcionarios del Hospital Dr. Gustavo Fricke, Viña del Mar con el objetivo de realizar un diagnóstico de la situación, evaluar a los funcionarios comprometidos y realizar acciones programáticas orientadas al cese. Material y método: Se encuestaron entre marzo y junio del 2013, 551 funcionarios en forma directa, de los cuales, los que fumaban y manifestaron su deseo a dejarlo, se les aplico 4 test (Fagestrom, Richmond, Goldberg y De los porqué) y se les ofreció integrarse a un programa de cesación con terapia farmacológica y no farmacológica. Resultados: Se pesquisaron 249 fumadores (45 por ciento), de los cuales 158 (63,4 por ciento) desean dejar de fumar. Las tasas más altas fueron de los profesionales no de la salud (70 por ciento) y las más bajas de los médicos (18 por ciento). Se pesquiso un 20 por ciento de fumadores severos (>15 al día) y una gran motivación al cese. Hasta Agosto 2014, 60 funcionarios (38 por ciento de los que deseaban dejar de fumar) , estaban en programa, los cuales se evaluaron con ficha clínica “ad hoc”, test de Fagestrom, Richmond, De los por qué y Goldberg (depresión). Las modalidades de terapia fueron consejería individual y farmacológica con vareniclina y/o chicles de nicotina, de acuerdo a flujograma que consideraba grados de adicción y motivación. Hasta agosto /2014, 10 funcionarios habían recibido terapia farmacológica, de los cuales 6 completaban 6 meses de cesación, 2 abandonos y 2 recaídas. Conclusiones: Fue posible realizar un programa de cesación tabáquica en funcionarios hospitalarios de acuerdo a lo programado...

Smoking, maintaining a level high prevalence in the general population, which is also evident in the subjects working health in our country. Objectives: A smoking cessation program was planned for subjects working Dr. Gustavo Fricke Hospital, Vina del Mar in order to make a diagnosis of the situation, evaluate and make subjects working committed actions aimed at cessation program. Material and method: They were surveyed between March and June 2013, 551 subjects working directly, of which, those who smoked and expressed his desire to leave, they applied four tests (Fagestrom, Richmond, Goldberg and “Of the why”) and offered integrated a cessation program with pharmacological and non-pharmacological therapy. Results: 249 smokers (45 percent), of which 158 (63.4 percent) want to stop smoking. The highest rates were among non-health professionals (70 percent) and the lowest of physicians 18 percent. 20 percent of heavy smokers (> 15 per day) and a great motivation to terminate. Until August 2014, 60 staff (38 percent of those who wanted to stop smoking), were in the program, which were evaluated with clinical record "ad hoc" test Fagestrom, Richmond, “Of the why” and Goldberg (depression). Modalities therapy, were individually counseling and pharmacological therapy with varenicline and / or nicotine gum, according to flowchart considered degrees of addiction and motivation. Until August / 2014, 10 staff had received drug therapy, of which 6 completed 6 months of cessation, 2dropouts and 2 relapses. Conclusions: It was possible to make a smoking cessation program in hospital officials as scheduled...

Management of nonalcoholic fatty liver disease: an evidence-based clinical practice review.

AIM: To build a consensus among Chilean specialists on the appropriate management of patients with nonalcoholic fatty liver disease (NAFLD) in clinical practice. METHODS: NAFLD has now reached epidemic proportions worldwide. The optimal treatment for NAFLD has not been established due to a lack of evidence-based recommendations. An expert panel of members of the Chilean Gastroenterological Society and the Chilean Hepatology Association conducted a structured analysis of the current literature on NAFLD therapy. The quality of the evidence and the level of recommendations supporting each statement were assessed according to the recommendations of the United States Preventive Services Task Force. A modified three-round Delphi technique was used to reach a consensus among the experts. RESULTS: A group of thirteen experts was established. The survey included 17 open-ended questions that were distributed among the experts, who assessed the articles associated with each question. The levels of agreement achieved by the panel were 93.8% in the first round and 100% in the second and third rounds. The final recommendations support the indication of lifestyle changes, including diet and exercise, for all patients with NAFLD. Proven pharmacological therapies include only vitamin E and pioglitazone, which can be used in nondiabetic patients with biopsy-proven nonalcoholic steatohepatitis (the progressive form of NAFLD), although the long-term safety and efficacy of these therapies have not yet been established. CONCLUSION: Current NAFLD management is rapidly evolving, and new pathophysiology-based therapies are expected to be introduced in the near future. All NAFLD patients should be evaluated using a three-focused approach that considers the risks of liver disease, diabetes and cardiovascular events.

Recent applications of first- and second-order multivariate calibration to analytical chemistry.

This report reviews recent literature on the application of multivariate calibration techniques to both first- and second-order data, aimed at the analytical determination of analytes of interest or sample properties in a variety of industrial, pharmaceutical, food, and environmental samples, including examples of process control. The most used data processing tools are briefly described, with emphasis on the advantages that can be obtained by applying specific combinations of multivariate data and algorithms. The main focus is on works devoted to first-order data (i.e., spectra, chromatograms, etc.) combined with partial least-squares regression, which has become the standard for this type of analytical research. A brief discussion on recent work on second-order data and algorithms is also included, as this field is rapidly growing, although at present it does not show, the general applicability of the first-order counterparts.

Determination of five pesticides in juice, fruit and vegetable samples by means of liquid chromatography combined with multivariate curve resolution.

The aim of this work was to quantify five commonly used pesticides (propoxur, carbaryl, carbendazim, thiabendazole and fuberidazole) in real samples as: tomato, orange juice, grapefruit juice, lemon and tangerine. The method used for the determination of these analytes in the complex matrices was high-performance liquid chromatography with diode array detection. In order to work under isocratic conditions and to complete each run in less than 10 min, the analysis was carried out applying multivariate curve resolution coupled to alternating least-squares (MCR-ALS). The flexibility of this applied multivariate model allowed the prediction of the concentrations of the five analytes in complex samples including strongly coeluting analytes, elution time shifts, band shape changes and presence of uncalibrated interferents. The obtained limits of detection (in µg L(-1)) using the proposed methodology were 2.3 (carbendazim), 0.90 (thiabendazole), 12 (propoxur), 0.46 (fuberidazole) and 0.32 (carbaryl).

Determination of enantiomeric composition of ibuprofen in pharmaceutical formulations by partial least-squares regression of strongly overlapped chromatographic profiles.

In this report, we demonstrate how chiral liquid chromatography combined with multivariate chemometric techniques, specifically unfolded-partial least-squares regression (U-PLS), provides a powerful analytical methodology. Using U-PLS, strongly overlapped enantiomer profiles in a sample could be successfully processed and enantiomeric purity could be accurately determined without requiring baseline enantioresolution between peaks. The samples were partially enantioseparated with a permethyl-ß-cyclodextrin chiral column under reversed-phase conditions. Signals detected with a diode-array detector within a wavelength range from 198 to 241 nm were recorded, and the data were processed by a second-order multivariate algorithm to decrease detection limits. The R-(-)-enantiomer of ibuprofen in tablet formulation samples could be determined at the level of 0.5 mg L⁻¹ in the presence of 99.9% of the S-(+)-enantiomorph with relative prediction error within ±3%.

A review on second- and third-order multivariate calibration applied to chromatographic data.

Quantitative analytical works developed by processing second- and third-order chromatographic data are reviewed. The various modes in which data of complex structure can be measured are discussed, with chromatographic separation providing either one or two of the data dimensions. This produces second-order data (matrices from uni-dimensional chromatography with multivariate detection or from two-dimensional chromatography) or third-order data (three-dimensional data arrays from two-dimensional chromatography with multivariate detection). The available algorithms for processing these data are classified and discussed, regarding their ability to cope with the ubiquitous phenomenon of retention time shifts from run to run. A summary of relevant works applying this combination of techniques is presented, with focus on quantitative analytical results. Special attention is paid to works achieving the full potentiality of the multidimensional data, i.e., the second-order advantage.