Appendiceal hernia: an extremely rare condition.

Appendix-associated hernias are extremely rare. They have been described sporadically in the literature, mostly as inguinal hernias. Appendix-associated incisional hernias are even more unusual. High clinical awareness is needed as complications can arise if misdiagnosis or delay occurs. We present an 80-year-old man with acute appendicitis in an incisional hernia. After successful surgery, the patient made a full recovery.

Administración y preparación de antimicrobianos en una unidad chilena de cuidados neonatales / Preparation and dispensing of antimicrobials in a Chilean neonatal care unit / Administração e preparação de antimicrobianos em uma unidade chilena de cuidados neonatais

Resumen Objetivo: Describir la preparación, administración y monitorización de los antimicrobianos utilizados en una Unidad de Cuidados Neonatales en Santiago de Chile. Métodos: Estudio descriptivo. Se realizó la aplicación de un instrumento a 20 matronas de neonatología de una Unidad Chilena de Cuidados Neonatales (UCHCN) en 2018, para recopilar información respecto a once variables en la preparación y administración de antimicrobianos. El estudio abarcó tres variables principales: preparación, mantención y monitorización de los antimicrobianos. Resultados: Se recopiló información de 14 antimicrobianos, de los cuales la presentación del 92.8% de ellos era inyectable y el 78.2% de los encuestados reconocía el valor de la unidad de dosificación del medicamento. Mantención 85.7% de los antimicrobianos son eliminados luego de su preparación. Para dilución se utiliza mayormente la solución fisiológica en un 76.9% de los casos y el volumen utilizado de diluyente y concentración final varió según cada medicamento. Un 92.8% de los antimicrobianos se administra por vía endovenosa y todos a través de una bomba de jeringa. Monitorización específica de la administración sólo se realiza en un 7.2% de ellos. Conclusiones: Debido a las variabilidades encontradas en los procesos de mantención, dilución y monitorización es que se propone la creación o el mejoramiento y difusión de protocolos locales, para evitar efectos adversos o complicaciones y así resguardar la seguridad de los pacientes.

Abstract Objetive: To describe the preparation, dispensing, and monitoring of antimicrobials used in a Neonatal Care Unit in Santiago de Chile. Methods: This is a descriptive study. An assessment instrument was administered to 20 midwives laboring in a Chilean Neonatal Care Unit during 2018 in order to gather information on 11 variables related to the preparation, dispensing, and monitoring of antimicrobials. Results: Information was gathered on 14 antimicrobials; 92.8% of these were injectable. 78.2% of the surveyed personnel recognized the value of the drug dosification unit. 85.7% of antimicrobials were eliminated after their preparation. Regarding the dilution, in 76.9% of the cases saline solution was used with diverse concentrations. A close monitoring of the drug administration was followed only in 7.2% of the cases. Conclusions: Due to the variability found in the processes of preservation, dilution, and monitoring of antimicrobials in this Neonatal Care Unit, an implementation of a local protocol to improve the procedures and avoid adverse events or complications is proposed.

Resumo Objetivo: Descrever a preparação, administração e monitorização dos antimicrobianos utilizados em uma Unidade de Cuidados Neonatais em Santiago de Chile. Métodos: Estudo descritivo. Realizou-se a aplicação de um instrumento a 20 parteiras de neonatologia de uma Unidade Chilena de Cuidados Neonatais (UCHCN) em 2018, para recopilar informação ao respeito de onze variáveis na preparação e administração de antimicrobianos. O estudo abrangeu três variáveis principais: preparação, manutenção e monitorização dos antimicrobianos. Resultados: Recopilou-se informação de 14 antimicrobianos, dos quais a apresentação do 92.8% deles era injetável e o 78.2% dos inquiridos reconhecia o valor da unidade de dosagem do medicamento. Manutenção 85.7% dos antimicrobianos são eliminados depois de sua preparação. Para diluição utiliza-se maiormente a solução fisiológica em um 76.9% dos casos e o volume utilizado de diluente e concentração final variou segundo cada medicamento. Um 92.8% dos antimicrobianos administra-se por via endovenosa e todos através de uma bomba de seringa. Monitoramento específica da administração só se realiza em um 7.2% deles. Conclusões: Devido às variabilidades encontradas nos processos de manutenção, diluição e monitoramento, é que se propõe a criação ou a melhoria e difusão de protocolos locais, para evitar efeitos adversos ou complicações e assim resguardar a segurança dos pacientes.

Reproductive biology of alfonsino Beryx splendens.

The main aim of this work is to provide a detailed analysis of the reproductive cycle of Beryx splendens in the Juan Fernández Archipelago. The gonadosomatic index (I(G)) and maturity ogives in both sexes were estimated using an extensive database collected by onboard scientific observers between January 2006 and October 2009. A histological analysis of maturation was also completed for females collected between May and December 2001. Variations in both I(G) and proportion of mature individuals were observed in fish with a fork length (L(F)) >37 cm for females and >33 cm for males. The main reproductive season was in the austral winter and spring (June to November). Fork length at 50% maturity (L(50)) was estimated as 39·67 cm for females (95% c.i. =39·34, 40·02 cm) and 36·88 cm for males (95% c.i. =36·45, 37·36 cm) using macroscopic analysis of gonads. Estimates for females using histological data varied slightly with an estimated L(50) of 43·67 cm (95% c.i. =42·82, 44·91 cm). Changes in I(G) and maturity were modelled as a function of month and L(F) within a generalized additive model framework. A high porportion of immature individuals were found throughout the year. The results of this study are compared with reproductive traits reported for B. splendens in other areas of its distribution and are discussed with reference to exploitation, vulnerability and conservation of the B. splendens stock in Juan Fernández Archipelago.

[Effectiveness and tolerability of zoledronic acid in the treatment of metastatic prostate cancer]. / Efectividad y tolerabilidad del acido zoledrónico en el tratamiento del cancer de próstata metastásico.

OBJECTIVES: To assess the effectiveness and tolerability of zoledronic acid in prostate cancer patients with bone metastases at the hormone-sensitive (HS) and hormone-independent (HI) stages. MATERIALS AND METHODS: A nationwide, observational, prospective, open and multi-centre trial was devised, with a total of 218 male patients diagnosed with prostate cancer at the HS stage (36%) or HI stage (64%) who were administered zoledronic acid (4 mg/IV/month for 6 months) in addition to their specific oncological treatment. Effectiveness was assessed by the following means: 1) Assessment of the improvement in pain and mobility; 2) Incidence and time to onset of skeletal-related events (SREs) and 3) Analysis of bone markers. Tolerability was assessed by means of registering the number and type of adverse effects. A satisfaction survey was carried out amongst the patients after the end of the trial. RESULTS: Out of the 218 patients, 170 (78%) were evaluable for effectiveness. A decrease in pain ratings at rest and during movement was observed in all patients, whether in the HS or HI groups (p < 0.0001). Improved mobility was observed likewise (p = 0.005), as was quality of life. The global incidence of skeletal events was 11.2%, with a time to onset of SREs of 10.7 months. There were no significant differences observed between HS vs. HI patients. Osteolysis markers (N-telopeptide) decreased significantly with the treatment across both the HS and HI groups. For safety reasons. 212 patients were evaluable (97.2%). The incidence of adverse drug reactions was 16% (34/212) and was found to be significantly higher in HS patients (22.4%) compared with HI patients (11.9%). Overall, the tolerability of zoledronic acid was good, with no significant morbidity in either group (HS and HI). 66% of the patients reported feeling satisfied or very satisfied. CONCLUSIONS: Zoledronic acid proved effective in the relief of pain, improving mobility and quality of life as well as reducing or delaying the occurrence of skeletal-related events in prostate cancer patients presenting metastatic bone disease, regardless of the phase, whether HS or HI, they found themselves in. Tolerability and patient satisfaction were rates as good.

Frecuencia de hidatidosis en los principales centros quirúrgicos de Santiago de Chile: comparación con notificación al Ministerio de Salud 1988-1997 / Frecuency of hydatidosis in the main surgical centers of Santiago, Chile: comparison with notification to Ministerio de Salud 1988-1997

La hidatidosis es una zoonosis parasitaria caracterizada por la presencia de herbívoros y en el hombre, de quistes pseudotumorales con larvas del céstodo echinococcus granulosus. En Chile es, desde 1951, una enfermedad de notificación obligatoria, con al menos 600 a 800 casos nuevos por año. El trabajo pretende analizar la frecuencia de esta zoonosis en algunos centros quirúrgicos de Santiago, entre 1988 y 1997 y confrontarla con los datos notificados al MInisterio de Salud, evaluando así la confiabilidad de este registro. Se reunieron los datos obtenidos en los Servicios de Estadística y los servicios de cirugía de los 14 hospitales públicos de Santiago desde enero de 1988 hasta diciembre de 1997. Se encontró un total de 1467 casos en el período de 10 años de estudio, con un número de casos anuales de entre 120 a 169. La relación entre los casos reunidos en nuestro estudio y los casos notificados muestran una clara diferencia que fluctúa entre 3,5:1 y 7,5:1 según el año. Se observó en todos los caños revisados, una significativa subnotificación que da una imagen incorrecta de la importancia e impacto real de la hidatidosis en nuestro medio, situación que se podría extrapolar a todo el país, influyendo en la asignación de recursos y la implementación de programas de prevención

Conocimientos sobre el síndrome de inmunodeficiencia adquirida en adolescentes tempranos, escolares de ciclo básico de colegios del área sur-poniente de Santiago de Chile, 1998 / Knowledge about AIDS in young adolescents assisting at basic schools from south-west Santiago, 1998

Se presentan los resultados de una encuesta destinada a orientar la promoción de un estilo de vida saludable, frente al síndrome de inmunodeficiencia adquirida (SIDA). Para ello se encuestaron en diciembre de 1988, con consentimiento previo y debidamente informado de padres y directivos, 636 adolescentes tempranos escolares, selecionando al azar, en 3 grupos de colegios: subvencionados (S), municipalizados (M) y particulares (P) de ciclo básico, de la Región Metropolitana, para determinar su grado de conocimiento sobre SIDA. En el análisis de los resultados se usó la prueba de Z, (p<0,05), comparando los porcentajes de respuestas correctas por sexo y colegio. Las niñas (44 por ciento) y los niños (56 por ciento) tuvieron un promedio de edad de 11,4 años, que fue similar en los tres grupos. Los resultados están extensamente presentado y detallados en el texto y, en términos generales avalan la necesidad de reforzar los esfuerzos educativos con claro enfoque preventivo, tanto en niños como niñas adolescentes precoces. Estos esfuerzos deben apoyarse y complementar los valores culturales trasmitidos por la familia y en especial por las madres