Locking Attachment Plate for the Surgical Treatment of Periprosthetic and Periimplant Fractures: Long-Term Follow-Up.

Objectives: The surgical management of periprosthetic fractures (PPF) and periimplant fractures (PIF) can be challenging. The locking attachment plate (LAP) was proposed in recent years for the osteosynthesis of such fractures. The aim of this study was to assess the experience of a third-level hospital with LAP for the treatment of PPF and PIF, and analyse the clinical outcomes. Methods: Data were prospectively collected and analysed from all patients whose PPF/PIF was treated surgically with LAP in a third-level hospital from June 2018 to June 2022. All fractures were postoperative low-energy femur fractures. The minimum follow-up period was six months. Results: Thirty-eight patients (31 women) met the eligibility criteria. The mean age was 86.3 years. The median time until surgery was 4 days. A mean of 3.61 screws were used for each LAP. The mean femur plate length was 14 holes, and the mean working length 7.1 holes. The median hospital stay was nine days. The mean follow-up was 19.56 months. At one month, 12 patients tolerated partial weight-bearing. Five patients walked independently indoors. One patient had died and seven patients were readmitted. At six months, six more patients had died. Fifteen patients tolerated full weight-bearing (FWB). Nine patients walked independently indoors, six outdoors. Twenty-five patients reached fracture consolidation without malalignment. Nine patients were readmitted. At 12 months, another patient had died. Seventeen patients tolerated FWB. Eleven patients walked independently indoors, six outdoors. Twenty-five patients achieved fracture consolidation without malalignment. Five patients were readmitted. Fourteen patients crossed the two-year postoperative threshold. All achieved fracture consolidation. Two patients passed the 4-year postoperative milestone. Conclusion: The clinical results of patients whose PPF or PIF was treated with the LAP are promising. This fixation method is a viable option to be considered when planning surgery for such fractures.

Accelerated atherosclerosis in Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis: case report.

Accelerated atherosclerosis has been identified as a complication of multiple autoimmune diseases, among which Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis stands out. We describe the case of a 60-year-old patient with a history of hypertension, diabetes mellitus, and chronic kidney disease of unknown etiology, who presented two acute coronary syndromes with only a six-month difference. Rapid progression of coronary involvement was evidenced, along with increased markers of inflammatory response, usual interstitial pneumonia on tomography, and positive anti-myeloperoxidase antibodies (anti-MPO), leading to the diagnosis of microscopic polyangiitis (MPA). In these cases, timely diagnostic suspicion is crucial, as early treatment significantly impacts the course and prognosis of the disease.

Reparación laparoscópica de las lesiones quirúrgicas de la vía biliar: factibilidad y evaluación de resultados / Laparoscopic repair of bile duct injuries: Feasibility and outcomes

Introducción: Las lesiones quirúrgicas de la vía biliar (LQVB) posteriores a la colecistectomía videolaparoscópica tienen una incidencia de 0,6% aproximadamente, siendo por lo general más graves y complejas. La hepaticoyeyunoanastomosis (HYA) en Y de Roux es la mejor opción terapéutica (tasas de éxito entre 75-98%). Algunas series demostraron factible el abordaje laparoscópico en la resolución de esta patología. El objetivo es describir nuestra experiencia en la reparación laparoscópica de las LQVB. Métodos: Estudio retrospectivo y descriptivo. Se incluyeron pacientes sometidos a reparación laparoscópica posterior a LQVB. Se analizaron variables demográficas, clínicas, quirúrgicas y posoperatorias. Se aplicaron análisis estadísticos descriptivos. Resultados: Se evaluaron 92 pacientes con LQVB; 81 se sometieron a reparación quirúrgica, ocho fueron candidatos a HYA laparoscópica (aplicabilidad 9,88%). En 75% (seis) se logró una reparación laparoscópica completa. La mayoría eran mujeres (75%). Edad promedio de 40,8 ± 16,61 años (rango 19-65). Las lesiones Strasberg-Bismuth ≥ E3 afectaron a 25% (dos). En la mitad se realizó una HYA laterolateral según la técnica de Hepp-Couinaud; tres usuarios recibieron una HYA terminolateral y otro una bi-HYA terminolateral en Y de Roux. El tiempo operatorio promedio fue de 260 min (rango 120-360). La morbilidad global fue de 37,5% (tres casos): dos complicaciones menores (bilirragia grado A y hemorragia por drenajes) y una mayor (bilirragia grado C). No se registró mortalidad. El seguimiento máximo fue de 26 meses (rango 6-26). Conclusiones: Nuestro estudio muestra que, en un grupo seleccionado de pacientes, la HYA laparoscópica es factible, con los beneficios de un abordaje miniinvasivo.(AU)

Introduction: Bile duct injuries (BDI) following laparoscopic cholecystectomy occurs in approximately 0.6% of the cases, often being more severe and complex. Roux-en-Y hepaticojejunostomy (RYHJ) is considered the optimal therapeutic option, with success rates ranging from 75% to 98%. Several series have demonstrated the advancements of the laparoscopic approach for resolving this condition. The objective of this study is to describe our experience in the laparoscopic repair of BDI. Methods: A retrospective, descriptive study was conducted, including patients who underwent laparoscopic repair after BDI. Demographic, clinical, surgical, and postoperative variables were analyzed using descriptive statistical analyses. Results: Eight patients with BDI underwent laparoscopic repair (out of 81 surgically repaired patients). Women comprised 75% of the sample. A complete laparoscopic repair was achieved in 75% (6) of cases. The mean age was 40.8 ± 16.61 years (range 19–65). Injuries at or above the confluence (Strasberg–Bismuth ≥ E3) occurred in 25% of cases (2). Primary repair was performed in two cases. Half of the cases underwent a Hepp-Couinaud laterolateral RYHJ, while three patients received a terminolateral RYHJ, and one underwent a bi-terminolateral RYH. The mean operative time was 260 min (range 120–360). Overall morbidity was 37.5% (three cases): two minor complications (bile leak grade A and drainage-related bleeding) and one major complication (bile leak grade C). No mortality was recorded. The maximum follow-up period reached 26 months (range 6–26). Conclusions: Our study demonstrates the feasibility of laparoscopic RYHJ in a selected group of patients, offering the benefits of a minimally invasive approach.(AU)

Abordaje del acceso vascular por equipo de terapia infusional: seguridad y calidad asistencial / Approach to vascular access by infusion therapy team: safety and quality of care

Objetivo: describir la evolución del modelo de atención del acceso vascular por un equipo de terapia infusional enfermero referente (ETI) y sus resultados en la seguridad vinculados al acceso vascular central de inserción periférica (PICC) en pacientes oncohematológicos. Métodos: estudio observacional en una cohorte retrospectiva de 3.423 pacientes oncohematológicos a los cuales se les indicó un PICC ambulatoriamente durante 2012-2021. Variables: modelo de atención, motivo de la indicación, método de comprobación de la colocación del acceso, complicaciones del acceso vascular. Recogida de información mediante datos primarios del registro de acceso vascular y registro clínico de la historia informatizada ESPOQ2©. Análisis descriptivo paquete estadístico IBM SPSS® V.23.0 . Resultados: la creación de un equipo referente de terapia infusional incrementó la capacidad de colocación de catéteres, pasando de 98 (2013) a 768 (2021). La indicación del PICC pasó del 45,80% por instauración de quimioterapia mediante bomba de infusión domiciliaria (2016) al 93,70% por indicación por fármaco irritante o vesicante (2021) (p< 0,001). La introducción de la técnica ecoguiada y método electro-intracavitario de control de punta disminuyeron las complicaciones por flebitis mecánicas y la radiación por comprobación de catéter (p< 0,001). Conclusiones: los modelos de atención con equipos de terapia infusional referentes consolidados incrementan la seguridad del paciente oncológico portador de acceso vascular PICC.(AU)

Objective: to describe the evolution of the vascular access care model led by a nurse infusion therapy (ETI) team and its safety results associated with peripherally inserted central vascular access (PICC) in oncohematology patients. Methods: descriptive observational study in a retrospective cohort in 3,423 oncohaematological patients who were indicated for a PICC on an outpatient basis during 2012 to 2021. Variables: Care model, reason for the indication, access placement verification method, vascular access complications. Data collection using primary data from the vascular access registry and clinical registry of the ESPOQ2© computerized history. Descriptive analysis using IBM® SPSS® Statistics V.23.0. Results: infusional teams' reference increased the capacity to place catheters, going from 98 (2013) to 768 (2021). The indication for the PICC went from 45.80% due to initiation of chemotherapy home infusion (2016) to 93.70% due to an indication for an irritant or vesicant drug (2021) (p< 0.001). The introduction of the ultrasound-guided technique and electro-intracavitary method of tip control decreased complications due to mechanical phlebitis and radiation due to catheter verification (p< 0.001). Conclusions: care models with consolidated reference infusion therapy teams increase the safety of cancer patients with PICC vascular access.(AU)

Symptomatic polycystic liver disease: a rare indication of hepatectomy.

We present the case of forty-four-year-old woman with autosomal dominant Polycystic liver disease (PLD) without kidney disease diagnosed for 18 years ago. She experienced progressive abdominal distension and malnutrition over the previous twelve months. The patient had no other comorbidities. Physical examination revealed an 8 cm hepatomegaly in the right hypochondrium region. Liver function analysis was normal. CT scan showed multiple liver cysts with smooth and regular walls, predominantly in the right lobe which was considered as type III according to Gigot´s classification. Due to the significant hepatomegaly, conventional surgery was performed. Exploration showed multiple cysts of varying sizes on the liver surface, with diffuse involvement of the right hemiliver. Standard right lobe mobilization was technically not possible. Fenestration was performed in dominant superficial cysts, to allow access to the deeper cysts and liver parenchyma. A right hepatectomy was carried up using ultrasound devices and ultrasonic aspirator. And the biggest cysts located in the surface of left hepatic lobe were surgically unroofed. No surgical complications occurred, and the patient was discharged 5 days after the intervention.

Laparoscopic repair of bile duct injuries: Feasibility and outcomes.

INTRODUCTION: Bile duct injuries (BDI) following laparoscopic cholecystectomy occurs in approximately 0.6% of the cases, often being more severe and complex. Roux-en-Y hepaticojejunostomy (RYHJ) is considered the optimal therapeutic option, with success rates ranging from 75% to 98%. Several series have demonstrated the advancements of the laparoscopic approach for resolving this condition. The objective of this study is to describe our experience in the laparoscopic repair of BDI. METHODS: A retrospective, descriptive study was conducted, including patients who underwent laparoscopic repair after BDI. Demographic, clinical, surgical, and postoperative variables were analysed using descriptive statistical analyses. RESULTS: Eight patients with BDI underwent laparoscopic repair (out of 81 surgically repaired patients). Women comprised 75% of the sample. A complete laparoscopic repair was achieved in 75% (6) of cases. The mean age was 40.8 ± 16.61 years (range 19-65). Injuries at or above the confluence (Strasberg-Bismuth ≥ E3) occurred in 25% of cases (2). Primary repair was performed in two cases. Half of the cases underwent a Hepp-Couinaud laterolateral RYHJ, while three patients received a terminolateral RYHJ, and one underwent a bi-terminolateral RYH. The mean operative time was 260 min (range 120-360). Overall morbidity was 37.5% (3 cases): two minor complications (bile leak grade A and drainage-related bleeding) and one major complication (bile leak grade C). No mortality was recorded. The maximum follow-up period reached 26 months (range 6-26). CONCLUSIONS: Our study demonstrates the feasibility of laparoscopic RYHJ in a selected group of patients, offering the benefits of a minimally invasive approach.

The healthy moms and babies app to prevent postpartum depression: analysis of user-profiles and dropout cases.

Introduction: Perinatal depression affects mothers, babies and society. Preventive interventions are needed, but face barriers to access. E-health interventions could be an effective and accessible option. To date, few studies have attempted to understand the use of mobile health (m-health) applications and why they are not more widely used. This study aims to understand the demographic characteristics of enrolled participants and examine dropout patterns through the Healthy Moms and Babies app. Methods: A longitudinal study was conducted with a sample of 511 women recruited between 2020 and 2022. Data were collected from the app, including sociodemographic information, the participant's progress through the modules of the app, and the permissions granted to use the app. Results: Out of the 511 women who completed the initial form to initiate participation, 279 downloaded the app and completed the evaluation. Results indicated that granting permission to be notified about the module's availability is related to an increase in the use of the first modules. Conclusion: This study shows the importance of establishing follow-ups in the use of mobile apps during the perinatal period.

BTN3A3 evasion promotes the zoonotic potential of influenza A viruses.

Spillover events of avian influenza A viruses (IAVs) to humans could represent the first step in a future pandemic1. Several factors that limit the transmission and replication of avian IAVs in mammals have been identified. There are several gaps in our understanding to predict which virus lineages are more likely to cross the species barrier and cause disease in humans1. Here, we identified human BTN3A3 (butyrophilin subfamily 3 member A3)2 as a potent inhibitor of avian IAVs but not human IAVs. We determined that BTN3A3 is expressed in human airways and its antiviral activity evolved in primates. We show that BTN3A3 restriction acts primarily at the early stages of the virus life cycle by inhibiting avian IAV RNA replication. We identified residue 313 in the viral nucleoprotein (NP) as the genetic determinant of BTN3A3 sensitivity (313F or, rarely, 313L in avian viruses) or evasion (313Y or 313V in human viruses). However, avian IAV serotypes, such as H7 and H9, that spilled over into humans also evade BTN3A3 restriction. In these cases, BTN3A3 evasion is due to substitutions (N, H or Q) in NP residue 52 that is adjacent to residue 313 in the NP structure3. Thus, sensitivity or resistance to BTN3A3 is another factor to consider in the risk assessment of the zoonotic potential of avian influenza viruses.

Decontamination protocols affect the internal microbiota of ticks.

Studies on the microbiota of ticks have promoted hypotheses about the combined effects of the bacterial community, its functional contributions to the tick's physiology or probable competition effects with some tick-borne pathogens. However, knowledge on the origin of the microbiota of newly hatched larvae is missing. This study aimed to elucidate the source(s) of the microbiota in unfed tick larvae, addressing the composition of the "core microbiota" and the best ways to decontaminate eggs for microbiota studies. We applied laboratory degree bleach washes and/or ultraviolet light treatments on engorged Rhipicephalus australis females and/or their eggs. No significant effects of these treatments on the reproductive parameters of females and the hatching rates of eggs were observed. However, the different treatments did show striking effects on the composition of the microbiota. The results indicated that bleach washes disrupted the internal tick microbiota in females, implying that bleach may have entered the tick and subsequently affected the microbiota. Furthermore, the analyses of results demonstrated that the ovary is a main source of tick microbiota, while the contribution of Gené's organ (a part of the female reproductive system that secretes a protective wax coat onto tick eggs) or the male's spermatophore requires further investigation. Further studies are needed to identify best practice protocols for the decontamination of ticks for microbiota studies.

Passive collection of ticks in New Hampshire reveals species-specific patterns of distribution and activity.

Ticks and tick-borne diseases are increasing in the United States, including New Hampshire (NH). We report on the findings of an ongoing free crowdsourcing program spanning four years within NH. The date of tick's submission was recorded along with species, sex, stage, location they were collected (translated into latitude and longitude), the activity the individual was doing when the tick was found, and host species. A total of 14,252 ticks belonging to subclass Acari, family Ixodidae and genera Ixodes, Dermacentor, Amblyomma, and Haemaphysalis was recorded from the period 2018-2021 throughout NH. A total of 2,787 Ixodes scapularis and 1,041 Dermacentor variabilis, were tested for the presence of Borrelia sp. (Spirochaetales: Spirochaetaceae), B. burgdorferi sensu lato, B. miyamotoi, B. mayonii, Babesia microti (Piroplasmida: Babesiidae), Anaplasma phagocytophilum (Rickettsiales: Anaplasmataceae), Francisella tularensis (Thiotrichales: Francisellaceae), and Rickettsia rickettsii (Rickettsiales: Rickettsiaceae) by PCR. For the I. scapularis ticks tested, the pathogen prevalence was 37% B. burgdorferi s.l. 1% B. miyamotoi, 6% A. phagocytophilum, and 5% Ba. microti. Only one D. variabilis resulted positive to F. tularensis. We created state-wide maps informing the differences of ticks as detailed by administrative divisions. Dermacentor variabilis peaked in June and I. scapularis peaked in May and October. The most reported activity by people with tick encounters was while walking/hiking, and the least was biking. Using the reported distribution of both species of ticks, we modeled their climate suitability in the target territory. In NH, I. scapularis and D. variabilis have distinct patterns of emergence, abundance, and distribution. Tick prevention is important especially during April-August when both tick species are abundant and active.

The Timing and Magnitude of the Type I Interferon Response Are Correlated with Disease Tolerance in Arbovirus Infection.

Infected hosts possess two alternative strategies to protect themselves against the negative impact of virus infections: resistance, used to abrogate virus replication, and disease tolerance, used to avoid tissue damage without controlling viral burden. The principles governing pathogen resistance are well understood, while less is known about those involved in disease tolerance. Here, we studied bluetongue virus (BTV), the cause of bluetongue disease of ruminants, as a model system to investigate the mechanisms of virus-host interactions correlating with disease tolerance. BTV induces clinical disease mainly in sheep, while cattle are considered reservoirs of infection, rarely exhibiting clinical symptoms despite sustained viremia. Using primary cells from multiple donors, we show that BTV consistently reaches higher titers in ovine cells than cells from cattle. The variable replication kinetics of BTV in sheep and cow cells were mostly abolished by abrogating the cell type I interferon (IFN) response. We identified restriction factors blocking BTV replication, but both the sheep and cow orthologues of these antiviral genes possess anti-BTV properties. Importantly, we demonstrate that BTV induces a faster host cell protein synthesis shutoff in primary sheep cells than cow cells, which results in an earlier downregulation of antiviral proteins. Moreover, by using RNA sequencing (RNA-seq), we also show a more pronounced expression of interferon-stimulated genes (ISGs) in BTV-infected cow cells than sheep cells. Our data provide a new perspective on how the type I IFN response in reservoir species can have overall positive effects on both virus and host evolution. IMPORTANCE The host immune response usually aims to inhibit virus replication in order to avoid cell damage and disease. In some cases, however, the infected host avoids the deleterious effects of infection despite high levels of viral replication. This strategy is known as disease tolerance, and it is used by animal reservoirs of some zoonotic viruses. Here, using a virus of ruminants (bluetongue virus [BTV]) as an experimental system, we dissected virus-host interactions in cells collected from species that are susceptible (sheep) or tolerant (cow) to disease. We show that (i) virus modulation of the host antiviral type I interferon (IFN) responses, (ii) viral replication kinetics, and (iii) virus-induced cell damage differ in tolerant and susceptible BTV-infected cells. Understanding the complex virus-host interactions in disease tolerance can allow us to disentangle the critical balance between protective and damaging host immune responses.

An Agenda for Research of Uncovered Epidemiological Patterns of Tick-Borne Pathogens Affecting Human Health.

The panorama of ticks and tick-borne pathogens (TBP) is complex due to the many interactions among vertebrates, vectors, and habitats, occurring at different scales. At a broad spatial range, climate and host availability regulate most tick processes, including questing activity, development, and survival. At a local scale, interactions are obscured by a high indeterminacy, making it arduous to record in field surveys. A solid modelling framework could translate the local/regional empirical findings into larger scales, shedding light on the processes governing the circulation of TBP. In this opinion paper, we advocate for a re-formulation of some paradigms in the research of these outstanding cycles of transmission. We propose revisiting concepts that faced criticisms or lacked solid support, together with the development of a conceptual scheme exploring the circulation of TBP under a range of conditions. We encourage (i) an adequate interpretation of the niche concept of both ticks and vertebrate/reservoir hosts interpreting the (a)biotic components that shape the tick's niche, (ii) an assessment of the role played by the communities of wild vertebrates on the circulation of pathogens, and (iii) the development of new approaches, based on state-of-the-art epidemiological concepts, to integrate findings and modelling efforts on TBP over large regions.

Hand Therapy Regimen for Functional Recovery Following Combined Face and Bilateral Hand Transplantation.

Intensive postoperative rehabilitation therapy is associated with positive functional recovery in hand transplants (HTs). Our goal is to share the hand therapy protocol developed for our patient who underwent a combined face and bilateral HT. The patient is a 23-year-old right-hand-dominant male with a history of third-degree burns to 80% of his body following a motor vehicle accident. A multidisciplinary evaluation established his candidacy for a combined face and bilateral HT, and surgery took place in August 2020. Our individualized hand therapy protocol consisted of 4 phases. The pre-surgery phase focused on planning the orthotics and patient/caregivers' education on the rehabilitation process. The intensive care unit (ICU)/acute care phase involved hand allograft protection and positioning via orthotic fabrication, safe limb handling, and edema/wound management. The inpatient rehabilitation phase aimed to prepare the patient for independent living via neuromuscular and sensory re-education, improvement of upper extremities strength/flexibility, training basic activities of daily living, and providing a home exercise program (HEP). Finally, the outpatient phase aimed to maximize our patient's range of motion and independency in performing his routine activities and HEP. The patient's post-transplant functional outcomes showed a significant improvement compared to the pre-operative baseline. We hope this report sheds light on a comprehensive hand therapy program in HT.

Is composition of vertebrates an indicator of the prevalence of tick-borne pathogens?

Communities of vertebrates tend to appear together under similar ranges of environmental features. This study explores whether an explicit combination of vertebrates and their contact rates with a tick vector might constitute an indicator of the prevalence of a pathogen in the quest for ticks at the western Palearctic scale. We asked how 'indicator' communities could be 'markers' of the actual infection rates of the tick in the field of two species of Borrelia (a bacterium transmitted by the tick Ixodes ricinus). We approached an unsupervised classification of the territory to obtain clusters on the grounds of abundance of each vertebrate and contact rates with the tick. Statistical models based on Neural Networks, Random Forest, Gradient Boosting, and AdaBoost were detect the best correlation between communities' composition and the prevalence of Borrelia afzelii and Borrelia gariniii in questing ticks. Both Gradient Boosting and AdaBoost produced the best results, predicting tick infection rates from the indicator communities. A ranking algorithm demonstrated that the prevalence of these bacteria in the tick is correlated with indicator communities of vertebrates on sites selected as a proof-of-concept. We acknowledge that our findings are supported by statistical outcomes, but they provide consistency for a framework that should be deeper explored at the large scale.

Sintomatología depresiva y trastornos neurocognitivos en pacientes con VIH adherentes y no adherentes a TARAA: estudio transversal analítico / Depressive symptomatology and neurocognitive disorders in haart-adherent and non-adherent hiv patients: a cross-sectional analytical study

Introducción: Las personas portadoras del virus de inmunodeficiencia humana (VIH) presentan mayor comorbilidad de trastornos neurocognitivos y del ánimo que la población general. La introducción de los antirretrovirales ha disminuido significativamente la demencia asociada a VIH, relacionado a la adherencia a la terapia antirretroviral altamente activa (TARAA). Diversos estudios han demostrado la coexistencia de otros factores para explicar dicho trastorno cognitivo, tales como enfermedad neurológica previa, enfermedad psiquiátrica, consumo de drogas, nivel educativo, reserva cognitiva, entre otras. Objetivo: Determinar el grado de sintomatología depresiva, deterioro cognitivo y su relación con la adherencia a TARAA y otros factores de curso clínico en pacientes portadores de VIH en control ambulatorio. Métodos: Estudio transversal. Se incluyeron pacientes que viven con VIH adscritos al programa de infectología del Hospital Dr. Gustavo Fricke, Viña del mar, Chile. Se utilizaron datos sociodemográficos, clínicos y se aplicaron las escalas Depression in the Medicaly III Questionary, Montreal Cognitive Assesment y Morysky Green Levin Test. Resultados: Se incluyeron 29 participantes, en su mayoría hombres (86,2%) y con escolaridad técnica o profesional (86.2%). No hubo diferencias entre variables biodemográficas, depresivas ni subdimensiones cognitivos. Entre pacientes adherentes y no adherentes se encontró diferencias significativas respecto a la presencia de algún deterioro cognitivo. Conclusiones: Los resultados deben ser interpretados con cautela, dado su alcance limitado. Futuros estudios traslacionales debieran incorporar mediciones más certeras del nivel de adherencia al TARAA.

Introduction: Human immunodeficiency virus (HIV) carriers present more neurocognitive and mood disorders than the general population. The introduction of antiretrovirals has significantly lowered the incidence of HIV associated dementia, and this is related to adherence to highly active antiretroviral therapy (HAART). Several studies have shown the coexistence of other factors that could explain the cognitive disorder, such as a pre-existing neurological disease, psychiatric disease, drug consumption, level of education, cognitive reserve, and others. Objective: To determine the degree of depressive symptomatology and cognitive impairment and their relation to adherence to HAART and other factors of the clinical course of HIV carriers in outpatient supervision. Methods: Cross-sectional study. We included HIV patients in the infectious diseases program, Dr Gustavo Fricke Hospital, Viña del Mar, Chile. We used sociodemographic and clinical data and we applied the Depression in the Medically Ill questionnaire, Montreal Cognitive Assessment, and the Morysky Green Levin Test. Results: 29 patients participated, mainly men (86.2%) with technical or professional education (86.2%). There were no significant differences in sociodemographic, depressive, or cognitive subdomain variables. There were significant differences in cognitive impairment between adherents and non-adherents. Conclusions: Care should be taken with interpreting the results, given their limited scope. Future cross-sectional studies should incorporate more accurate measurements of HAART adherence.