In the last decade, medical students stood out as active agents in their training, which implies their involvement in the design, implementation, evaluation, and curricular co-governance. This article describes a model of active undergraduate student participation from 2014 to 2021 and compares the face-to-face and synchronous online modalities, later brought forward by the SARS-COV-2 pandemic. Annually, a call was made to UC School of Medicine undergraduate students to establish the topics and areas to be addressed during self-managed seminars. Then, medical students located in Chile were invited to attend the activity. Psychiatry was established as a priority topic in six out of eight years. Five seminars were conducted, the last two in synchronous online mode. The number of people enrolled in the online modality increased by 251% compared to the face-to-face modality (face-to-face mean = 133 ± 33 SD; online mean = 336 ± 24SD), with no significant differences in rates of attendance between modalities (Odds ratio (OR) = 1,12; 95% CI= 0,82 - 1,55; p = 0,45). The online modality was associated with a higher proportion of enrollees belonging to an institution outside the Metropolitan Region (OR 12,63; 95% CI = 8,64 - 18,46; p < 0,01). The self-managed psychiatry seminars correspond to a model of active undergraduate student participation, with the synchronous online modality representing an opportunity to massify it throughout the national territory.

ABSTRACT The COVID-19 pandemic is an event of large and complex proportions. The Peruvian government tried for countless times to deal with its consequences during the first year of the crisis. However, due to the social and economic conditions of most of the population, these attempts turned out to be unsuccessful and in specific cases only exacerbated the effects of the pandemic. In that regard, native communities, and generally indigenous peoples, suffered from structural public service lacks in terms of access to drinking water and health that COVID-19 oversaw revealing. Belated responses of the central government and preferences for economic reactivation revealed a serious contradiction between priorities in managing the crisis in the Amazonian territories. This paper addresses these structural conditions referred to public services, especially those related to access to drinking water and health in native communities. It additionally analyzes legislative and administrative measures implemented to protect native communities and strengthen their capacities against COVID-19. All this leads to an inquiry on the real flaws and deficiencies of the national proposal for economic reactivation and the problem experienced by these communities in the first year of the crisis.

RESUMEN La pandemia por el COVID-19 es un evento de grandes y complejas proporciones. El Gobierno peruano ha tratado, innumerables veces, de lidiar con sus consecuencias durante el primer año de la crisis. Sin embargo, debido a las condiciones sociales y económicas de la gran mayoría de la población, estos intentos resultaron ser infructuosos y en casos específicos solo agravaron aún más los efectos de la pandemia. En ese sentido, las comunidades nativas, y en general los pueblos indígenas, sufrieron por las ausencias estructurales en materia de servicios públicos (acceso a agua potable y salud) que el COVID-19 se encargó de revelar. Las respuestas tardías del Gobierno central y las preferencias por la reactivación económica dieron cuenta de una seria contradicción entre las prioridades en la gestión de la crisis en los territorios amazónicos. En el presente trabajo se abordan, en primer lugar, estas condiciones estructurales en materia de servicios públicos, sobre todo aquellas relacionadas con el acceso a agua potable y salud en las comunidades nativas. En segundo lugar, se analizan las medidas legislativas y administrativas implementadas para la protección de las comunidades nativas y el fortalecimiento de sus capacidades contra el COVID-19. Con todo ello, se indagará en las verdaderas falencias y deficiencias de la propuesta nacional para la reactivación económica y el problema vivido por dichas comunidades en el primer año de la crisis.

Abstract Background Agriculture in South America (SA) had a great expansion in the last decades and weed control changed accordingly with region and crop practices. Objective The objective of this review is to present the history of herbicide use and discuss the main changes in weed management in SA. Methods Herbicide use quantities were obtained from official institutions and commercial organizations in Argentina, Brazil, Chile, Paraguay and Uruguay. Data were summarized per active ingredient, herbicide mode of action or crop. The evolution of the cultivated area of the main crops in each country, and the crop and weed management associated to it were considered to discuss the importance and the consequences of the main herbicides used. Results In 2019 the most used herbicides in Brazil were glyphosate, 2,4-D, atrazine, paraquat and diuron representing 62, 15, 7, 5 and 2% of the total amount used. In Argentina, the increasing selection of herbicide resistant populations (4 cases/year), resulted in utilization of older chemistries. Weed control in Uruguay is traditionally benefited from crop/pasture rotations but recently is also facing problems of continuous cropping systems. Agriculture in Chile is more diverse, but similar patterns and problems of herbicide use are present. Conclusions Intensification of agriculture, no-tillage, glyphosate resistant crops, and herbicide resistant weeds were the most important drivers of herbicide use changes in SA. Integrated weed management is unpostponable to provide sustainable increasing food production in SA.

Coronary arterial trunk disease is found in 5-7% of patients undergoing coronary arteriography. Acute coronary syndrome (ACS) resulting from complications of an atheromatous plaque in the distal portion of the arterial trunk has a mortality rate of 50% in the following 3 months. We present the case of a 20-year-old woman with end stage renal disease undergoing dialysis who presented an acute history of chest pain during the procedure, her EKG and heart ultrasound images were compatible with ACS, and 95% obstruction of the main left coronary artery in its distal portion was found in the coronary angiography. The two possible interventions were discussed, surgery and percutaneous procedures opting for the second one with success.

La enfermedad del tronco se encuentra en el 5 a 7% de pacientes sometidos a angiografía coronaria. El síndrome coronario agudo (SICA) secundario a la complicación de la placa ateromatosa a este nivel, frecuentemente en porción distal, tiene una tasa de mortalidad de 50% en los siguientes tres años. Se presenta el caso de una mujer de 20 años, con enfermedad renal crónica terminal en hemodiálisis, con historia de dolor torácico y disnea recurrente, siendo el último episodio durante la sesión de hemodiálisis, en la cual mostró cambios electrocardiográficos y ecocardiográficos compatibles con SICA, y obstrucción del 95% de arteria epicárdica izquierda principal en porción proximal (enfermedad troncal ostial) en la angiocoronariografía. Se discute sobre las dos posibles opciones terapéuticas, la cirugía de revascularización y el intervencionismo coronario percutáneo, optando por este último, el cual finalmente tuvo éxito en el caso presentado.

Exposure to traumatic events is frequent in the general population and psychiatric sequelae such as post-traumatic stress disorders are common. The symptoms of psychiatric sequelae after trauma are vague, with multiple psychological and physical symptoms, which can confuse the health care professional. This paper seeks to facilitate the work in primary care, providing practical information about the diagnosis, initial management and referral of patients who have suffered traumatic experiences. Some early interventions and treatments are suggested.

One of the most important topics mentioned by people from places affected by the February 27th, 2010 earthquake to the Presidential Delegation for the Reconstruction, was the urgent need of mental health care. Given the enormous individual and social burden of mental health sequelae after disasters, its treatment becomes a critical issue. In this article, we propose several actions to be implemented in Chile in the context of the process of recovery and reconstruction, including optimization of social communication and media response to disasters; designing and deployment of a national strategy for volunteer service; training of primary care staff in screening and initial management of post-traumatic stress reactions; and training, continuous education and clinical supervision of a critical number of therapists in evidence-based therapies for conditions specifically related to stress.

The use of native flora by Apis mellifera L. in Chile has been demonstrated in many studies; however, certain species that are viewed as weeds contribute extensively to the floral composition of honey. A total of 92 honey samples from the Libertador General Bernardo O'Higgins region in Chile were analyzed to determine which weeds are most important in honey production and which are most preferred by melliferous bees. Their relative contributions to the pollen fraction of each honey sample were also determined using melissopalynological tests in accordance with Chilean regulation (NCh2981.Of2005; Ministerio de Agricultura. 2006) to evaluate the botanical origins of the honey samples. Species considered weeds were classified according to their importance in Chilean crops, as proposed by Matthei (1995), based on the classification system by Holm (1979). These authors categorize weeds on a scale that ranges from "very serious", if they potentially cause significant crop loss, to "occasionally present as weeds" if they are part of the national flora. A total of 19 weeds were identified at the species level from the pollen types found, and five weeds were identified at the genus level. The weeds were classified as contributing very frequently, frequently, rarely and occasionally to honey using the methodology described by Louveaux et al. (1970) for determining the frequency with which plant species contribute to honey based on the corresponding pollen types found in honey. Overall, 74% of the weeds used by Apis mellifera were European, and 53% of the weeds had perennial life cycles. The families that contributed the most to honey production were Fabaceae, Asteraceae and Brassicaceae. The importance of species viewed as weeds in the production of Chilean honey is discussed.

Estudios en Chile han demostrado la utilización de flora nativa por Apis mellifera L., sin embargo existen situaciones en que especies consideradas malezas tienen una alta participación en la composición floral de la miel. Para determinar qué malezas son las más importantes y preferidas por la abeja melífera, se analizaron 92 mieles provenientes de la Región del Libertador General Bernardo O'Higgins, a las cuales se les determinó su participación relativa en la fracción polínica. Para la evaluación del origen botánico se utilizó la Norma Chilena (NCh2981.Of2005) mediante análisis melisopalinológico. A las especies consideradas malezas se las clasificó según la importancia que poseen en los cultivos chilenos, de acuerdo a lo propuesto por Matthei (1995) usando la clasificación definida por Holm (1979). Estos autores categorizan las malezas desde muy seria, si tienen el potencial de causar pérdidas significativas del cultivo; a malezas con presencia ocasional, si solo son parte de la flora del país. Del total de morfos polínicos encontrados, se logró identificar 19 malezas a nivel de especie y cinco a nivel de género, las que varían entre muy frecuente, frecuente, raro y esporádicos, de acuerdo a la metodología para diagnosticar la frecuencia específica en mieles descrita por Louveaux et al. (1970). Del total, el 74% de las malezas usadas por Apis mellifera fueron de origen europeo, y 53% corresponden a malezas con ciclo de vida perenne. Las familias más importantes corresponden a Fabaceae, Asteraceae y Brassicaceae. Se discute la importancia de especies consideradas malezas en la producción de miel chilena.

Resumen Si bien la teoría puede llegar a constituir el punto de partida fundamental, que aporta una cultura general especifica al estudiante, lo cierto es que éste debe adquirir destrezas, técnicas, habilidades y análisis a situaciones muy concretas, y la práctica empresarial es uno de los medios más importantes para adquirir estas competencias, que le permitirán en un futuro, desenvolverse con seguridad e idoneidad en su campo profesional. Su desenvolvimiento profesional será evaluado por sus habilidades prácticas; hay que tener en cuenta que este es un mundo de resultados.

Abstract While theory may constitute the fundamental starting point, giving students a general culture specific for their careers, the fact is that they must acquire the skills, techniques, and analytical tools for very specific situations, and internships are one of the most important means to acquire these skills, which will allow them, in the future, to operate with self-assurance and expertise in their field. Their professional performance will be evaluated by their practical skills, bearing in mind that this is a world of results.

A search for meta analyses and systematic reviews on psychological support to disaster victims was carried out to devise a local support model. Based on 36 meta analyses and systematic reviews, the support should be carried out in five echelon levels: diffusion, social support, general medical care, general psychiatric care and psychiatric care carried out by experts. Only victims with well-established formal psychiatric disorders should receive psychotherapy or psychotropic medication. The rest should only receive psychological first aid. According to the best evidence available, a model for psychological care is proposed.