Background: Peer tutoring is a process of accompaniment carried out by a student with certain features and skills, whose objective is to support and guide, academically and emotionally, other students who may require it. Aim: To assess the experience of medical students who played the role of peer tutor. Material and Methods: We carried out semi-structured in-depth interviews, with prior informed consent, to a non-probabilistic and intentional sample of six students who performed the role of peer tutor, during 2017 and 2018. The data analysis followed the scheme of constant comparison and progressive reduction in a manual way, according to the comparative method, guaranteeing scientific rigor, maintaining criteria of credibility, dependence, confirmability, and transferability. Results: The first level identified 234 units of meaning that originated in the third level, two qualitative domains, oriented to the contribution of peer tutors derived from their experience to strengthen both the process of peer tutor training and the management of peer tutoring. Conclusions: Peer tutoring as a teaching-learning strategy contributes to the development of generic competences and metacognitive skills, generating high levels of personal satisfaction and identification their teaching role.

ABSTRACT: This paper critically examines studies dealing with the so-called competence in an indigenous language in Chile. Through an analysis articulated around the notion of language ideology, it is shown that these studies are shaped, theoretically and methodologically, by the influence of monoglossic and standard language ideologies. These ideologies impose a monolingual bias and a view of languages as reified, standard and homogenous on the study of competence. It is argued that the propositions contained in these studies do not reflect the sociolinguistic characteristics of contact situations in Chile and that they enforce external categories and hierarchies of speakers. It is concluded by suggesting a different approach to the study of the sociolinguistics of indigenous languages where the emphasis is not so much on an ill-defined notion of competence but on the discovery, description and explanation of language practices and communicative repertoires that include speakers’ perspectives in relation to their changing sociocultural realities.

RESUMEN: Mediante una discusión articulada en torno al concepto de ideología lingüística, en este trabajo se examinan críticamente aquellos estudios que han investigado la competencia en lengua indígena en Chile. Si bien dichos estudios no definen adecuadamente su objeto de análisis, todos ellos reflejan, tanto a nivel teórico como metodológico, la influencia de las ideologías monoglósica y de la lengua estándar. Estas ideologías lingüísticas imponen al estudio de dicha competencia en lengua indígena un sesgo monolingüe y una visión de las lenguas como entidades con una forma canónica uniforme. Se argumenta que las proposiciones contenidas en los estudios de competencia no solo no se corresponden con las características sociolingüísticas presentes en situaciones de contacto, sino que también repercuten en la evaluación que se hace de los sujetos al crear e imponer externamente jerarquías y categorías de hablantes. El artículo finaliza sugiriendo una aproximación diferente al estudio de la situación sociolingüística de las lenguas indígenas en Chile que supere la fijación con una noción de competencia vagamente definida y que invite al descubrimiento, la descripción y la comprensión de las prácticas lingüísticas y los repertorios verbales y comunicativos de -y desde- los hablantes, en relación directa con sus complejas y cambiantes realidades sociales, culturales y comunicativas.

Objective: To present our experience and assess the recurrence of juvenile nasopharyngeal angiofibroma after a surgical treatment (open versus endoscopic approach) in the country’s northwestern Department of Otorhinolaryngology. Materials and methods: An observational, retrospective, analytical study. The medical records of patients diagnosed with juvenile nasopharyngeal angiofibroma, who were treated at the Department of Otorhinolaryngology - Head and Neck Surgery of this institution from 2014 to 2017, were reviewed. Results: A total of 19 patients diagnosed with juvenile nasopharyngeal angiofibroma underwent a surgical procedure, out of which 14 had an open surgery and 5 an endoscopic one. Recurrence accounted for 50 % and 40 %, respectively, which was not statistically significant (p = 0.88). However, other variables were compared, such as the need for admission to the Intensive Care Unit (ICU), which was represented by 71 % in the case of the open approach and 20 % for the endoscopic approach, where a significant difference was found (p = 0.04). Conclusions: The study shows no statistically significant advantage of the endoscopic approach versus the open approach, but demonstrates less need for ICU admissions, which would reduce healthcare costs.

Objetivo: Exponer nuestra experiencia y evaluar la recurrencia en el manejo quirúrgico del angiofibroma nasal juvenil, abordaje abierto contra endoscópico, en el servicio de otorrinolaringología del noroeste del país. Materiales y métodos: Estudio observacional, retrospectivo, analítico. Se revisaron los expedientes clínicos de los pacientes con diagnóstico de angiofibroma nasal juvenil de 2014 a 2017, atendidos en el Servicio de Otorrinolaringología y Cirugía de Cabeza y Cuello de esta institución. Resultados: Un total de 19 pacientes con diagnóstico de angiofibroma nasal juvenil, fueron sometidos a un procedimiento quirúrgico, 14 abiertos y 5 endoscópicos, la recurrencia fue de 50 % y 40 % respectivamente, lo cual no fue estadísticamente significativo (p=0.88). No obstante, se contrastaron otras variables, como la necesidad de la Unidad de Cuidados Intensivos (UCI) para ambos grupos, 71 % en abordaje abierto y 20 % para el endoscópico, en lo cual si encontramos diferencia significativa (p=0.04). Conclusiones: El estudio no muestra una ventaja estadísticamente significativa del abordaje endoscópico frente al abordaje abierto, pero sí una menor necesidad de hospitalización en UCI, lo que reduciría los costos de atención.

Abstract OBJECTIVE: We report a case of a patient with arteriovenous fistula secondary to an instrumented uterine curettage, related to presence of placental polyps. CLINICAL CASE: A 29-year-old woman, who went to a doctor’s office for a pregnancy protocol, reached spontaneously, but its finalized in abortion for an anembrionrary pregnancy of 8 weeks. The Doctor performed instrumented uterine curettage. Five months after the event, the patient had abnormal (abundant) uterine bleeding, which required hospitalization. Ultrasound with increased vascularization in the posterior wall, with suspected venereal arteries, normal Doppler velocimetry, and low diastole with low resistance. The physician suggested selective arterial embolization. A comprehensive evaluation of the pathology was performed by ultrasound, in which an intracavitary mass was observed with mixed echoes, suggestions of retention of ovuloplacental remains, later verified with hysteroscopy. During the hysteroscopic procedure (with Hopkins II, Karl Storz of 2 mm and a 2.8 mm "diagnostic" shirt), a mass compatible with the ovuloplacental remains attached to the posterior aspect of the uterus was detected. After the integral evaluation, it was decided to perform the uterine evacuation, using hysteroscopy, with a resectoscope without energy. The histopathological study reported ovuloplacental remains with marked changes by retention, necrotic and hemorrhagic decidua, with severe subacute inflammation. The patient progressed satisfactorily during the postoperative period. The ultrasonographic evaluation of control did not show the arteriovenous fistula.

Resumen OBJETIVO: exponer el caso clínico de una paciente con fístula arteriovenosa uterina secundaria a legrado instrumentado, asociada con pólipos placentarios. CASO CLÍNICO: paciente de 29 años de edad, que acudió a consulta médica por deseo de embarazo, obtenido de manera espontánea, que finalizó en aborto por embarazo anembriónico de 8 semanas. El médico tratante efectuó legrado uterino instrumentado. Cinco meses después del evento, la paciente tuvo sangrado uterino anormal (abundante), que requirió hospitalización. El ultrasonido reportó útero con aumento de vascularización en la pared posterior, con sospecha de fístulas arteriovenosas, velocimetría Doppler normal y diástole alta de baja resistencia. El médico le sugirió embolización arterial selectiva. Una vez valorada por el equipo médico, se efectuó la evaluación integral de la patología uterina mediante ultrasonido, en el que se observó una masa intracavitaria con ecos mixtos, sugerentes de retención de restos ovuloplacentarios, comprobados posteriormente con histeroscopia. Durante el procedimiento histeroscópico (efectuado con histeroscopio Hopkins II Karl Storz de 2 mm y “camisa” diagnóstica de 2.8 mm de grosor) se detectó una masa compatible con restos ovuloplacentarios adheridos a la cara posterior del útero. Después de la valoración integral se decidió efectuar la evacuación uterina, por vía histeroscópica, con resectoscopio sin energía. El estudio histopatológico reportó restos ovuloplacentarios con marcados cambios por retención, decidua necrótica y hemorrágica, con inflamación subaguda severa. La paciente evolucionó satisfactoriamente durante el periodo posquirúrgico. La evaluación ultrasonográfica de control no mostró la fístula arteriovenosa uterina (desapareció la imagen en “ovillo”).

The aim was to investigate the haematological and blood biochemistry changes of adult rabbits after two intravenous administrations of low-doses of E. coli lipopolysacharide (LPS). Six clinically healthy rabbits were distributed through a cross over design to experimental groups: Group 1 (LPS) treated with two intravenous doses of 1 μg/kg bw of E. coli LPS at 6 h intervals. Group 2 (Control) treated with an equivalent volume of saline solution (SS) at similar intervals. Rectal temperature (T°R), serum concentrations of interleukin-6 (IL-6), C-reactive protein (CRP), haemogram, and the activity of enzymes aspartate aminotransferase (AST) and gamma glutamil transferase (GGT) were measured before and after LPS or SS administration. The administration of LPS in rabbits induced significant increases in IL-6 and CRP concentrations. Leukopenia associated to significant decreases of monocytes, lymphocytes and platelet count, with no significant changes in neutrophil count, were observed at 4 and 8 h after LPS administration. There were significant increases in total leukocytes and neutrophils count at 12 and 24 h. No significant changes (P > 0.05) were observed in mean values of PCV, total proteins, albumin and in the activity of enzymes AST and GGT. The administration of low doses of E. coli LPS induces a fast increase in body temperature, haematological and biochemical shifts, which are milder and have a lower intensity and shorter than previous reports in rabbits treated with high doses of LPS. These changes seem to be consistent with an initial inflammatory response induced by a gram-negative infection.

El objetivo fue investigar los cambios hematológicos y en la bioquímica sanguínea inducidos por la administración de dosis bajas de lipopolisacárido de Escherichia coli (LPS) en conejos. Seis conejos clínicamente sanos fueron distribuidos en dos grupos experimentales mediante un diseño cruzado: Grupo 1 (LPS) tratado con dos dosis intravenosas de 1 μg/kg de LPS. Grupo 2 (Control) fue tratado con un volumen equivalente de solución salina (SS). Previo y posterior a la administración de LPS se midió temperatura rectal (°C), se determinaron las concentraciones de interleukina 6 (IL-6), proteína C reactiva (PCR), además se realizó hemograma y se midió la actividad de las enzimas aspartato aminotransferasa (AST) y gamma glutamil transferasa (GGT). La administración de LPS produjo aumentos significativos en la temperatura rectal, IL-6 y PCR. A las 4 y 8 h posteriores a la inyección de LPS se observó leucopenia asociada a disminución en el recuento de monocitos, linfocitos y plaquetas, mientras que a las 12 y 24 h el recuento de leucocitos y neutrófilos aumentó significativamente. No se observaron cambios en los promedios de VGA, concentración de proteínas totales y albúmina o en la actividad de las enzimas AST y GGT. Se concluye que las modificaciones hematológicas y de bioquímica sanguínea inducidas por la administración de dosis bajas de LPS son de moderada intensidad y corta duración en comparación a las descritas en conejos tratados con dosis altas de LPS. Estos cambios son consistentes con un estado de respuesta inflamatoria inicial inducida por una infección por Gram negativos.

Fraturas tibiotársicas são comuns em aves, pois, na maioria das aves, o tibiotarso é o osso mais longo e exposto nesses animais. Fraturas transversais são mais comuns, sendo que as forças de rotação e cisalhamento devem ser estabilizadas de modo a alcançar uma boa regeneração óssea. Um periquito macho do tipo psitacídeo de 230g, com mais de 5 anos, foi recebido apresentando claudicação a 24 horas não devido a transferência de carga. Os exames radiográficos revelaram uma fratura fechada completa, não triturada, transversal de diáfise distal do osso esquerdo tibiotársico. A fixação foi feita com massa epóxi de endurecimento rápido (10 minutos). A fim de avaliar a temperatura de polimerização da massa epóxi e a possibilidade de necrose desses ossos, a temperatura foi registrada a cada 30 segundos durante 12 minutos, com três quantidades diferentes de epóxi em teste in vivo. A temperatura das amostras fragmentadas atingiu um pico de 50-60ºC, em que o pico mais elevado corresponde à maior quantidade de massa epóxi. Quando foram utilizados cerca de 6g de massa de vidraceiro, o pico de temperatura foi de apenas 51ºC. Esse pico foi alterado para 58ºC quando se aumentou a quantidade de massa epóxi quatro vezes. Se a temperatura dos pinos inseridos no osso for superior a 70ºC, pode ocorrer necrose do osso. À luz desses resultados, a fratura foi tratada com 6g de massa epóxi deixada polimerizar sobre uma fixação externa, em configurações 1A 2/2 usando pinos de 1mm, dobrados em 90º e unidos com fios de cerclage. Após 6 semanas da cirurgia, o pássaro tinha formado um calo ósseo primário, sendo os fixadores externos removidos. Com essa abordagem, conclui-se que houve a restauração das funções normais do membro e total recuperação da ave.

Tibiotarsal fractures are common in birds because in most birds this is the longest, most exposed bone in the leg. Transverse fractures are most common and rotational and shear forces must be stabilized in order to achieve good bone regeneration. A 230g male Slender-billed Parakeet or Choroy parakeet (Enicognathus leptorhynchus), with more than five years of age, was received with non-weight bearing lameness with 24 hours duration. X-rays were taken, and these revealed a closed, complete, non-comminuted transverse fracture of the distal diaphysis of the left tibiotarsal bone. Fixation was planned with 10-minute fast-setting epoxy putty. In order to assess the temperature of polymerization of the epoxy dough and the possibility of heat-bone necrosis, the temperature was recorded every 30 seconds for 12 minutes with three different amounts of the epoxy material in an ex vivo test. The temperature of the pieces reached a peak of 50-60ºC, where the highest peak corresponds to the highest amount of material. When approximately 6g of putty were used, the peak temperature reached only 51ºC. This peak changed to 58ºC when 4 times more epoxy was mixed and measured. If the temperature of the pins inserted in the bone exceeds 70ºC, bone necrosis could occur. In light of these results, the fracture was treated with 6 g of epoxy putty that was allowed to polymerize over a 1A 2/2 external skeletal fixation, with 1-mm pins bent at 90º and joined together with cerclage wire. At 6 weeks after surgery the bird had formed a good primary bone callus, and the external fixators were therefore removed. With this approach a satisfactory recovery of the patient was achieved with normal use of the affected limb.

Nowadays, alternative techniques are being developed for short-time manufacturing of full prostheses, entailing different materials for the denture base. The purpose of the present study was to compare transverse deflection among polymer-based materials currently proposed as an alternative to materials commonly used to conventionally manufacture a full prosthesis. For the denture base the following materials were tested: thermo-cured (setting) acrylic resin, self-cured acrylic resin, 60 and 80 gauge acetate sheets coated with self-cured acrylic resin, liquid (fluid) acrylic resin as well as light-cured resin. Ten 65 x 10 x 2.5 mm samples of each material were manufactured. The samples were placed in water at 37°C for 50 hours. Transverse deflection was measured and results were analyzed with the help of one-way analysis of variance (ANOVA). Results exhibited statistically significant differences among groups. Acetate sheets coated with self-cured acrylic could represent an alternative for the rapid manufacturing of temporary denture basis.

En la actualidad se están desarrollando técnicas alternativas para la fabricación en tiempos cortos de prótesis totales en relación con la utilización de diferentes materiales para la base de dentadura. El propósito de este estudio fue comparar la deflexión transversa entre materiales a base de polímeros, propuestos como una alternativa a los materiales comúnmente utilizados para realizar una prótesis total en forma convencional. Se probaron resina acrílica termocurable, resina acrílica autocurable, láminas de acetato calibre 60 y 80 recubiertas con resina acrílica autocurable, resina acrílica fluida y resina fotopolimerizable para base de dentadura. Se fabricaron diez muestras de 65 x 10 x 2.5 mm de cada material. Las muestras se colocaron en agua a 37°C por 50 horas, se midió la deflexión transversa y se analizaron los resultados por análisis de varianza (ANOVA) de una vía. Los resultados mostraron que hubo diferencia estadísticamente significativa entre los grupos. Las láminas de acetato recubiertas con acrílico autocurable pueden ser una alternativa para la rápida fabricación de bases de dentadura de uso temporal.

Cavernomatous malformations (CM) are mamelonated vascular hamartomas, initially described by Virchow, which are considered the most common vascular malformation after developmental venous anomalies, with a prevalence of 0.5-0.7% in the overall population, without gender predilection. In imaging they show a broad range of dynamic behavior given their different levels of growth, possible regression, de novo formation and the risk of bleeding. In these circumstances, magnetic res onance imaging (MRI), especially T2 gradient echo sequence (T2GRE) and susceptibility weighted imaging (SWI), become very important for the detection and follow-up/monitoring of CM. This article reviews and updates the epidemiological and pathological features of CM; as well as presenting its various locations and characteristics, so that the diagnosis is not complicated.

Las malformaciones cavernomatosas (MC) son hamartomas vasculares de aspecto mamelonado, inicialmente descritos por Virchow, que son consideradas la malformación vascular más frecuente, después de las anomalías del desarrollo venoso, con una prevalencia de 0,5-0,7% en la población general, sin predilección entre géneros. Se presentan con un amplio comportamiento dinámico en las imágenes dado su diverso grado de crecimiento, la posible regresión, la formación de novo y el riesgo de sangrado. En estas circunstancias, la resonancia magnética (RM), especialmente las potenciaciones en T2 gradiente (T2GRE) y susceptibilidad (SWI), cobran gran importancia en su búsqueda y seguimiento. Se revisa y actualiza su epidemiología y patología; además se presentan sus diversas ubicaciones y características, de tal forma que su diagnóstico no sea complejo.

The nutritional and sensorial characteristics of chicken meat can be affected by oxidative rancidity, process of oxidation of lipids in the meat that constitutes one of the main forms of food deterioration. This problem may be prevented or reduced by adding antioxidants to the meat during the process of marination. In the present study, the addition of a polyphenol-rich quillay extract (QLPerm®) at 5 levels (0, 0.05, 0.10, 0.15, and 0.20%) to the marinade of chicken meat was evaluated. The marinated meat was stored under refrigeration (6 ºC) for 0, 2, 4, 6, and 8 days. Basal and induced lipid oxidation was evaluated by TBARS analysis. Microbiological quality was assessed by total coliforms and mesophillic aerobe counts. The application of this natural antioxidant reduced, in some cases, meat lipidic oxidation, improved its microbiological quality, and did not leave any perceivable residues as analyzed by a sensorial evaluation panel.

El presente artículo no pretende analizar en detalle las diferentes formas en que la borrachera ha sido mostrada en el cine nacional, sino apenas describir la importancia que se le ha otorgado al acto de embriagarse en aquellas cintas que se consideran representativas de los últimos 25 años. Tampoco se trata de ensayar una interpretación sobre los modos de representación de la fiesta, y no sólo porque el tema, de por sí, se preste a estudios específicos en los que intervienen otros componentes además de la embriaguez, sino porque se considera que el consumo de bebidas alcohólicas no es un comportamiento exclusivo de las celebraciones.

Este artigo não visa analisar em detalhe as diferentes formas em que a embriaguez foi mostrada no cinema, mas apenas descrever a importância que tem sido dado ao ato de se embebedar nessas fitas que são consideradas representativas dos últimos 25 anos. Nem é tentar interpretar os modos de representação da festa, porque o tema, em si, se presta a estudos específicos em que intervierem outros componentes como a embriaguez, mas porque que o consumo de bebidas alcoólicas é considerado um comportamento não exclusivo das celebrações.

This article pretends to analyze in detail not only the different ways that drunkenness has been shown in the Bolivian cinema, but to describe the importance that has been given to the act of getting drunk on those tapes that are considered representative of the last 25 years. Nor it is an attempt to interpret the modes of representation on the party, and not just because the subject, in itself, lends to specific studies with other components as drunkenness, but because it is considered that the consumption of alcoholic beverages is not a unique behavior of the celebrations.

Introduction: Chronic rhinosinusitis (CRS) is an inflammatory condition where bacteria play an important role. Acute exacerbations of chronic sinusitis (AECS) in patients who underwent endoscopic sinus surgery (EES) are not infrequent. Treatment of these exacerbations is complex due to the emergence of new agents and to an increase in bacterial resistance. Therefore, it is important to develop methods to culture and identify these agents and their antimicrobial resistance and sensibilities. Aim: To develop a technique for recovery ofpathogens in the paranasal sinuses of patients with AECS after EES. Material and Method: 32 patients that had undergone EES were recruited. Aspiration of the maxillary sinus under direct endoscopio visión was performed. Samples obtained were sent for aerobic, anaerobio and fungal cultures. Results: Of the 50 samples collected, 46 were positive. Of these, 44 cultured aerobes, 7 cultured anaerobes, and 2 cultured fungí. The resistance to betalactamic antibiotics was 48.2% with at least 36% resistance to two different types ofantibiotics. Conclusión: This is the first report in Chile ofthe microorganisms involved in AECS after EES. The results suggest that the sampling method described here is a useful tool for the study of patients with AECS.

Introducción: La rinosinusitis crónica (RSC) es un cuadro inflamatorio en el que las bacterias juegan un rol importante. Las exacerbaciones agudas de rinosinusitis crónica (EARSC) en pacientes posoperados no son infrecuentes. Sin embargo, su manejo es complejo debido a la aparición de nuevos agentes y el aumento de la resistencia a antibióticos. Objetivo: Desarrollar una técnica de toma de muestra en cavidades paranasales, que permita caracterizar a los agentes involucrados en EARSC en pacientes posoperados. Material y método: Se recluta ron 32 pacientes posoperados. Se realizó aspirado de seno maxilar bajo visión endoscópica. Las muestras fueron cultivadas para aerobios, anaerobios y hongos. Resultados: Se enviaron 50 muestras a cultivo, en 46 de ellas se aislaron gérmenes (92%), de los cuales 44 fueron aerobios. En 7 de las muestras se aislaron anaerobios, y en 2 se obtuvo cultivo positivo para hongos. La resistencia a betalactámicos fue de 48,2%, observándose 36% de resistencia a lo menos a dos familias de antibióticos. Discusión y conclusiones: Nuestro estudio es el primero a nivel nacional en caracterizar a los agentes involucrados en EARSC en pacientes poscirugía endoscópica nasal. Los resultados obtenidos, posicionan a los cultivos endoscópicos como una excelente herramienta clínica para estudiar las EARSC.

Introducción El 5 de setiembre del 2002 el Centro Penitenciario Cocorí en Cartago, notificó al Sistema de Vigilancia del Ministerio de Salud, la presencia de 133 casos de diarrea. Ante esta situación, las autoridades de salud plantearon la investigación, para identificar los factores asociados a la presencia del brote. Material y métodos Mediante la revisión de los expedientes de los casos atendidos por diarrea en el Centro Penitenciario, se identificaron los que cumplieran con la siguiente definición: persona con deposiciones líquidas que podían acompañarse de náuseas, vómitos, dolor de cabeza, dolor abdominal, tenesmo y meteorismo, y que consumieron alimentos en el Centro Penitenciario el 4 de setiembre del 2002. Para determinar el mecanismo de transmisión, comparamos la exposición de los alimentos servidos durante el desayuno, almuerzo y cena del 4 de setiembre, de los casos con 41 prisioneros no enfermos. Se aislaron enteropatógenos, de muestras del pollo servidos y de heces de los casos seleccionados al azar. Resultados Se identificaron 133 casos ocurridos en el centro penitenciario. El primer caso ocurrió 4:30 horas después de servido el almuerzo. El 100% presentó diarrea, ninguno tuvo fiebre, ni recibió antibióticos. Las personas que consumieron pollo en salsa presentaron un RR = 2,92 (95% CI: 1,217,04). El laboratorio aisló Cl. perfringens en una concentración de 10 5 u.f.c. por gramo de heces y 10 4 u.f.c. por gramo de carne de pollo. Conclusiones La presencia de CI. perfringes en el pollo y heces de los casos demuestran la transmisión del agente en la población del Centro Penitenciario (fuente común).

Background: Lung transplantation is a valid treatment for some patients with severe lung disease who have a poor prognosis with medical treatment. Objective: to evaluate the results and complications of lung transplantation in a series of patients at Clinica Las Condes. Patients and methods: 21 lung transplanted patients from April 1999 to May 2003; 10 single and 11 bilateral; mean age 48 years, range 13 to 70 years; 13 men (62%). The most frequent diagnosis was idiopathic pulmonary fibrosis (10 patients; 48%). Mean FVC for restrictive disorders was 1 827 ml (43% predicted) and mean FEV1 for obstructive disorders was 818 ml, (24%). All patients were dependant on oxygen. Results: in the first 30 days after transplantation 3 patients died: cerebral hemorrhage (1), massive hemoptisis (1), and sepsis (1). After 30 days an additional patient died from chronic rejection. Overall survival was 15 out of 21 (72%). Follow up: Complications were severe reimplantation response in 2 patients; acute rejection in 4; airway damage in 2; CMV pneumonia in 2 and bronchiolitis obliterans in 3. Conclusions: these results are similar to those reported in international publications and indicate that lung transplantation is a feasible alternative in our country for some patients with a terminal stage lung disease

El trasplante pulmonar es una alternativa terapéutica para pacientes con enfermedad pulmonar severa sin respuesta a tratamiento. Objetivos: Evaluar los resultados y complicaciones de los pacientes trasplantados en Clínica Las Condes. Material y método: 21 pacientes trasplantados entre abril 1999 a mayo de 2003: 10 trasplantes simples y 11 bipulmonares, edad x 48 años (13-70);13 hombres; patología predominante fibrosis pulmonar idiopática: 10 (48%). Espirometría basal en patología restrictiva CVF: x 1.827 ml (43 %) (1.170 - 2.430 ml) y obstructiva: VEF1 x 818 ml (24%) (352 - 1.756 ml), todos dependientes de oxígeno. Inmunosupresión triasociada: prednisona, azatioprina y ciclosporina o tacrolimus. Resultados: 3 pacientes fallecen a los 30 días por hemorragia cerebral, hemoptisis masiva y sepsis respectivamente. Seguimiento de 2 a 45 meses. Evolución espirométrica (VEF1): 1 año 2.107 ml (67% ), 2 años 2.012 ml (65%) y 3 años 2.440 ml (74%). Todos suspenden oxígeno y realizan actividad física. Complicaciones: Disfunción primaria de injerto 2, rechazo agudo 4, lesión vía aérea 2, neumonia por Citomegalovirus 2, síndrome de bronquiolitis obliterante (SBO) 3 y fallecen dos. Conclusiones: El trasplante pulmonar mejora calidad de vida en pacientes con enfermedad pulmonar terminal y nuestros resultados confirman que es una alternativa posible en nuestro país

Cardiovascular diseases are the main causes of death in Chile and there is a high prevalence of cardiovascular risk factors in the population. Aim: To assess the prevalence of those risk factors in a group of employees. Subjects and methods: We studied 2,219 individuals, 1,378 males with a mean age of 46.2±10.4 years and 841 females with a median age of 41.9±10.3 years. Results: High blood pressure was observed in 39.7% of men and in 21.8% of women. A serum cholesterol between 200 and 239 mg/dl was observed in 38% of men and 31.3% of women. A cholesterol over this value was seen in 23.7% of men and 18.8% of women. A low proportion of those with high blood pressure, or elevated cholesterol, were under treatment. Prevalence of smoking was high in men and women: 43.5 and 48.9.2%, respectively. Eighty four percent of men and 61.3% of women over 54 years were overweight or obese. The prevalence of diabetes mellitus was 4.5%. Twenty percent of men and 13% of women exercised regularly, at least 3 times a week. Conclusions: There is a high prevalence of untreated cardiovascular risk factors in this population (Rev Méd Chile 2003; 131: 129-34)

Focal nodular hyperplasia (FNH) is a benign tumour probably arising secondary to an altered vascularization of the hepatic parenchyma. It is rare in the paedriatric age group. We report a patient with FNH who underwent orthotopic liver transplantation (OLT) and we review the literature with respect to therapeutic approaches in treatment of FNH. A 15 year old boy presented with a palpable abdominal mass. Abdominal ultrasound and a CT scan showed multifocal tumours in both hepatic lobes. These were unresectable and a biopsy confirmed the diagnosis of FNH. The patient developed portal hypertension secondary to portal vein compression, with ascites, encephalopathy and renal failure. The decision between an expectant approach versus a surgical approach should be based on individual findings in each case. OLT is a therapeutic alternative in patients with benign unresectable liver tumours

La Hiperplasia Nodular Focal (HNF) del hígado es una tumoración benigna probablemente secundaria a una alteración en la vascularización del parénquima hepático, rara en la edad pediátrica. Objetivo: Reportar un caso clínico de HNF que requirió trasplante hepático ortotópico (THO) y revisar la literatura actual con respecto a la conducta terapéutica a seguir. Caso clínico: Niño de 15 años de edad con una masa abdominal palpable. Ecografía y tomografía axial computada de abdomen demostraron un tumor multifocal en ambos lóbulos hepáticos de características irresecables. Biopsia operatoria del hígado confirmó una HNF. El paciente desarrolló hipertensión portal debido a compresión tumoral de la vena porta, con ascitis, encefalopatía hepática e insuficiencia renal, por lo que se decidió su manejo mediante un THO en injerto total, con una excelente evolución a 5 años de seguimiento. Conclusión: La decisión entre un enfoque conservador o quirúrgico depende de las características de cada caso, siendo el THO una alternativa terapéutica en pacientes con tumores hepáticos benignos e irresecables