Introduction: Neurological emergencies constitute 10-15% of medical emergencies. The main reasons for consultation are cerebrovascular disease, seizures and headaches. Dr. Hernan Henriquez Hospital (HHHA) began with neurologists in the Adult Emergency Service in April 2011. In July 2013 24/7 neurology shifts at emergency room were added. Objective: To describe the clinical profile of neurologic consultations at our emergency center. Method: A convenience sample of consultations on shift No. 1, at the Adult Emergency Service HHHA between October 2013 and September 2014. The statistical analysis was performed using STATA 12.0 software. Results: 1,080 consultations were recorded in theperiod. 51.2% were women. Mean age = 58 years (SD = 20.2). 36.7% of consultations are conducted in a non-business hour. The most frequent diagnoses were stroke (30.7%), epilepsy (15%) and headache (11.3%). 34.6% ofpatients were discharged; 25.8% were hospitalized in the Internal Medicine dept; 21% were referred to other hospitals; 12% were referred to other specialists and 5.7% were admitted to Critical Patient Unit. 0.83% of the patients died in the SUA. Conclusions: The main reasons for neurological consultation at our Emergency Service were cerebrovascular disease, epilepsy and headaches. Because more than a third of consultations occur on non-schedule hours, neurology system 24/7 shifts are justified in the Emergency Service.

Introducción: Las urgencias neurológicas constituyen el 10-15% de las urgencias médicas. Los principales motivos de consulta son la enfermedad cerebrovascular, crisis epilépticas y cefalea. El Hospital Dr. Hernán Henríquez A. (HHHA) comenzó con neurólogos en el Servicio de Urgencia Adultos (SUA) en horario hábil, en abril de 2011. En julio de 2013 se iniciaron turnos con neurólogo 24/7, presenciales en el SUA. Objetivo: Describir el perfil clínico de las consultas neurológicas en el SUA de nuestro centro. Método: Muestra noprobabilística, por conveniencia, de las consultas realizadas en el Turno N°1, del SUA-HHHA, entre octubre de 2013 y septiembre de 2014. El análisis estadístico se realizó con el software STATA 12.0. Resultados: Se registraron 1.080 consultas en el período. 51,2% fueron mujeres. Promedio de edad = 58 años (DE = 20,2). El 36,7% de las consultas se realizó en horario inhábil. Los diagnósticos más frecuentes fueron infarto cerebral (30,7%), epilepsia (15%) y cefalea (11,3%). El 34,6% de los pacientes fue dado de alta; 25,8% se hospitalizó en el Servicio de Medicina Interna; 21% fue derivado a otros hospitales; 12% fue derivado a otros especialistas y 5,7% ingresó a la Unidad de Paciente Crítico. 0,83% de los pacientes falleció en el SUA. Conclusiones: Los principales motivos de consulta neurológica en nuestro Servicio de Urgencia fueron enfermedades cerebrovasculares, epilepsia y cefalea. Debido a que más de un tercio de las consultas ocurre en horario inhábil, se justifica el sistema de neurología 24/7 presencial en el Servicio de Urgencia.

Cocoa (Theobroma cacao L.) is one of the main crops of economic importance in Ecuador since small and medium farmers on the coast rely on this income. However, fungal diseases decreases yield. In this research 10 experimental cocoa clones of National type and two commercial control varieties (EET-103 and CCN-51) were evaluated from 2008 to 2011, at plantations located in Quevedo and Tenguel. The objective of this research was to identify disease tolerant clones to frosty pod rot (Moniliophthora roreri) and witches' broom (Moniliophthora perniciosa), while maintaining high production levels. Experimental design was a randomized complete blocks in a factorial arrangement with four replications. Variables measured were number of branches showing witches' broom per tree; percentage of diseased pods; number of healthy pods; total number of pods; and yield of dried cacao almonds (kg ha-1). Commercial clone CCN-51 exhibited the lowest incidence of diseases and the highest production of healthy pods and average almond yield (1047.7 kg ha-1). Four experimental clones showed desirable traits: L46-H57 had the highest number of healthy pods and total pod number; L21-H43, L46-H57 and L46-H88 yielded more than 550 kg ha-1 of almonds; L18-H58 presented fewer number of witches' broom (7.3), and L21-H43 had the lowest incidence of diseased pods (37.0 %). These clones might be used for breeding programs and genetic conservation. The Quevedo location showed higher incidence of fungal diseases and yield of dry cocoa beans than Tenguel.

El cacao (Theobroma cacao L.) es uno de los principales cultivos de importancia económica en el Ecuador, principalmente para los pequeños y medianos agricultores del litoral. Sin embargo, las enfermedades fungosas reducen el rendimiento de este cultivo. Durante los años 2008 a 2011 se evaluó en las localidades Quevedo y Tenguel, el comportamiento de 10 clones experimentales de cacao tipo Nacional con el objetivo de seleccionar los de mayor productividad y tolerancia a dos enfermedades: moniliasis (Moniliophthora roreri) y escoba de bruja (Moniliophthora perniciosa), en comparación con dos testigos comerciales (EET-103 y CCN-51). El diseño experimental fue de bloques completos al azar con arreglos factorial, con cuatro repeticiones. Se registró el número de escobas de bruja vegetativas, porcentaje de mazorcas enfermas, número de mazorcas sanas y totales, así como el rendimiento de almendras secas de cacao. El clon comercial CCN-51 presentó la menor incidencia de enfermedades, así como la mayor producción de mazorcas sanas y rendimiento promedio de almendras (1047.7 kg ha-1). Cuatro clones experimentales presentaron características deseables: L46-H57 con una mayor producción de mazorcas sanas y totales, L21-H43, L46-H57 y L46-H88 con un rendimiento de almendras superior a 550 kg ha-1, L18-H58 con el menor número de escoba de bruja (7.3), y L21-H43 con la menor incidencia de mazorcas enfermas (37.0 %). Estos clones pueden ser utilizados en programas de mejoramiento y conservación. La incidencia de enfermedades fúngicas y el rendimiento de almendras secas de cacao fueron mayores en Quevedo que en Tenguel.

Background: A significant number of students in health careers do not have the knowledge to approve basic courses. Therefore, educational programs to level off knowledge have been developed. Aim: To associate the results of a leveling program with the academic performance in cell biology (CB) and biochemistry (BC) of first year medical students. Material and Methods: We applied a test to first year medical students at the beginning and end of the leveling program (control test). The results obtained at the end of the leveling program were correlated with the results obtained in CB and BC. Results: Fifty seven of 89 (64%) first year medical students met the study entry criteria (54% female). Students who completed the leveling program had a significantly higher approval rate in CB (93% versus 75%, P = 0.024), and in BC (95% versus 69%, P = 0.001). After completing the leveling program, the risk of failing CB and BC, decreased by 72 and 84% respectively Conclusions: This study shows that medical students who participate in the leveling program decrease the chances of failing in CB and BC.

Background: The quality of life in children is associated with their experiences, family and their socio-cultural environment. Objective: To identify the significant components in assessing quality of life from the children's perception. Participants and Method: Using a cross-sectional design, the Child Life Quality Scale was applied to a total of 200 children aged 8-12 years, from an urban and a rural area located in northern Chile. Three open questions were presented about experiences of satisfaction, dissatisfaction and desire for change, classifying the answers in six categories. Results: No significant differences in the perception of quality of life in children from urban and rural areas were found, however, the evaluation of the content of the answers allowed us to establish some differences between the two groups. Conclusion: In the urban area, the greatest experiences of satisfaction level were associated with interpersonal relationships, while in the rural area, with leisure and recreational activities.

Introducción: La calidad de vida infantil está asociada con las propias vivencias de los menores, la de sus familias, como con variables del entorno sociocultural donde se desarrollan. Objetivo: Identificar los componentes significativos en la evaluación de la calidad de vida desde la percepción infantil. Participantes y Método: Bajo un diseño transversal, se aplicó la Escala de Calidad de Vida Infantil a un total de 200 niños y niñas de 8 a 12 años de una comuna urbana y de una comuna rural ubicadas al Norte de Chile. Se presentaron tres preguntas abiertas sobre experiencias de satisfacción, insatisfacción y deseos de cambio, clasificando las respuestas en 6 dimensiones. Resultados: Muestran la inexistencia de diferencias en la percepción de calidad de vida en niños urbanos y rurales a partir del cuestionario; sin embargo, la evaluación del contenido de las preguntas abiertas permitió establecer algunas diferencias entre ambos grupos. Conclusión: En la comuna urbana, las mayores experiencias de satisfacción se dieron a nivel de las relaciones interpersonales, en tanto en el sector rural, en torno a las actividades de ocio y recreativas.

Even though concentrations of most chemical elements in Antarctic ecosystems are very low as compared to other world's areas, their increasing time trends, as a consequence of the strong population growth and industrial development in countries of the Southern Hemisphere, could be affecting some vulnerable endemic species such as penguins. Concentrations (dry weight) of arsenic (As), cadmium (Cd), mercury (Hg) and lead (Pb) and porphyrins (copro-, uro- and proto-) were determined in feces of Gentoo penguins (Pygoscelis papua), collected at two locations of the Antarctic Peninsula (O'Higgins and Videla). We found higher (p< 0.05) levels of Hg in excreta of penguin colonies at O'Higgins (7.55 ± 1.28 μg g-1), whereas penguins at Videla showed the highest concentrations of Cd (1.68 ± 0.71 μg g-1). Gentoo penguins from O'Higgins site showed higher levels of copro- (1.81 ± 0.61 nmol g-1), uro- (1.74 ± 0.72 nmol g-1) and protoporphyrins (1.24 ± 0.46 nmol g-1), directly related to higher levels of Hg and Pb measured. These findings imply that some Gentoo penguin colonies of the Antarctic Peninsula are likely to develop some biochemical effects through trace metal contamination at some level. These preliminary results raise concerns about anthropogenic pollutants in Antarctica.

Aunque las concentraciones de la mayoría de los elementos químicos en la Antártica son bajas en comparación con otras áreas del planeta, éstas se han ido incrementando con el tiempo debido al gran crecimiento de la población y desarrollo industrial de los países del Hemisferio Sur, lo cual podría estar afectando a especies vulnerables como los pingüinos. Se determinaron las concentraciones (peso seco) de arsénico (As), cadmio (Cd), mercurio (Hg) y plomo (Pb) y porfirinas (copro-, uro- y proto-) en heces de colonias de pingüinos Papua (Pygoscelis papua), colectadas en dos lugares de la península Antártica (O'Higgins y Videla). Se encontraron mayores (P < 0,05) niveles de Hg (7,55 ± 1,28 μg g-1) en las heces de colonias de pingüinos en O'Higgins, mientras que las colonias de pingüinos en Videla exhibieron mayores concentraciones de Cd (1,68 ± 0,71 μg g-1). Los pingüinos Papua de O'Higgins mostraron mayores (P < 0,05) niveles de copro- (1,81 ± 0,61 nmol g-1), uro- (1,74 ± 0,72 nmol g-1) y protoporfirinas (1,24 ± 0,46 nmol g-1), en directa relación con los mayores niveles de Hg y Pb medidos. Esto podría implicar que algunas colonias de pingüinos Papua de la península Antártica están propensas a desarrollar algunos efectos bioquímicos asociados a contaminación por metales traza. Estos resultados preliminares levantan inquietantes interrogantes acerca de la contaminación de origen antropogénico que estaría afectando áreas tan remotas como la Antártica.

The aim of the present study was to develop a classifier able to discriminate between healthy controls and dyspeptic patients by analysis of their electrogastrograms. Fifty-six electrogastrograms were analyzed, corresponding to 42 dyspeptic patients and 14 healthy controls. The original signals were subsampled, filtered and divided into the pre-, post-, and prandial stages. A time-frequency transformation based on wavelets was used to extract the signal characteristics, and a special selection procedure based on correlation was used to reduce their number. The analysis was carried out by evaluating different neural network structures to classify the wavelet coefficients into two groups (healthy subjects and dyspeptic patients). The optimization process of the classifier led to a linear model. A dimension reduction that resulted in only 25% of uncorrelated electrogastrogram characteristics gave 24 inputs for the classifier. The prandial stage gave the most significant results. Under these conditions, the classifier achieved 78.6% sensitivity, 92.9% specificity, and an error of 17.9 ± 6% (with a 95% confidence level). These data show that it is possible to establish significant differences between patients and normal controls when time-frequency characteristics are extracted from an electrogastrogram, with an adequate component reduction, outperforming the results obtained with classical Fourier analysis. These findings can contribute to increasing our understanding of the pathophysiological mechanisms involved in functional dyspepsia and perhaps to improving the pharmacological treatment of functional dyspeptic patients.

Background: Nonsyndromic cleft lip/palate (NSCLP) is a congenital malformation with the characteristics of a complex genetic trait. Based on experimental evidences as well as on association and linkage studies candidate genes TGFA, RARA and BCL3 have been postulated as being involved in the genetic etiology of this pathology. Aim: To test the possible association due to linkage disequilibrium between microsatellite markers located at less than 1cM from the three candidate genes and nonsyndromic cleft lip/palate using the case-parents trio design. Patients and Methods: The sample consisted of 58 case-parents trios. Two microsatellite markers, flanking each one of the candidate genes were analyzed by means of the polymerase chain reaction (PCR) with fluorescent labeled microsatellite markers. Electrophoresis of the PCR products was performed on a laser-fluorescent automatic DNA sequencer. Nonparametric ETDT was used to analyze the genotype data. Results: Significant linkage disequilibrium was detected between D2S443 (TGFA) and NSCLP. Significance was almost reached between D17S800 (RARA) and NSCLP. Alleles 239bp (D2S443) and 172bp (D17S800) showed significant preferential transmission from heterozygous parents to affected offspring. In the case of BCL3 both markers showed no significant results. Conclusions: The results of the present study do not show clear evidence that TGFA or RARA could be involved in the genetic etiology of NSCLP. Even though the importance of retinoic acid in the development of the embryo is well documented the results obtained for RARA are difficult to analyze. In relation to the possible role of BCL3 in NSCLP, recent information postulates that other genes located in the same chromosome region could be involved in NSCLP (Rev Méd Chile 2005; 133: 1051-58).

Background: Genetic studies indicate that nonsyndromic cleft lip/palate (NSCLP) has the characteristics of a complex genetic trait. Reports from different authors have suggested several candidate genes mapping in different chromosome regions. Association studies have suggested that a clefting locus is located on chromosome 6p. On these grounds we have investigated the possible association between five microsatellite markers located on 6p22-25 and NSCLP. Aim: To test the hypothesis on the possible association of a clefting locus with microsatellite markers located in 6p22-25. Patients and Methods: The sample consisted of 54 unrelated case-parent trios that comprise 54 NSCLP probands and 108 parents. Five microsatellite markers spanning the region 6p22-25 were analyzed for each individual by means of polymerase chain reaction with fluorescent labeled microsatellite markers. Electrophoresis of the PCR products was performed on a laser-fluorescent DNA sequencer. Nonparametric ETDT and MCETDT programs, were used to analyze the genotype data. Results: The family based association study showed that for the genotype wise analysis, only D6S259 presented a significant p-value (0.03). Nevertheless no individual allele of this marker showed an evident preferential transmission from heterozygous parents to affected offspring. Conclusions: The results of the present study do not show a clear evidence that a candidate gene for NSCLP may be located within or near the analyzed chromosome region in our sample. Nevertheless, it must be emphasized that the genotype wise analysis shows a significant p-value for D6S259 marker (Rev Méd Chile 2003; 131: 765-72)

Background: Breast cancer is the most common malignancy among women, and is the second cause of cancer mortality among Chilean women. Female mortality due to breast cancer in Chile has shown a steady increase from 9.5 deaths per 100.000 women in 1985 to 12.8 deaths per 100.000 in 1995. A family history of breast cancer is one of the main risk factors for the development of the disease. BRCA1 and BRCA2 are two major hereditary breast cancer susceptibility genes. Mutations in these genes are associated to inherited breast cancer; 664 predisposing mutations have been described, but in specific populations only some of them, such as 185delAG have been found to be associated with susceptibility to breast cancer. Aim: To establish the frequency of the 185delAG mutation in the BRCA1 gene in Chilean healthy women with a family history of breast cancer. Patients and Methods: The 185delAG mutation was studied by mismatch polymerase chain (PCR) reaction in 382 Chilean healthy women with at least two relatives affected with breast cancer. The PCR products were digested with the restriction enzyme HinfI. Digestion of the normal allele (170 pb fragment) produces a 150 pb fragment; the PCR product for the mutant allele does not contain a site for HinfI and therefore remains as a 170 bp fragment after digestion. Results: One of the 382 healthy women presented the fragment of 170 pb after digestion with HinfI suggesting that she was heterozygous carrier for this mutation. The mutant patient had a mammography without suspicion of cancer. Conclusions: The frequency of the 185delAG mutation in BRCA1 was 0.26% (1/382) in Chilean healthy women with a family history of breast cancer (Rev Méd Chile 2002; 130: 1113-23)

Background: Recent studies in mice have demonstrated that the Msx-1 homebox gene is implicated in cleft palate. Thus, it has been suggested that its human homologue, MSX1 (HOX-7), located in chromosome 4 could be involved in the etiology of non syndromic cleft lip palate. Aim: To study the linkage between non syndromic cleft palate and variations of MSX1 gene. Patients and methods: Seventy three patients with non syndromic cleft lip palate (34 simplex and 37 multiplex), 127 unaffected relatives of the cases (61 relatives of simplex cases and 66 relatives of multiplex cases) and 77 controls were studied. DNA was extracted from leukocytes and the intragenic microsatellite sequence was amplified by PCR. Results: A polymorphism of four alleles was observed, 1 (175 bp), 2 (173 bp), 3 (171 bp) and 4 (169 bp). Alleles 2 and 4 showed a joint variation in males with multiplex cleft lip palate and in their respective unaffected male relatives, that was significant when compared with male controls. Instead, the joint variation of alleles 1 and 4 of unaffected female relatives had significant differences with female controls. Females with multiplex cleft lip palate differed from female controls only in allele 1. Conclusions: These results support the hypothesis of a genetic heterogeneity in the etiology of non syndromic cleft lip palate.