Showing papers in "Revista Medica De Chile in 2005"
TL;DR: In this article, two types of revisiones, i.e., revisiones narrativas and revisiones topico, are defined: 1. Revisiones narrated: These revisanun topico de forma mas o menos exhaustiva,generalmente by un experto en el tema.
Abstract: s en las revistas biomedicasde importancia en medicina de adultos, es decirque un medico necesitaria leer, en promedio,unos 17 articulos diarios para mantenerse actuali-zado 1 . Peor aun, muchas veces al revisar un tema,se habra sentido frustrado al encontrar no solodemasiada informacion sino que estudios conresultados discordantes.En este escenario las “revisiones”, que sinteti-zan y actualizan la informacion cientifica, seransiempre bienvenidas. No obstante, como cual-quier publicacion cientifica, estas deben ser eva-luadas criticamente para determinar su validez. EnMedicina Basada en Evidencia (MBE) distinguimos2 tipos de revisiones: 1. Revisiones narrativas: Son aquellas que revisanun topico de forma mas o menos exhaustiva,generalmente por un experto en el tema. Tipica-mente, este tipo de revision dara cuenta de muchosaspectos del topico revisado: epidemiologicos, etio-logicos, fisiopatologicos, diagnosticos, pronosticosy terapeuticos. En general, el autor presenta el temaen un formato narrativo sin declarar explicitamentelos metodos utilizados para obtener y seleccionar lainformacion presentada. Asi, este tipo de revisionesson ideales para responder preguntas de prepara-cion (
57 citations
TL;DR: It is felt that patients are progressively acquiring more protagonism in health care decisions and the reconstruction of the bond between patients physicians within these new scenarios is indispensable to improve the degree of satisfaction of both patients and professionals.
Abstract: This feeling is in accordance with other reports showing that patientsare progressively acquiring more protagonism in health care decisions. The reconstruction of thebond between patients physicians within these new scenarios is indispensable to improve thedegree of satisfaction of both patients and professionals (Rev Med Chile 2005; 133: 11-6).(
53 citations
TL;DR: These guidelines were proposed after a thorough literature review and discussion with groups that practice bariatric surgery using defined protocols, and specific recommendations for patient management and the formation of reference centers for surgical management of obesity are given.
Abstract: Obesity is a chronic disease with an increasing prevalence in all groups of age, and is associated to increased general mortality and cardiovascular risk. The multidisciplinary non surgical approach must be the treatment of choice for obese subjects. However, the results of such approach among subjects with severe or morbid obesity, are unsatisfactory. In this group of patients, bariatric surgery and specifically gastric bypass achieves good long term results, maintaining a low body mass index, reducing complications and improving quality of life. Considering the widespread practice of bariatric surgery in Chile, the Nutrition Unit of the Ministry of Health formed a task force to propose update guidelines for the surgical treatment of obesity. These guidelines were proposed after a thorough literature review and discussion with groups that practice bariatric surgery using defined protocols. This document provides a summarized version of the guidelines. The first section discusses the background for bariatric surgery and the second part give specific recommendations for patient management and the formation of reference centers for surgical management of obesity.
45 citations
TL;DR: One hundred eighty one patients had ulcerative colitis and 57 had Crohn’s disease, with an UC/CD ratio of 3.2/1.
Abstract: One hundred eighty one patients had ulcerative colitis (UC)and 57 had Crohn’s disease (CD), with an UC/CD ratio of 3.2/1. Forty eight percent of patientswere aged between 20 and 39 years old and 69% were diagnosed after 1995. Patients fromHCUCH had more severe disease, more complications and needed surgery more often.
44 citations
TL;DR: The incidences of oral cancer is increasing in Chilean women, but men are more commonly affected, while the morbidity rate for both genders increased while the mortality rate was relatively constant.
Abstract: Background: Most oral cancers are squamous cell carcinomas (90%) which are two to four times more common in men than in women. The reasons for these differences are associated with exposure to factors such as tobacco and alcohol. Age is also considered as a risk factor (about 90% of the cases are diagnosed after 45 years of age). Aim: To analyze the frequency of oral cavity cancer during the last years in Chile. Material and methods: Mortality rates were obtained from death records of the "Instituto Nacional de Estadisticas" and publications of the World Health Organization, from 1955 to 2002. Morbidity from 1969 to 2002 was obtained from hospital discharge records of the Chilean Ministry of Health. Results: Oral cancer corresponded to 1.6% of total cancer cases in Chile, with a male:female ratio of 2.3 to 1. Deaths due to oral cancer was 1% of all cancer deaths, with a male:female ratio of 2.8 to 1. The morbidity rate for both genders increased while the mortality rate was relatively constant. However, we observed an increase in the mortality rate among women from 1980 to 2002, associated with more than 100% increase in the frecuency of smoking, between 1970 and 1998. The most common anatomical location was the tongue. Conclusions: The incidences of oral cancer is increasing in Chilean women, but men are more commonly affected
43 citations
TL;DR: A meta-analysis of published data on neural tube defects (NTDs) was carried out to determine whether there is an increased risk to have a child with NTDs for younger and older mothers and if this risk differs depending on the type of NTD as mentioned in this paper.
Abstract: Background Recent evidence from birth order data suggest that maternal factors can differently influence anencephaly and spina bifida. Aim To study the influence of maternal age on the risk for neural tube defects. Material and methods A meta-analysis of published data on neural tube defects (NTDs) was carried out to determine whether there is an increased risk to have a child with NTDs for younger and older mothers and if this risk differs depending on the type of NTD. All data available with information regarding the frequency of live births and NTDs cases by maternal age (five- or ten-year intervals) were included in the analysis. Effect sizes calculations were performed. Results The analysis supports the hypothesis that there is an increased risk of having an offspring with NTDs for mothers 40 years of age or older. However, this effect is stronger for spina bifida than for anencephaly. There is also evidence that mothers 19 years old or younger have a higher risk for having a child with spina bifida. Conclusions Maternal age influences the risk of having an offspring with neural tube defects.
39 citations
TL;DR: Infantile obesity is associated with metabolicdisturbances that determine a higher risk of type 2 diabetes, high blood pressure and atherosclerotic vascular disease in adulthood.
Abstract: Infantile obesity is associated with metabolicdisturbances (hiperinsulinism, impaired glucose, dislypidemia) that determine a higher risk oftype 2 diabetes, high blood pressure and atherosclerotic vascular disease in adulthood. Insulinresistance is a central mechanism of complications of obesity and is associated to body fat mass.
33 citations
TL;DR: A meta-analysis of published data on neural tube defects supported the hypothesis that there is an increased risk of having an offspring with NTDs for mothers 40 years of age or older, but this effect is stronger for spina bifida than for anencephaly.
Abstract: A meta-analysis ofpublished data on neural tube defects (NTDs) was carried out to determine whether there is anincreased risk to have a child with NTDs for younger and older mothers and if this risk differsdepending on the type of NTD. All data available with information regarding the frequency of livebirths and NTDs cases by maternal age (five- or ten-year intervals) were included in the analysis. Effectsizes calculations were performed.
33 citations
TL;DR: In Chile, leptospirosis exists not only in rural areas but semi urban ones close to Santiago, although the prevalence is low, and education is necessary among semi urban population to avoid infection.
Abstract: Leptospirosis is a zoonotic disease and its incidence isknown in Chile since 2002, when it was incorporated as a disease that must be reported tohealth authorities. A serologic survey for leptospirosis was performed in humans and animalsfrom a farm in a semi urban area in Santiago Chile, after the death of a farmer due to Weildisease in that place.
32 citations
TL;DR: The psychological preferences and learning styles of 65 students of the 2001-graduating cohort of the Pontificia Universidad Catolica de Chile School of Medicine were evaluated and correlated with the information of their specialty choice or occupation two years after graduation.
Abstract: Background: Several studies indicate that doctors who work in the same area of the medical profession tend to behave somehow similarly. Thus, it has been suggested that personality relates to the medical specialty choice. However, it is not known whether people selfselect into the medical specialties according to their personality or the professional practice in a particular field influences their behavior. Aim: To explore the possible association between the graduate’s personality features and learning styles and their chosen specialty. Subjects and Methods: The psychological preferences and learning styles of 65 students of the 2001-graduating cohort of the Pontificia Universidad Catolica de Chile School of Medicine were evaluated with the Myers Briggs Type Indicator and the Kolb Learning Style Inventory, respectively. These variables were correlated with the information of their specialty choice or occupation two years after graduation. Results: Graduates distributed unevenly in different areas of the medical profession. Surgical specialties concentrated a larger proportion of extraverted, intuitive and structured doctors, whereas in Pediatrics and Internal Medicine predominated intuitive and people-oriented MD’s. Primary Care concentrated individuals with introverted, intuitive and flexible attitudes. Convergent learners (interested in problem-solving) preferred Surgery and Primary Care whereas Assimilator learners
32 citations
TL;DR: The clinical features of microscopic polyangiitis and Wegener's granulomatosis in a Chilean cohort of patients are similar to other published data, and in the WG and MPA patients the main predictor for death was a serum creatinine above 2 mg/dl.
Abstract: Background: Systemic vasculitis are a group of heterogeneous diseases characterized by inflammation and necrosis of blood vessel walls. The etiology is not known, but geographic and environmental factors are implicated. Aim: To describe the clinical features of microscopic polyangiitis (MPA) and Wegener's granulomatosis (WG) in a Chilean cohort of patients. Patients and methods: Retrospective review of the medical records of 123 patients with the diagnosis of systemic vasculitis (65 MPA and 58 WG), seen from 1990 to 2001. The diagnosis were made based on the American College of Rheumatology and Chapel Hill criteria. Results: The mean follow-up for MPA was 15 months (1-120) and for WG, 20 months (1-120). The median age (years) at diagnosis for MPA was 61 (19-82) and WG 50 (20-82). Gender distribution was similar in both groups (male: 68% and 57% respectively).The main clinical features in the MPA group were renal involvement (68%), peripheral nervous system involvement (57%), pulmonary hemorrhage (28%), and skin disease (32%). In the WG group were alveolar hemorrhage (62%), renal involvement (78%), paranasal sinus involvement (57%), and ocular disease (26%). In both, creatinine levels above 2.0 mg/dl were associated with a higher mortality (p< 0.01). ANCA by immunofluorescence was performed in 56 MPA patients (75% had pANCA, 4% had cANCA and 21% were ANCA negative) and in 55 WG patients (17% had pANCA, 79% had cANCA and 4% were ANCA negative). Global mortality was 18% and 17% respectively, and the most common causes of death were infections. Conclusions: The clinical features of our patients are similar to other published data. In our WG and MPA patients the main predictor for death was a serum creatinine above 2 mg/dl. (Rev Med Chile 2005; 133: 273-8)
TL;DR: The evidence in the literature of therapeutical interventions with proved efficacy in slowing the rate of reduction of renal function is discussed, particularly the optimal control of hypertension, reduction of proteinuria and renin angiotensin system blocking.
Abstract: Chronic kidney disease is a worldwide health problem. The incidence and prevalence of kidney failure is in constant increase, involving poor outcomes and high costs. The leading causes of kidney failure are type 2 diabetes and hypertension. The new initiative "Kidney Disease Improving Global Outcomes (KDIGO)" is a global public health approach to face this problem. A formal definition for chronic kidney disease and a staging of kidney diseases from kidney damage with preserved function to kidney failure, were proposed. We reviewed the main mechanisms involved in renal disease progression, with emphasis in the proteinuria and the intrarenal activation of renin angiotensin system. Moreover, the evidence in the literature of therapeutical interventions with proved efficacy in slowing the rate of reduction of renal function is discussed, particularly the optimal control of hypertension, reduction of proteinuria and renin angiotensin system blocking. Finally, we recommend a strategy for the clinical management of patients in the different stages of chronic kidney disease.
TL;DR: The HEI is a tool that can be used in the Chilean population and can beused to assess the effectiveness of health promotion initiatives and also can help to focalize educational programs to specific nutrients.
Abstract: Background: Several studies have attempted to assess the global quality of diet. One of such initiatives is the Healthy Eating index (HEI), developed in the Unites States. However, its application in other countries requires certain adaptations. Aim: To adapt the HEI to the Chilean population and to assess its value in Chilean school age children and adults. Material anal methods: A random sample of 264 school age children aged 13.4 ± 0.7 years and 264 adults aged 35.7 ± 0.6 years was studied. A 24 hours food recall was done and the HEI seas calculated considering 10 variables based in the Feeding Guides for the Chilean population. Feeding habits were classified as healthy when the score was over 80 (of a maximum of 100), as requiring changes when the score was between 51 and 80 and as unhealthy when the score was 50 or less. Results: The mean scores for children and adults were 58.4 ± 11.3 and 56.2 ± 11.1 respectively (p< 0.02). The variables with lower scores were vegetables, fruits, dairy products and sodium. Only 1.5% of the population had healthy feeding habits, without differences by sex or age. Feeding quality was significantly worse among obese subjects. Conclusions: The HEI is a tool that can be used in the Chilean population and can be used to assess the effectiveness of health promotion initiatives. It also can help to focalize educational programs to specific nutrients (Rev Med Chile 2005; 133: 175-82)
TL;DR: Los aspirados nasofaringeosobtenidos en las primeras 48 h de hospitalizacion procesaron para aislamiento viral (AV) y detec-cion antigenica por inmunofluorescencia indirecta (IFI) for VRS, adenovirus, virus influenza A y B yparainfluenza 1 a 3, como se ha descrito.
Abstract: . Seexcluyeron ninos prematuros, con obstruccionesrespiratorias recurrentes, asmaticos y con enfer-medades de base neurologica, cardiaca o pulmo-nar cronicas. Los aspirados nasofaringeosobtenidos en las primeras 48 h de hospitalizacion,se procesaron para aislamiento viral (AV) y detec-cion antigenica por inmunofluorescencia indirecta(IFI) para VRS, adenovirus, virus influenza A y B yparainfluenza 1 a 3, como se ha descrito
TL;DR: Clinical evolution, blood glucose, seruminsulin, insulin resistance measured with the homeostasis model assessment (HOMA) and serum lipid levels were analyzed.
Abstract: Two hundred thirty two morbid obese patientssubjected to gastric bypass, were evaluated in the preoperative period and every three monthsafter surgery, during a minimum of 12 months. Clinical evolution, blood glucose, seruminsulin, insulin resistance measured with the homeostasis model assessment (HOMA) andserum lipid levels were analyzed.
TL;DR: Observations and preliminary studies in humans give a rationale for the assessment of IP in minimizing or preventing IR injury during surgery and non surgical conditions of tissue hypoperfusion.
Abstract: Ischemia-reperfusion (IR) liver injury is associated with temporary clamping of hepatoduodenal ligament during liver surgery, hypoperfusion shock and graft failure after liver transplantation. Mechanisms of IR liver injury include: i) loss of calcium homeostasis, ii) reactive oxygen and nitrogen species generation, iii) changes in microcirculation, iv) Kupffer cell activation, and (v) complement activation. Pre-exposure of the liver to transient ischemia increases the tolerance to IR injury, a phenomenon known as hepatic ischemic preconditioning (IP). IP involves: i) recovery of the energy supply and calcium, sodium and pH homeostasis, ii) enhancement in the antioxidant potential, and iii) expression of multiple stress-response proteins, including acute phase proteins, heat shock proteins, and heme oxygenase. These observations and preliminary studies in humans give a rationale for the assessment of IP in minimizing or preventing IR injury during surgery and non surgical conditions of tissue hypoperfusion.
TL;DR: More than one third of children between 2 and 4 years of age tested positive to one or more allergen, demonstrating its applicability in this age group (Rev Med Chile 2005; 133: 195-201).
Abstract: Background: Skin prick test (SPT) of immediate hypersensitivity is a main instrument in the diagnosis of allergy. Aim: To demonstrate the applicability of skin prick test in different age groups. Patients and Methods: We studied children and adolescents with the diagnosis of allergy in the Pediatric Respiratory Laboratory of the Catholic University of Chile, from January 2001 to March 2002. The SPT was performed using a standardized technique. The allergens were applied on the volar surface of the forearm in children older than 4 years of age and in younger children it was applied on their back. For study purposes we separated them into three age groups: GI ≤2 years and 11 months, GII from 3 to 4 years and 11 months, GIII ≥5 years. Results: We studied 408 children, aged between 8 months and 15 years. The SPT was applied to all patients with no adverse effects of any kind. There was a positive reaction in 57.7% of children. The reaction was positive in 37% in G1, 39% in GII and 65% in GIII (p <0.001). The predominant allergens for each group were dust mites (Dermatophagoides pteronissinus and farinae). Conclusions: SPT was useful when used on a selected pediatric population. The frequency of sensitization increased significantly with age. However, more than one third of children between 2 and 4 years of age tested positive to one or more allergen, demonstrating its applicability in this age group (Rev Med Chile 2005; 133: 195-201). (Key Words: Antigens, Dermatophagoides; House dust mites; Hypersensitivity; Skin tests)
TL;DR: Pregnant women with pre-existing or gestational diabetes have a higher risk of giving birth a child with malformations, particularly among women with diabetes mellitus before pregnancy.
Abstract: Background: The risk of congenital malformations is two to three times higher among women with diabetes mellitus before pregnancy. Gestacional diabetes is emerging as a risk factor for malformations. Aim: To study the rate and type of congenital malformations among offspring of women with pre-gestational or gestational diabetes. Material and methods: A search in the databases of the Collaborative Latin American Study for Congenital Malformations and of the Neonatology Unity of The University of Chile Clinical Hospital. All births from January 1998 through June 2004 were investigated. Results: In the study period, 13,965 births occurred, of which 0.7% were stillbirths and 8.1% had malformations. A total of 295 women (2.1%) had diabetes (gestational diabetes in 1.8% and pre gestational diabetes in 0.3%). The prevalence of congenital malformations was 14% and 18.3% among offspring of mothers with pre-gestational and gestational diabetes, respectively (p=NS). The prevalence of congenital malformations among offspring of non diabetic women was 7.9% (p <0.001 with respect to diabetic women). Major malformations were found in 83% and 70% of malformed offspring of women with pre-gestational and gestational diabetes, respectively. Conclusions: Pregnant women with pre-existing or gestational diabetes have a higher risk of giving birth a child with malformations
Journal Article•
TL;DR: The medical records of 11 patients with amyloidosis were obtained and patients with the generalized disease consulted for anarsarca, three for weight loss and 2 for chronic diarrhea.
Abstract: The medical records of 11patients with amyloidosis were obtained (aged 35 to 71 year old, seven females). Seven had asystemic and four a localized disease. Six patients had primary amyloidosis and in one, it wassecondary to a disseminated tuberculosis. Five patients with the generalized disease consultedfor anarsarca, three for weight loss and 2 for chronic diarrhea. Patients with localized diseaseconsulted for tonsil enlargement, dysphonia and skin lesions. Five patients with generalizeddisease had renal involvement and five had cardiac involvement. Three patients hadmalabsorption.
TL;DR: Prudence, warmth and bioethical reasoning are required for a good medical practice and the physician must provide this information timely and taking into account the capacity, interest and emotional status of the patients.
Abstract: Truth telling in medicine is difficult and stressful. Medical trainingteaches to mitigate pain and suffering, but death and health deterioration causes feelings offrustration among physicians. Physicians tend to conceal bad news to avoid the sufferingcaused by such adverse information. However, veracity is an integral part of a respectfulrelationship and is the basis of confidence between patients and health providers. However,confusing truthfulness with a mere exposure of all the available information is anoversimplification of the problem. Therefore the real issue drifts from “how convenient is tocommunicate the truth” to “how to share the information with my patient” in a setting in whichhe can express his feeling and thoughts. Communicating the truth is an ethical imperative. Thepatient has the right to be informed and the physician must provide this information timely andtaking into account the capacity, interest and emotional status of the patients. Thereforeprudence, warmth and bioethical reasoning are required for a good medical practice (Rev MedChile 2005; 133: 693-8).(
TL;DR: It was found that in utero as well as postnatal growthrates were independent determinants of insulin sensitivity and secretion, and later in life syndrome X may develop, featuringhypertension, dyslipidemia, central obesity and type 2 diabetes, associated to an excessive foodintake.
Abstract: There is a strong association between low birth weight and insulin resistance. The thrifty phenotype hypothesis, which postulates fetal programming for adaptation to an adverse intrauterine environment, resulting in a lower insulin sensitivity in utero, is one of the hypothesis to explain this association. Later in life, syndrome X may develop, featuring hypertension, dyslipidemia, central obesity and type 2 diabetes, associated to an excessive food intake. Our investigation during the first three years of life in a prospective cohort of small (SGA) or appropriate for gestational age newborns, demonstrated that a significant increase of insulin levels is detected in SGA, as early as during the first year of life, but only when catch up growth (CUG) occurs. Orexigenic peptides such as Ghrelin appear to participate in this CUG phenomenon. We also sought to determine whether these associations were observed in individuals born with very low birth weight. We found that in utero as well as postnatal growth rates were independent determinants of insulin sensitivity and secretion. Education about feeding practices and physical activity in SGA children, is a future challenge to prevent the onset of syndrome X in this predisposed population.
TL;DR: Themain indication of BiPAP, in 80% of cases, was pulmonary restrictive disease and the patients required fiberoptic bronchoscopy for massive or lobar atelectasis and one thirdremained on domiciliary NIV program.
Abstract: Themain indication of BiPAP, in 80% of cases, was pulmonary restrictive disease. Indications ofNIV were acute exacerbations in patients with chronic domiciliary NIV in three patients,hypoxic ARF in six and hypercapnic ARF in five. The diagnoses were pneumonia/atelectasis inseven patients, bilateral extensive pneumonia in three, RSV bronchiolitis in two, apnea in one,and asthma exacerbation in one. Only one patient required intubation for mechanicalventilation, all others improved. The procedures did not have complications. NIV lasted less thanthree days in 5 patients, 4 to 7 days in four patients and more than 7 days in five. One third ofthe patients required fiberoptic bronchoscopy for massive or lobar atelectasis and one thirdremained on domiciliary NIV program.
TL;DR: Several polymorphisms of the RET proto-oncogene, including those located inexon 11, 13, 14 and 15 have been described in the general population and some of them seem to be over-represented in sporadic MTC patients from European countries, especially G691S, L769L and S836S.
Abstract: Medullary thyroid carcinoma (MTC) may occur either assporadic or as hereditary. Even though the sporadic form corresponds to the majority of cases, thepathogenesis is still unclear. Several polymorphisms of the RET proto-oncogene, including those located inexon 11, 13, 14 and 15 have been described in the general population and some of them seem to be over-represented in sporadic MTC patients from European countries, especially G691S, L769L and S836S.
TL;DR: There is an important disease burden among the studied subjects, specially among obese and older individuals, and healthy lifestyles should be promoted in this population.
Abstract: Background: The epidemic of cardiovascular diseases in Chile, requires the development of strategies in health promotion and prevention. Aim: To assess the prevalence of risk factors for chronic non communicable diseases among workers of a financial company in Metropolitan Santiago. Material and Methods: Assessment of 2,225 workers (1,383 males with a median age of 49 years and 842 females with a median age of 43 years). All answered an enquiry about education, medical history, smoking habits and physical activity. Body mass index and blood pressure were measured and a blood sample was obtained to measure blood glucose and lipid levels. Logistic repression models were used to determine the main risk factors for hypertension, diabetes, obesity, hypercholesterolemia and hyperuricemia. Results: Sixteen percent of studied subjects were obese, 49% had overweight, 57% had hypercholesterolemia, 28% had high blood pressure, 4% were diabetic, 4% had hyperuricemia, 45% smoked and 83% were sedentary. Each worker had a mean of 2.4±1.1 risk factors. This figure was significantly higher among men, obese subjects, those older than 40 years and those with a lower educational level. Conclusions: There is an important disease burden among the studied subjects, specially among obese and older individuals. Healthy lifestyles should be promoted in this population
TL;DR: Psychological tests were applied to analyze self-efficiency, motivation of achievement, self-esteem and knowledge of the illness and its treatment, and as a measure of patient compliance, glycosilated hemoglobin was measured.
Abstract: Background: Treatment compliance among patients with type 1 diabetes mellitus, is low in 50% of diabetic teenagers, becoming a social and medical problem. Aim: To determine psycho-social factors associated to treatment compliance among Chilean diabetic type 1 teenagers. Patients and methods: A non experimental study of 61 diabetic teenagers (age 14.9±1.9 years, 37 male). The number of blood glucose determinations, socioeconomic level and practice of sports was measured. Psychological tests were applied to analyze self-efficiency, motivation of achievement, self-esteem and knowledge of the illness and its treatment. As a measure of patient compliance, glycosilated hemoglobin (HB1Ac) was measured. Results: Six patients had a good control of diabetes (HB1Ac <7%), 24 had HB1Ac values between 7 and 8.9, and 31 (51%) had values of 9% or more, considered as a poor diabetes control. The intensified insulin treatment scheme, the knowledge of the illness and its treatment and the sense of self-efficiency, were the factors associated with a better compliance with treatment. Teenagers of higher socio-economical levels had a better compliance with treatment. Conclusions: Fifty percent of Chilean diabetic teenagers in this sample had a poor control of the disease and the variable knowledge about the disease is the better predictor of patient compliance (Rev Med Chile 2005; 133: 307-13)
Journal Article•
TL;DR: The emergence of Vibrio parahaemolyticus as an important cause of epidemic summer diarrheal in Chile in 2004 and 2005, confined mainly to the tenth region in Chile, could be a manifestationof this trend as discussed by the authors.
Abstract: There is interest in the paradigm that relates environmental seachanges to the emergence of diseases that affect both aquatic organisms in the sea and humanbeings. The emergence of Vibrio parahaemolyticus as an important cause of epidemic summerdiarrhea in 2004 and 2005, confined mainly to the tenth region in Chile, could be a manifestationof this trend. This and other areas of the country have also experienced several outbreaks of paralyticshellfish poisoning (PSP), diarrheal shellfish poisoning (DSP) and amnesic shellfish poisoning (ASP)caused by harmful algal blooms (HAB) of Alexandrium catenella, Dinophysis acuta andPseudonitzchia species, respectively. The short historical record of these pathological phenomena inChile suggests that they are increasing in frequency and expanding their geographical range. The Vparahaemolyticus isolates responsible for the Chilean outbreaks correspond mainly to the pandemicstrain O3:K6. HAB found in Chile and the intoxications caused by them have similar biologicalcharacteristics to those described in other areas of the world. The tenth region, the area where theseproblems are emerging, produces approximately 80-90% of the shellfish consumed in Chile and alarge proportion of the shellfish that is exported. Prevention of these public health problems can beattained by developing policies that increase environmental surveillance for Vibrios and toxic algae,improve the epidemiological surveillance of acute diarrhea and algal intoxications after theingestion of raw bivalves, and educate the population on the mode of transmission of these diseases.Scientific capacity and laboratories need to be developed to widen the limited knowledge of thebiology of Vibrio and toxic algae and the environmental factors that favor their emergence as publichealth and economic problems in Chile (Rev Med Chile 2005; 133: 1081-88).(
Journal Article•
TL;DR: Blood samples from 187 cats living in three Chilean cities were obtained and the presence of Bartonella henselae in positive cultures was confirmed by restriction fragment length polymorphism polimerase chain reaction (RFLP-PCR).
TL;DR: In this article, the authors studied the changes in the nutritional status of six years-old Chilean children from 1987 to 2003, and found that the prevalence of obesity has not increased since the year 2000.
Abstract: Background: As a consequence of the epidemiological transition in Chile, the nutritional status of the population has changed notoriously. Aim: To study the changes in the nutritional status of six years-old Chilean children from 1987 to 2003. Material and Methods: The computer data base of a government institution in charge of the School Lunch Program (JUNAEB) was used. It contains data on weight, height, sex and date of birth of six years old children, in the years 1987, 1990, 1993, 1996, 2000, 2001, 2002 and 2003. Results: The data of approximately 80,000 children was analyzed. Both weight and height increased over the study years. There was a significant reduction in the number of children with weight deficit but also an increase in the proportion of children with obesity. Stunting was also reduced. The proportion of children with HAZ over 2 SD increased from 0.76 in 1987 to 2.2% in 2003. The prevalence of obesity has not increased since the year 2000. Conclusion: The stabilization in the prevalence of obesity is a positive finding, considering its adverse consequences for health (Rev Med Chile 2005; 133: 1013-20).