The catastrophic effects of groundwater intensive exploitation and Megadrought on aquifers in Central Chile: Global change impact projections in water resources based on groundwater balance modeling.

Central Chile is undergoing its most severe drought since 2010, affecting ecosystems, water supply, agriculture, and industrial uses. The government's short-term measures, such as increasing groundwater extraction (by 383 % from 1997 to 2022), are exacerbating the situation, leading to long-term hydrological deterioration. The objective of this research is to establish the main processes driving the water table depth evolution within Central Chile over the period 1979-2023. This is done by conducting groundwater balances on five major hydrological basins of Central Chile. For the Megadrought (MD) period (2010-2022), the groundwater level depths reflect not only the recharge variability but, especially, the forcing trend of groundwater withdrawals: they represent 35 % and 65 %, respectively, of the total phreatic level drawdown. This result underlines the dominant role played by groundwater withdrawals in the current delicate state of Central Chile's groundwater resources, while revealing that drought is a new complex phenomenon to deal with, in the midterm, to revert the current water resource trend in Central Chile. Our study moreover presents the impact of climate change in the basin in the framework of six different groundwater withdrawal scenarios. In the worst case (i.e., RCP8.5), the aquifer recharge decreases 18 % with respect to 1979-1997, which is the period assumed to be unaffected by the impact of MD and withdrawals. Such a reduction may be irrelevant in the dynamics of the aquifer system if the current extraction rate does not change. The estimated recovery time needed to reach aquifer conditions equal to those of the unaffected period is approximately 50 years.

Características radiográficas de la neumonía adquirida en la comunidad en el adulto inmunocompetente hospitalizado según el agente causal / Radiographic characteristics of community-acquired pneumonia in the immunocompetent adult hospitalized according to the etiologic agent

Resumen En la práctica clínica, la radiografía de tórax permite confirmar el diagnóstico y la extensión de la neumonía adquirida en la comunidad (NAC). Objetivos: Examinar las características radiográficas de la NAC según el agente causal y el grado de concordancia interobservador (CI) en la descripción de los hallazgos radiográficos. Métodos: Se evaluaron las radiografías de tórax de 300 pacientes adultos inmunocompetentes hospitalizados por NAC, tres residentes de radiología consignaron el patrón de los infiltrados pulmonares, su localización anatómica y extensión, la presencia de derrame pleural y otros hallazgos radiográficos. Se realizaron cultivos de esputo, hemocultivos, pruebas serológicas y técnicas de biología molecular de hisopado nasofaríngeo para identificar los principales patógenos respiratorios. Resultados: Las manifestaciones clínicas y los hallazgos de la radiografía de tórax fueron similares en las neumonías causadas por diferentes patógenos respiratorios: bacterias clásicas, virus respiratorios y microorganismos atípicos. En las neumonías bacterianas predominó el patrón de relleno alveolar de distribución lobar, en las neumonías vírales y atípicas predominó el patrón intersticial o mixto alvéolo-intersticial con opacidades en vidrio esmerilado. La CI fue satisfactoria (kappa > 0,6) para determinar el patrón principal de los infiltrados pulmonares, su localización anatómica y la presencia de derrame pleural, su localización y extensión. La CI fue moderada (kappa 0,4-0,6) para definir la extensión de la neumonía y detectar signos radiológicos asociados a congestión pulmonar. Conclusión: Los hallazgos de la radiografía de tórax no permitieron identificar con precisión el agente causal de la neumonía, siendo útil en la caracterización de los infiltrados pulmonares y para detectar complicaciones como el derrame paraneumónico.

In a clinical setting the chest radiograph is the reference standard in establishing the diagnosis of community-acquired pneumonia (CAP). Objectives: This study aimed to assess interobserver reliability (IR) of radiographic findings and the relationship to different respiratory pathogens in CAP. Methods: Chest radiographs of 300 immunocompetent adult patients hospitalized with pneumonia, obtained from a database, were reviewed by three residents of radiology without specific clinical information. Main pattern of pulmonary infiltrates, topographic localization, extent of pneumonia, presence of pleural fluid, thickened bronchial walls, lymphadenopathy and air bronchogram were scored. Sputum and blood cultures, serological tests and nasopharyngeal swab for respiratory virus detection by molecular diagnostic techniques were performed to identify the causative pathogen. Results: Clinical manifestations and chest X-ray findings were similar in pneumonias caused by different respiratory pathogens: classic bacteria, respiratory viruses and atypical microorganisms. The alveolar pattern of lobar distribution predominated in bacterial pneumonia; meanwhile, interstitial or mixed alveolar-interstitial pattern with ground glass opacities predominated in viral and atypical pneumonias. IR was fair to good (kappa > 0.6) for determining the main pattern of infiltrates, anatomical location and the presence of pleural effusion, their anatomical location and extension. IR was moderate (kappa 0.4-0.6) for determining the extent of pneumonia and signs of congestive heart failure. Conclusion: Simple features such as main pattern description, anatomical location, identifying the involved lobes and pleural fluid recognition showed fair to excellent interobserver reliability. Chest radiographs was of limited value in predicting the causative pathogen but were of beneficial use to characterize pulmonary infiltrates and to detect complications such as parapneumonic effusion.

Identifying self-report measures of emotion regulation and evaluating their psychometric properties: a protocol for a systematic review.

INTRODUCTION: Successful emotion regulation (ER) is critical for psychological health. Disturbances in this ability are associated with several psychiatric disorders. There are several self-report questionnaires to assess ER. However, there are no studies synthesising the evidence on their psychometric properties. We aim to identify all available instruments addressing ER in adolescents or adults and to critically appraise, compare and summarise the quality of their psychometric properties. For this, we will use COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) criteria. METHOD AND ANALYSIS: The search process to identify eligible studies will be conducted in April 2021 including the ProQuest, PubMed, Scopus and Web of Science databases with no restriction in terms of publication date. Eligibility criteria include peer-reviewed research articles written in English or Spanish by means of patient-reported outcome measures focused on ER among participants of 13 years or older. We will assess the quality of measures according to the COSMIN Risk of Bias Checklist. The psychometric properties will be assessed by the COSMIN updated criteria for good measurement. The available evidence will be addressed by the Grading of Recommendations, Assessment, Development and Evaluations approach. Our findings will be synthesised independently for each measure, including information on their sample, theoretical model and psychometric properties when possible. ETHICS AND DISSEMINATION: Ethical approval is not required, as this study does not involve any participants or collection of primary data. Results are expected to be published in a peer-reviewed journal in the field of youth mental health and presented at relevant meetings and conferences. PROSPERO REGISTRATION NUMBER: CRD42021249498.

Delayed lower extremity paresis following iliosacral screws: Atypical complication and treatment.

Percutaneous iliosacral screw placement has become the technique of choice for treating injuries to the posterior pelvis. However, the technique requires an understanding of the anatomy surrounding the bone corridors to avoid complications and detect them early if they occur. We present the clinical case of a patient with a U-shaped fracture of the sacrum that evolves with gluteal pain and left foot equine paresis after percutaneous fixation with iliosacral screws. Angio-CT of the pelvis shows active arterial bleeding from the superior gluteal artery associated to extensive hematoma in the thickness of the gluteus medius muscle. Emergency embolization is performed by installing coil and gelatin. Successful control of bleeding is achieved. To avoid this complication, a complete imaging study is recommended in planning the surgery and to avoid multiple repositioning of the guide or screw. Arterial injury should be suspected in case of increasing pain despite analgesia, functional impairment or neurological deficit and the angiographic study and resolution by selective embolization of the bleeding vessels must be performed.

Eficacia de la cirugía bariátrica-metabólica en pacientes con obesidad y diabetes mellitus tipo 2 / Efficacy of bariatric-metabolic surgery in patients with obesity and type 2 diabetes mellitus

La prevalencia de la diabetes mellitus tipo 2 está incrementando rápidamente a nivel mundial de manera paralela a la epidemia de obesidad. El número de personas con diabetes, alrededor del mundo, se ha duplicado en los últimos 20 años; una de las características más preocupantes de este rápido crecimiento es el aparecimiento de diabetes tipo 2 en niños, adolescentes y adultos jóvenes. Debido a la reducción de la esperanza de vida causada por las morbilidades producidas por la diabetes, los pacientes que sufren de esta patología requieren un manejo integral. La cirugía bariátrica / metabólica ha demostrado que: • Mejora significativamente el control glucémico. • Reduce los factores de riesgo cardiovasculares. • Incluso ha demostrado la posibilidad de producir remisión de la diabetes tipo 2, hipertensión arterial y otras comorbilidades asociadas con la obesidad. Los resultados de múltiples estudios demuestran claramente la eficacia de la cirugía metabólica en el control glucémico y de otras comorbilidades asociadas con la diabetes tipo 2 y la obesidad; se observa, con mucha frecuencia, casos de remisión de la diabetes, incluso hasta 5 años después de la intervención quirúrgica. Por esta razón, la Asociación Americana para la Diabetes (ADA) considera a la cirugía bariátrica como una opción terapéutica viable en pacientes obesos con diabetes mellitus tipo 2.Las cirugías gastrointestinales diseñadas para controlar la obesidad pueden mejorar la homeostasis de la glucosa más efectivamente que el tratamiento farmacológico-clínico y producir cambios importantes en el estilo de vida; incluso, en un considerable número de pacientes, se logra la remisión de la diabetes tipo 2. (AU)

The prevalence of type 2 diabetes mellitus is rapidly increasing to global level parallel to the epidemic that obesity. The number of people with diabetes, around the world, have doubled in the last 20 years; one of the most worrisome features of this rapid growth It is the appearance of type 2 diabetes in children, adolescents and young adults. Due to the reduction in life expectancy caused by morbidities produced by diabetes, patients suffering from this pathology require comprehensive management bariatric / metabolic surgery has shown that: • Significantly improves glycemic control. • Reduces cardiovascular risk factors. • It has even demonstrated the possibility of producing diabetes remission type 2, arterial hypertension and other comorbidities associated with obesity. The results of multiple studies clearly demonstrate the effectiveness of the metabolic surgery in glycemic control and other associated comorbidities with type 2 diabetes and obesity; cases are very often observed of remission of diabetes, even up to 5 years after the intervention surgical For this reason, the American Diabetes Association (ADA) considers bariatric surgery as a viable therapeutic option in obese patients with type 2 diabetes mellitus. Gastrointestinal surgeries designed to control obesity can improve glucose homeostasis more effectively than treatment clinical pharmacological and produce important changes in lifestyle; even, in a considerable number of patients, remission of the type 2 diabetes. (AU)

Frecuencia de diabetes mellitus en pacientes con tratamiento para tuberculosis en Colombia / Prevalence of diabetes mellitus in patients with treatment for tuberculosis in a public hospital in Colombia

RESUMEN Introducción: La tuberculosis es una enfermedad infectocontagiosa causada por el Mycobacterium tuberculosis; entre los factores de riesgo para su desarrollo se encuentra la diabetes mellitus. Las personas con Tuberculosis activa y diabetes pueden complicarse negativamente en los resultados del tratamiento de la Tuberculosis, retrasando el tiempo de respuesta microbiológica, lo que aumenta la probabilidad de un resultado no favorable y aumenta el riego de recaídas, la resistencia a fármaco y la muerte en algunos casos. Objetivo: Establecer la frecuencia de diabetes mellitus en pacientes con tuberculosis que estaban en tratamiento en un Hospital público en Valledupar, Colombia; y su correlación con los factores de riesgo. Material y Métodos: Se efectuó un estudio descriptivo transversal, en todos los casos diagnosticados con Tuberculosis que asistieron al tratamiento en un Hospital. El diagnostico de diabetes se realizó con prueba de glicemia basal, con la historia clínica de los pacientes y encuestas. A todos los participantes se le realizó una encuentra para evaluar los factores de riesgos. Resultados: De 70 pacientes con tuberculosis, 8 (11,4 %) fueron diagnosticados con DM. Se observó que la edad > 40 años (p= 0,030) constituye un factor de riesgo para el binomio Tuberculosis-diabetes; pero no hubo diferencia estadísticamente significativa con respecto al sexo, consumo de alcohol y tabaco, VIH, índice de masa corporal (p > 0,05). Conclusiones: La prevalencia del binomio diabetes mellitus y tuberculosis en el Hospital estudiado coincide con las cifras establecida por la OMS.

ABSTRACT Introduction: Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis. Diabetes Mellitus is among the risk factors for the development of Tuberculosis. People with active Tuberculosis and diabetes can be negatively complicated by the results of Tuberculosis treatment, delaying the time of microbiological response which increases the probability of an unfavorable result and the risk of relapse, drug resistance, and death in some cases. Objective. To establish the prevalence of Diabetes mellitus and its correlation with risk factors in patients with Tuberculosis who underwent treatment in a public Hospital in Valledupar, Colombia. Material and Methods. A cross-sectional descriptive study was carried out in all cases diagnosed with Tuberculosis that underwent treatment in a public Hospital in Valledupar, Colombia. The diagnosis of diabetes was made with the use of a test to measure basal glycemia, the clinical histories of the patients, and surveys. All participants were surveyed for the evaluation of risk factors. Results. Of the 70 patients with Tuberculosis, 8 (11.4%) were diagnosed with DM. It was observed that the age> 40 years (p = 0.030) constitutes a risk factor for the TB-DM binomial; but there was no statistically significant difference with regard to sex, alcohol consumption, tobacco consumption, HIV, and body mass index (p> 0.05). Conclusions . The prevalence of Diabetes mellitus-Tuberculosis binomial in the Hospital studied corresponds to the figures established by the World Health Organization (WHO).

Relationships of body surface thermography with core temperature, birth weight and climatic variables in neonatal lambs born during early spring in an arid region.

The main cause of death in newborn lambs is hypothermia, so is necessary to identify the factors affecting variations in body surface temperatures of sheep neonates because approximately 60% of their body heat losses occur through the skin. This study aimed to establish relationships among body surface thermography from different regions with rectal temperature (RT), birth weight (BW) and climatic variables in hair breed newborn lambs during early spring in an arid region. Data of body surface temperatures measured by infrared thermography (entire head, eye, muzzle, ear, entire body, shoulder, rump, loin, right flank, belly and leg), RT and BW were collected at 0, 12 and 24 h post-lambing in 85 lambs born in early spring. Relative humidity [RH], temperature [Te] and temperature-humidity index [THI] were also recorded. RT was not correlated with surface temperatures at 0 and 24 h, but it was at 12 h with all of them (0.36 ≤ r ≤ 0.44). BW and some surface temperatures were negatively correlated at 0 and 24 h (-0.24 ≤ r ≤ -0.30), but positively at 12 h (0.25 ≤ r ≤ 0.27). All surface temperatures were positively correlated (0.51 ≤ r ≤ 0.85) with Te and THI in the three sampling times. Principal component (PC) analysis showed that PC1 explained the majority of the variance (71-72%), followed by PC2 (8-9%) at 0, 12 and 24 h. Body surface temperatures increased as Te and THI also increased, but decreased with the increase in HR. In conclusion, under early spring environment (predominantly cold), the variations in body surface temperatures of hair sheep neonates were more closely related to climatic variables than to RT and BW. Thermography proved to be an effective tool to determine body heat loss by radiation in skin of neonate lambs.

Economic evaluation of the environmental impact of a dairy cattle intensive production cluster under arid lands conditions.

At a global level, dairy cow production systems (DCPS) are important sources of nourishment and profits, but they generate environmental impacts such as overexploitation of different resources including water, lands and fossil energy. Quantification of water and carbon footprint to define mitigation strategies and a more rational use of natural resources, is a reiterated claim. The aim of this study was to perform an economic evaluation of the environmental impact of the DCPS from the Comarca Lagunera, Mexico (24°N, 102°W, 220 mm, hot-semiarid climate) We contrasted the economic value (EV) generated by the DCPS with respect to the economic costs (EC) due to the greenhouse gas emissions (GHGE) and the water footprint (WFP) of this DCPS. While quantifications of GHGE considered those proposed by the Intergovernmental Panel on Climate Change, the WFP involved the use of blue, gray and green water by the DCPS and related activities. Quantification of the EC of WFP considered an international average price of water. In the year 2017, the Comarca Lagunera registered a dairy cow inventory of 493 144 heads, with 227 142 lactating cows, which produced 2386 million liters of milk per year with an annual average EV of €525.3 million. The EC (€, millions) generated by the GHGE and WFP were €311.8 and €11 980.7, respectively, with a total EC of € 12 292.5 million. When the EV of milk production and the total environmental EC are compared, the contrast demonstrates not only the noteworthy environmental impact but also the significant and senseless biological and EC. In addition, having a large dairy cow concentration creates pollution concerns and the DCPS transfers both nutrients and water resources from an ecologically vulnerable arid region. Therefore, some mitigation strategies such as, better cow genotype, feed and manure management combined with the production of forages and grains in a different geographical region are suggested to promote an optimum use of water in order to uphold the social, economic and biologic sustainability of the Comarca Lagunera, Mexico.

Thermoregulatory response to outdoor heat stress of hair sheep females at different physiological state.

Forty Dorper × Pelibuey sheep females were used to evaluate the effects of physiological state on physiological variables and serum concentrations of metabolites, thyroid hormones, and electrolytes under outdoor heat stress conditions. Females were selected as follows (n = 10 per group): weaning ewe lambs (WEL; 3 months old), replacement nulliparous ewes (RNE; 8 months old), non-pregnant and non-lactating multiparous ewes (NME; 3-4 years old) and lactating multiparous ewes (LME; 3-4 years old). While physiological variables were measured both morning and afternoon, blood samples were collected before feeding in the morning to determine all blood components. Three contrasts were constructed: (1) WEL vs. older ewes, (2) RNE vs. multiparous ewes, and (3) NME vs. LME. Compared with older ewes, WEL had higher (P < 0.01) rectal temperature (RT) and hair coat temperatures through the day, and also higher (P < 0.01) respiratory rate (RR) only in the afternoon. Serum levels of glucose and cholesterol were lower (P ≤ 0.02) in WEL than in older ewes. Nulliparous ewes compared with multiparous had always similar RT but higher (P ≤ 0.05) hair coat temperatures in most of the body regions by the morning and higher (P < 0.01) RR, without difference for hair coat temperatures in the afternoon. Only serum glucose (P = 0.07) and urea nitrogen (P < 0.01) levels were affected by parturition number, being lower in multiparous ewes. Regarding the effect of lactation, while RR was unaffected, afternoon RT and hair coat temperatures in most of the body regions through the day were higher (P ≤ 0.03) in lactating ewes. In addition, LME had lower (P < 0.01) serum levels of glucose, cholesterol, and urea nitrogen, but higher (P = 0.02) triiodothyronine levels than NME. In conclusion, ewe lambs and lactating ewes were less tolerant to heat stress, while nulliparous and multiparous ewes showed similar thermoregulatory ability.

Lupus eritematoso sistémico asociado a síndrome de McCune-Albright: reporte de un caso / Systemic lupus erythematosus associated a McCune-Albright syndrome: case report

RESUMEN El Síndrome de McCune-Albright (SMA) es una enfermedad poco frecuente compuesta por una tríada clásica: displasia fibrosa poliostótica (DFP), manchas cutáneas de color café con leche y alteraciones endocrinas, siendo la más frecuente la pubertad precoz. Este síndrome no se ha visto asociado a enfermedades autoinmunes. Reportamos el primer caso de una paciente con SMA y lupus eritematoso sistémico.

ABSTRACT McCune-Albright Syndrome (MAS) is a rare disease characterized by a classical triad: polyostotic fibrous dysplasia (PFD), cafe-au-lait macules and endocrine abnormalities, most frequently precocious puberty. This syndrome has not been associated with autoimmune diseases. We report the first case of a patient with MAS and systemic lupus erythematosus.

The use of female estrogenized goats as sexual stimulator of crossbred dairy males subsequently exposed to acyclic goats during two phases of the anestrous season.

This research evaluated the possible influence of exposure of male goats to estrogenized female goats ("female effect") upon males' sexual behavior [appetitive (ASB) & consummatory (CSB)], as well as the induction of reproductive activity of crossbred dairy female goats exposed to such treated males ("male effect") during the early and deep anestrous periods. Crossbred dairy adult male goats (n = 12; 24-48 mo. old) and 80 anovulatory crossbred dairy adult female goats (34-50 mo. old) were used during two experimental periods: March to April and April to May. First, males were separated into four groups (n = 3 each), roughly homogeneous regarding body weight and body condition score and randomly assigned to four experimental groups. The first two groups included males + estrogenized females, then such males were exposed to anestrous females either during March (group 1: three males; 20 females; EFEM-MAR), or during April (group 2: three males; 20 females; EFEM-APR). The second two groups were respective control groups: Males + non-treated-anestrous females, and then such males exposed to acyclic females either during March (group 3: three males; 20 females; CONT-MAR) or April (group 4: three males; 20 females; CONT-APR). Once the male-to-female contact was established, both odor (ODT) and behavior (BEHT) tests (2 d × 2 h) were performed during both anestrous periods. On day 10 after introduction of the males, in both anestrous periods, one ultrasonography scanning ("US") was performed to quantify the presence, number and size of corpus luteum (US-CL) to determine the effectiveness of the "male effect" and indicators of ovarian activity. Then, on day 45 after introduction of the males, a second US was performed to evaluate pregnancy rate (US-PREG). The EFEM-males, regardless of the phase of the anestrous cycle, had an increased (P < 0.05) odor intensity with respect to the control groups. In addition, while an increased (P < 0.05) ASB occurred in the EFEM-males, no CSB differences (P > 0.05) arose when treatments were compared, neither in March-April nor in April-May. The EFEM-males exposed to acyclic goats in March-April (i.e. early anestrous period), promoted not only the largest estrus and ovulatory responses (P < 0.05), but also the largest pregnancy rate (P < 0.05) in these previously anestrus goats, suggesting that in April-May (i.e. profound anestrous), the presence of active males was not enough to completely suppress cyclic reproductive arrest. This study generates interesting out-of-season reproductive outcomes in a goat population with a large proportion of highly seasonal dairy breeds (i.e. Alpine, Saanen and Toggenburg), augmenting the possibility to expand milk production and the economic income of goat producers across the year. Besides, this practice may serve as an interesting reproductive tool to increase the sustainability of marginal goat production systems under semiarid conditions.

Pancreatoyeyunoanastomosis con técnica de Blumgart modificada para reconstrucción post-pancreatoduodenectomía: estudio de serie de casos con seguimiento / Pancreatojejunostomy with modified Blumgart technique for post-pancreatoduodenectomy reconstruction

Resumen Introducción: La pancreatoduodenectomía es una cirugía compleja, con cifras de morbilidad cercanas a 30% y mortalidad entre 1 a 5%. El principal factor responsable de morbilidad y mortalidad es la fístula pancreática posoperatoria (FPPO). En la actualidad no existe una técnica universalmente estandarizada para la reconstrucción pancreática. Objetivo: Determinar la prevalencia de FPPO clínicamente relevante en una serie de pacientes en los que se realizó reconstrucción pancreática con pancreatoyeyunoanasto- mosis con técnica de Blumgart modificada para reconstrucción post-pancreatoduodenectomía en Hospital Hernán Henríquez Aravena entre los años 2014-2017. Material y Método: Serie de casos con seguimiento de julio de 2014 a abril de 2017. Se incluyeron pacientes a quienes se realizó reconstrucción pancreática con técnica de Blumgart modificada. La modificación consistió en el uso de pledgets® (poli-tetrafluoro- etileno) en los puntos iniciales en el páncreas con la idea de disminuir la posibilidad de desgarro del tejido. Se excluyeron pacientes a quienes se realizó otra técnica de reconstrucción. Se consideró FPPO clínicamente relevante (grado B/C) para evaluar morbilidad. Se utilizó estadística descriptiva con medidas de tendencia central y dispersión. Resultados: Serie de casos de 12 pacientes, 9 (75%) de género femenino y 3 (25%) de género masculino. La edad promedio fue de 59 ± 8,5 años. La morbilidad fue de 25% y la tasa de fístula grado B/C fue 0%. Todas las fístulas pancreáticas fueron grado A (33,3%), sin relevancia clínica. Conclusión: La técnica de Blumgart modificada parece ser una técnica segura y reproducible para pancreato-yeyuyoanastomosis.

Introduction: Pancreatoduodenectomy is a complex surgery, with morbidity close to 30% and mortality between 1% and 5%. The main contributing factor to morbidity and mortality is postoperative pancrea- tic fistula (POPF). At present, there is no globally standardized technique for pancreatic reconstruction. Aim: To determine the prevalence of clinically relevant POPF in a sample of patients who underwent pancreaticojejunal anastomosis reconstruction with Blumgart's modified technique for post-pancreato- duodenectomy reconstruction at Hospital Hernán Henríquez Aravena between 2014 and 2017. Material and Method: Case series with follow-up from july 2014 to april 2017. Patients who underwent pancreatic reconstruction with Blumgart's modified technique were included. The modification consisted of the use of Pledgets® (poly-tetrafluoro-ethylene) at the inicial points in páncreas with the idea of reducing the possibility of tissue tearing. We excluded patients who underwent another reconstruction technique. Clinically relevant POPF (grade B/C) was considered to asses morbidity. Descriptive statistics were used with measures of central tendency and dispersion. Results: Case series of 12 patients, 9 (75%) were female and 3 (25%) were male. The mean age was 59 ± 8.5 years. The morbidity was 25% and the rate of grade B/C fistula was 0%. All pancreatic fistulas were grade A, not clinically relevant. Conclusion: The Blumgart's modified technique seems to be a safe and reproducible technique for pancreticojejunal anastomosis.

[Abnormal expansion of C9orf72 gene in familial frontotemporal dementia]. / Expansión anormal de hexanucleótido en gen C9orf72 en una familia con demencia frontotemporal y cuadros asociados.

Frontotemporal Dementia (FTD) and Motor Neuron Disease (MND) may share similar pathogenic mechanisms. An abnormal hexanucleotide expansion in C9orf72 gene is the most common genetic abnormality of these conditions and explains their concurrence in the same family. We report a 77-year-old female presenting with non-fluent aphasia leading to mutism and a mild Parkinsonism. A magnetic resonance imaging showed a severe atrophy of frontal and temporal lobes. Several family members of the patient suffered of atypical Parkinsonism, lateral amyotrophic sclerosis and dementia. We identified an abnormal hexanucleotide expansion in the C9orf72 gene in the proband. To the extent of our knowledge, this is the first time that this diagnosis is confirmed in our country. The knowledge of the genetic basis of neuro degenerative disorders improves diagnosis and opens expectatives for future treatments of these disabling conditions.

Expansión anormal de hexanucleótido en gen C9orf72 en una familia con demencia frontotemporal y cuadros asociados / Abnormal expansion of C9orf72 gene in familial frontotemporal dementia

Frontotemporal Dementia (FTD) and Motor Neuron Disease (MND) may share similar pathogenic mechanisms. An abnormal hexanucleotide expansion in C9orf72 gene is the most common genetic abnormality of these conditions and explains their concurrence in the same family. We report a 77-year-old female presenting with non-fluent aphasia leading to mutism and a mild Parkinsonism. A magnetic resonance imaging showed a severe atrophy of frontal and temporal lobes. Several family members of the patient suffered of atypical Parkinsonism, lateral amyotrophic sclerosis and dementia. We identified an abnormal hexanucleotide expansion in the C9orf72 gene in the proband. To the extent of our knowledge, this is the first time that this diagnosis is confirmed in our country. The knowledge of the genetic basis of neuro degenerative disorders improves diagnosis and opens expectatives for future treatments of these disabling conditions.

Oral diseases: a 14-year experience of a Chilean institution with a systematic review from eight countries.

BACKGROUND: Retrospective studies to assess the distribution of oral diseases (ODs) are helpful in estimating the prevalence of oral diagnoses in the population, and thus help in preventive and curative services. Prevalence and frequency data for ODs are available from many countries, but information from Chile is scarce. MATERIAL AND METHODS: This study investigated the frequency of OD in a Chilean population. For this, we included all patients treated at the University of Talca (UTALCA, Chile) between 2001 and 2014. Patient characteristics were retrieved from medical files. To contextualize our results, we conducted a systematic review (SystRev) using Publish or Perish software (PoP), Google Scholar and MEDLINE/PubMed. RESULTS: One hundred sixty-six ODs were diagnosed, and the most prevalent groups were soft tissue tumours, epithelial pathology and salivary gland pathology. Individually, irritation fibroma, oral lichen planus (OLP) and mucocele were the most common diagnoses. ODs frequently affected unspecified parts of the mouth (including cheek, vestibule and retromolar area), gum, lips, tongue and palate. In the SystRev, the more studied diagnoses were leukoplakia, OLP and recurrent aphthous stomatitis; prevalent lesions included Fordyce's spots, recurrent aphthous stomatitis and fissured tongue. Chilean patients and SistRev shared almost all ODs. CONCLUSIONS: The results reflect ODs diagnosed in a specialized service of oral pathology and medicine in Chile and will allow the establishment of preventive/curative policies, adequate health services and dentistry curriculum.

The Evidence-Informed Policy Network (EVIPNet) in Chile: lessons learned from a year of coordinated efforts

Informing the health policymaking process with the best available scientific evidence has become relevant to health systems globally. Knowledge Translation Platforms (KTP), such as the World Health Organization's Evidence Informed Policy Networks (EVIPNet), are a recognized strategy for linking research to action. This report describes the experience of implementing EVIPNet in Chile, from its objectives, organizational structure, strategy, activities, and main outputs, to its evolution over the course of its first year. Lessons learned are also covered. Of the activities initiated by EVIPNet-Chile, the Rapid Response Service proved to be a good starting point for engaging policymakers. Capacity building workshops and policy dialogues with relevant stakeholders were also successful. Additionally, EVIPNet-Chile developed a model for engaging academic institutions in policymaking through a network focused on preparing evidence briefs. A number of challenges, such as changing methods for producing rapid evidence syntheses, were also identified. This KTP implementation model located in a Ministry of Health could contribute to the development of similar initiatives in other health systems.

Cerebral vasomotor reactivity assessment using Transcranial Doppler and MRI with apnea test.

Differently from previous studies that used Transcranial Doppler (TCD) and functional MRI (fMRI) for cerebral vasomotor reactivity (CVR) assessment in patients with carotid stenosis (CS), we assessed CVR using an identical stimulus, the Breath-Holding Test (BHT). We included 15 patients with CS and 7 age-matched controls to verify whether fMRI responded differently to BHT between groups and to calculate the agreement rate between tests. For TCD, impaired CVR was defined when the mean percentage increase on middle cerebral artery velocities was ≤31% on 3 consecutive 30-s apnea intercalated by 4-min normal breathing intervals. For fMRI, the percent variation on blood oxygen level-dependent (BOLD) signal intensity in the lentiform nucleus (LN) ipsilateral to the CS (or both LNs for controls) from baseline breathing to apnea was measured. The Euclidian differences between the series of each subject and the series of controls and patients classified it into normal or impaired CVR. We found different percent variations on BOLD-signal intensities between groups (P=0.032). The agreement was good in Controls (85.7%; κ=0.69) and overall (77.3%; κ=0.54). We conclude that BHT was feasible for CVR assessment on fMRI and elicited different BOLD responses in patients and controls, with a good overall agreement between the tests.

Exposure of sexually inactive males to estrogenized females increased the investigative and consummatory sexual behavior.

Two trials were conducted to evaluate the effect of diverse socio-sexual cues upon male sexual behavior and the reproductive performance of anestrous does (AD). Trials were conducted in northern Mexico (26°N) during the natural anestrous season (Feb-Mar) with crossbred dairy bucks. In Experiment 1, sexually inactive bucks (SIB, n=12) were randomly allotted to three groups, four males/group: a) DEE 9novelty stimulation) - daily exchange of estrogenized females (EF) 12&12h, b) NEE (no novelty stimulation) - no-exchange of EF, 24h, or c) CON (saline-treated_ -daily exchange of AF 12&12h. Sexually active bucks (SAB) from the DEE, NEE and CON groups were subsequently exposed to AD (n=72; n=24/group) and the reproductive outcomes were recorded. In Experiment 2, SAB (n=12; n=6/group) were randomly divided in: 1) B+EF - males+four-EF exposed to AF (n=36), and 2) B+NEF; males+four-saline-treated AD and exposed to AD (n=36). Prior to the onset of the experimental breeding in both experiments, the investigative (ISB), consummatory (CSB) and resting (RSB) sexual behavior of males were quantified (2h×d×2d). Sexual behaviors considered were: ISB - flehmen, ano-genital sniffing, approaches, vocalizations, kicking, penis extrusion, CSB; mount attempts and mounts, and RSB - isolation, attempted escape, aggression and distractions. While EF were an effective stimulus (P<0.05) for evoking mounting in SIB males, daily exchange of estrous does used to stimulate males promoted an enhanced response (P<0.05) in terms of both ISB and CSB. After being exposed to AD, the B+EF bucks induced an earlier estrous response (P<0.05) as compared with the B+NEF bucks. The untreated females did not induce any sexual activity in males and stimulation of ovarian function did not occur when saline treated (CON) AD were exposed to AD. Also, the B+EF group induced an enhanced increase (P<0.05) of the male ISB and CSB, inducing in turn an increase percentage onset of estrus in does that had previously been anestrus (P<0.05).

Recent climatic events controlling the hydrological and the aquifer dynamics at arid areas: The case of Huasco River watershed, northern Chile.

The investigation assesses the influence of recent climatic events in the water resources and the aquifer dynamics in the Huasco watershed by means of the analysis of precipitation, streamflow and piezometric levels during the last 50years. These hydrological and hydrogeological parameters were evaluated by an exploratory geostatistical analysis (semivariogram) and a spectral analysis (periodogram). Specifically, the hydrological and hydrogeological data analyses are organized according to three sub-basins, the Del Carmen River (Section I), the El Tránsito River (Section II), and the Huasco River (Section III). Data ranges for rainfall are from 1961 to 2015, for streamflow from 1964 to 2015, and for groundwater levels from 1969 to 2014, available from Water Authority of Chile. The analyses allowed the identification of cycles in the hydrological and hydrogeological records. The study area is located in a transient climatic fringe where the convergence of several climatic systems can be identified in the hydrological and hydrogeological records. Results indicate that the nival areas and the small glaciers are especially important to the recharge processes in the Huasco watershed during the spring-summer snowmelting. Water reservoirs in the main aquifer (Section III) and in the Santa Juana dam are highly sensitive to ENSO oscillation climatic patterns. The main climatic events that control this record are the El Niño and La Niña events. In addition, the climatic influence of the westerlies and the SE extratropical moisture were also identified. Spectral analysis identified the presence of a 22.9-yearcycle in piezometric levels of the alluvial aquifer of the Huasco River. This cycle is consistent with the 22-year Hale solar cycle, suggesting the existence of a solar forcing controlling the ENSO oscillations. Moreover, semivariogram and spectral analysis identified a 10.65-yearcycle and a 9.2-yearcycle in groundwater, respectively, which were attributed to the strong mode of ENSO oscillations.