Resumen: Se viene surgiendo una controversia sobre el aumento o la disminución de la vasectomía; sin embargo, la evidencia aún es escasa en América Latina. Este estudio ecológico analizó las tendencias de la vasectomía y las enfermedades de transmisión sexual (ETS) durante un período de 10 años en Chile y determinó si existe alguna relación entre ellas. Este es un estudio ecológico mixto que utiliza datos secundarios representativos sobre el número de vasectomías y casos de ETS de 2008 a 2017. Las tasas de vasectomía se calcularon por grupos de edad teniendo en cuenta a hombres entre 20-59 años de edad y ETS específicas (VIH, clamidia, gonorrea, tricomoniasis y sífilis) para el mismo período. Los modelos de regresión binomial negativa multivariante se ajustaron para evaluar las tendencias y las relaciones entre las tasas. La edad media de la vasectomía fue de 40,3 años, sin diferencias significativas entre el período del estudio (p = 0,058). La tasa general de vasectomía tuvo un incremento significativo para el período de 2008 a 2017 (p < 0,001), con diferencias entre los grupos de edad (p < 0,001). El incremento más significativo se observó en hombres de entre 30-49 años (p < 0,001). Las tasas de ETS tuvieron una alza significativa (p < 0,05) durante el período de estudio. Hubo una correlación positiva significativa entre las tasas de vasectomía y las tasas de incidencia de gonorrea (p = 0,008) y una correlación inversa con las tasas de incidencia de hepatitis B (p = 0,002). Se concluye que las tendencias de la vasectomía y las tasas de ETS presentaron un incremento significativo en período de 2008 a 2017 en Chile, especialmente entre los hombres de entre 30-49 años. La relación entre la vasectomía y el incremento de las ETS puede ser un nuevo factor de riesgo para las políticas de salud sexual y reproductiva que puede ayudar a controlar la epidemia del VIH y las ETS.

Abstract: A controversy about the increase or decline of vasectomy is emerging; however, the evidence is still scarce in Latin America. This ecological study analyzed the vasectomy and sexual transmitted diseases (STD) trends over a period of 10 years in Chile and determined if there is any relationship between them. We conducted a mixed ecological study using secondary and representative data on the number of vasectomies and STD cases from 2008 to 2017. Vasectomy rates were calculated for age-specific groups of men aged 20-59 years, and specific STD (HIV, chlamydia, gonorrhea, trichomoniasis, and syphilis) for the same period. Multivariate negative binomial regression models were fitted to evaluate rate trends and relationships. The mean vasectomy age was 40.3 years, with no significant differences between the years of the study (p = 0.058). The overall vasectomy rate significantly increased from 2008 to 2017 (p < 0.001), with differences between age groups (p < 0.001). The most significant increase was observed in men aged 30-49 (p < 0.001). The STD rates significantly increased (p < 0.05) during the study period. A significant positive correlation was found between vasectomy and gonorrhea incidence rates (p = 0.008) and an inverse correlation was found with hepatitis B incidence rates (p = 0.002). Vasectomy trends and STD rates significantly increased from 2018 to 2017 in Chile. especially among men aged 30-49 years. The relationship between vasectomy and STD increments suggests a new risk factor for reproductive and sexual health policies to aid controlling the HIV and STD epidemic.

Resumo: Uma controvérsia sobre o aumento ou declínio da vasectomia está surgindo; no entanto, as evidências ainda são escassas na América Latina. Este estudo ecológico analisou as tendências de vasectomia e doenças sexualmente transmissíveis (DST) em um período de dez anos no Chile e determinou se há alguma relação entre elas. Este é um estudo ecológico misto utilizando dados secundários e representativos sobre o número de vasectomias e casos de DSTs de 2008 a 2017. As taxas de vasectomia foram calculadas por grupos etários, considerando homens de 20-59 anos de idade e DSTs específicas (HIV, clamídia, gonorreia, tricomoníase e sífilis) para o mesmo período. Modelos de regressão binomial negativa multivariada foram ajustados para avaliar tendências e relações entre taxas. A média de idade da vasectomia foi de 40,3 anos, sem diferenças significativas entre os anos do estudo (p = 0,058). A taxa geral de vasectomia aumentou significativamente de 2008 a 2017 (p < 0,001), com diferenças entre grupos etários (p < 0,001). O aumento mais significativo foi observado em homens de 30-49 anos (p < 0,001). As taxas de DST aumentaram significativamente (p < 0,05) durante o período de estudo. Houve correlação positiva significativa entre as taxas de vasectomia e as taxas de incidência de gonorreia (p = 0,008) e uma correlação inversa com as taxas de incidência de hepatite B (p = 0,002). As tendências de vasectomia e as taxas de DST aumentaram significativamente de 2008 para 2017 no Chile, especialmente entre homens de 30-49 anos. A relação entre vasectomia e incrementos de DST sugere um novo fator de risco para políticas de saúde sexual e reprodutiva para auxiliar no controle da epidemia de HIV e DST.

Resumo: Uma controvérsia sobre o aumento ou declínio da vasectomia está surgindo; no entanto, as evidências ainda são escassas na América Latina. Este estudo ecológico analisou as tendências de vasectomia e doenças sexualmente transmissíveis (DST) em um período de dez anos no Chile e determinou se há alguma relação entre elas. Este é um estudo ecológico misto utilizando dados secundários e representativos sobre o número de vasectomias e casos de DSTs de 2008 a 2017. As taxas de vasectomia foram calculadas por grupos etários, considerando homens de 20-59 anos de idade e DSTs específicas (HIV, clamídia, gonorreia, tricomoníase e sífilis) para o mesmo período. Modelos de regressão binomial negativa multivariada foram ajustados para avaliar tendências e relações entre taxas. A média de idade da vasectomia foi de 40,3 anos, sem diferenças significativas entre os anos do estudo (p = 0,058). A taxa geral de vasectomia aumentou significativamente de 2008 a 2017 (p < 0,001), com diferenças entre grupos etários (p < 0,001). O aumento mais significativo foi observado em homens de 30-49 anos (p < 0,001). As taxas de DST aumentaram significativamente (p < 0,05) durante o período de estudo. Houve correlação positiva significativa entre as taxas de vasectomia e as taxas de incidência de gonorreia (p = 0,008) e uma correlação inversa com as taxas de incidência de hepatite B (p = 0,002). As tendências de vasectomia e as taxas de DST aumentaram significativamente de 2008 para 2017 no Chile, especialmente entre homens de 30-49 anos. A relação entre vasectomia e incrementos de DST sugere um novo fator de risco para políticas de saúde sexual e reprodutiva para auxiliar no controle da epidemia de HIV e DST. Resumo surgindo entanto Latina (DST elas 200 2059 20 59 20-5 HIV, (HIV clamídia sífilis 403 40 3 40, p 0,058. 0058 0,058 . 0 058 0,058) 201 0,001, 0001 0,001 , 001 0,001) 0,001. 3049 30 49 30-4 0,05 005 05 0,008 0008 008 0,002. 0002 0,002 002 0,002) 205 2 5 20- 4 000 0,00 00 304 30- 0,0 0,

Abstract: A controversy about the increase or decline of vasectomy is emerging; however, the evidence is still scarce in Latin America. This ecological study analyzed the vasectomy and sexual transmitted diseases (STD) trends over a period of 10 years in Chile and determined if there is any relationship between them. We conducted a mixed ecological study using secondary and representative data on the number of vasectomies and STD cases from 2008 to 2017. Vasectomy rates were calculated for age-specific groups of men aged 20-59 years, and specific STD (HIV, chlamydia, gonorrhea, trichomoniasis, and syphilis) for the same period. Multivariate negative binomial regression models were fitted to evaluate rate trends and relationships. The mean vasectomy age was 40.3 years, with no significant differences between the years of the study (p = 0.058). The overall vasectomy rate significantly increased from 2008 to 2017 (p < 0.001), with differences between age groups (p < 0.001). The most significant increase was observed in men aged 30-49 (p < 0.001). The STD rates significantly increased (p < 0.05) during the study period. A significant positive correlation was found between vasectomy and gonorrhea incidence rates (p = 0.008) and an inverse correlation was found with hepatitis B incidence rates (p = 0.002). Vasectomy trends and STD rates significantly increased from 2018 to 2017 in Chile. especially among men aged 30-49 years. The relationship between vasectomy and STD increments suggests a new risk factor for reproductive and sexual health policies to aid controlling the HIV and STD epidemic. Abstract emerging however America (STD 1 them 200 agespecific 2059 20 59 20-5 HIV, (HIV chlamydia trichomoniasis syphilis relationships 403 40 3 40. p 0.058. 0058 0.058 . 0 058 0.058) 201 0.001, 0001 0.001 , 001 0.001) 0.001. 3049 30 49 30-4 0.05 005 05 0.008 0008 008 0.002. 0002 0.002 002 0.002) epidemic 205 2 5 20- 4 000 0.00 00 304 30- 0.0 0.

Resumen: Se viene surgiendo una controversia sobre el aumento o la disminución de la vasectomía; sin embargo, la evidencia aún es escasa en América Latina. Este estudio ecológico analizó las tendencias de la vasectomía y las enfermedades de transmisión sexual (ETS) durante un período de 10 años en Chile y determinó si existe alguna relación entre ellas. Este es un estudio ecológico mixto que utiliza datos secundarios representativos sobre el número de vasectomías y casos de ETS de 2008 a 2017. Las tasas de vasectomía se calcularon por grupos de edad teniendo en cuenta a hombres entre 20-59 años de edad y ETS específicas (VIH, clamidia, gonorrea, tricomoniasis y sífilis) para el mismo período. Los modelos de regresión binomial negativa multivariante se ajustaron para evaluar las tendencias y las relaciones entre las tasas. La edad media de la vasectomía fue de 40,3 años, sin diferencias significativas entre el período del estudio (p = 0,058). La tasa general de vasectomía tuvo un incremento significativo para el período de 2008 a 2017 (p < 0,001), con diferencias entre los grupos de edad (p < 0,001). El incremento más significativo se observó en hombres de entre 30-49 años (p < 0,001). Las tasas de ETS tuvieron una alza significativa (p < 0,05) durante el período de estudio. Hubo una correlación positiva significativa entre las tasas de vasectomía y las tasas de incidencia de gonorrea (p = 0,008) y una correlación inversa con las tasas de incidencia de hepatitis B (p = 0,002). Se concluye que las tendencias de la vasectomía y las tasas de ETS presentaron un incremento significativo en período de 2008 a 2017 en Chile, especialmente entre los hombres de entre 30-49 años. La relación entre la vasectomía y el incremento de las ETS puede ser un nuevo factor de riesgo para las políticas de salud sexual y reproductiva que puede ayudar a controlar la epidemia del VIH y las ETS. Resumen embargo Latina (ETS 1 ellas 200 2059 20 59 20-5 VIH, (VIH clamidia sífilis 403 40 3 40, p 0,058. 0058 0,058 . 0 058 0,058) 201 0,001, 0001 0,001 , 001 0,001) 0,001. 3049 30 49 30-4 0,05 005 05 0,008 0008 008 0,002. 0002 0,002 002 0,002) 205 2 5 20- 4 000 0,00 00 304 30- 0,0 0,

Abstract: Introduction: Health-related quality of life (HRQoL) deterioraton is a risk factor for suicide in adults, however, this aspect has been little studied in adolescents. Objective: To evaluate the asso ciation between HRQoL (measured with EQ-5D-5L) and suicidal risk in adolescents and its capacity for cross-sectional detection of suicidal risk. Patients and Method: 128 adolescents (15-19 years old) from Puerto Aysen (Chile) responded to the EQ-5D-5L questionnaire, the Okasha Suicide Scale and two anchoring questions of imminent suicide risk. A suicide risk case was considered to have a > 5 score on the Okasha scale or the affirmative answer to one of the anchoring questions. The index value of EQ-5D-5L was calculated and Odds Ratios (ORs) were estimated with confidence intervals (95% CI), adjusted for confounders. Areas under the ROC curve (AUC-ROC) were calculated to assess the discriminatory performance of EQ-5D-5L. Results: 21 (16.4%) adolescents were at suicidal risk. Controlling for confounders, the EQ-5D-5L dimensions associated with suicidal risk were pain/ discomfort (OR: 2.5; 95% CI 1.1-6.1) and anxiety/depression (OR: 2.2; 95% CI 1.3-3.6). The AUC- ROC for both dimensions was 85% (95% CI 0.75-0.91) and 81% for the EQ-5D-5L index value (95% CI 0.72-0.89). Conclusions: HRQoL could be a risk factor for suicide in adolescents and in this way, the EQ-5D-5L could help in searching for high risk and hidden cases of suicidal risk.

Resumen: Introducción: El deterioro de la calidad de vida relacionada con la salud (CVRS) es un factor de riesgo de suicido en adultos; no obstante, poco se ha estudiado esta dimensión en adolescentes. Ob jetivo: Evaluar la asociación entre calidad de vida relacionada con la salud, medido con el EQ-5D-5L, y riesgo suicida en adolescentes y su capacidad de detección transversal de riesgo suicida. Pacientes y Método: 128 jóvenes (15-19 años) de la comuna de Puerto Aysén (Chile) respondieron transver salmente el EQ-5D-5L, la escala de suicidalidad de Okasha y dos preguntas de anclaje de riesgo in minente de suicidio. Se consideró como caso de riesgo suicida a un puntaje > 5 en la escala Okasha o la respuesta afirmativa a una de las preguntas de anclaje. Se calculó el valor índice con los perfiles de salud del EQ-5D-5L. Se estimaron Odds Ratios (OR’s) con intervalos de confianza (IC95%), ajus tando por confusores y se calcularon áreas bajo la curva ROC (AUC-ROC) para evaluar la capacidad de pesquisa del EQ-5D-5L. Resultados: 21 (16,4%) adolescentes fueron considerados como casos de riesgo suicida. Controlando por confusores, las dimensiones del EQ-5D-5L que se asociaron con ries go suicida fueron: dolor/malestar (OR: 2,5; IC95% 1,1-6,1) y ansiedad/depresión (OR: 2,2; IC95% 1,3-3,6). El AUR-ROC para ambas dimensiones fue del 0,85% (IC95% 0,75-0,91) y de 0,81% para el valor del índice del EQ-5D-5L (IC95% 0,72-0,89). Conclusiones: La CVRS podría ser un factor de riesgo de suicidio en adolescentes; y el EQ-5D-5L que mide esta dimensión, podría ayudar a pesquisar futuros casos y casos ocultos de riesgo suicida.

Abstract: Objective: We present the preliminary results of the implementation of RADAR: a community suicide prevention program in adolescents implemented in two high schools in a south region of Chile. Method: In a pilot study, during 2016, we implemented RADAR in two high schools of Puerto Aysen, in in the Region of Aysen of Chile. A total of 409 actors were trained (among students, school teachers, caregivers and health professionals) for the screening and referral of high suicide risk adolescents. Results: Out of a total of 144 students who passed the RADAR screening systems, 29 cases were detected as suicide risk (20%) and 27 of them were opportunely referred to the Emergency Service of the Hospital of Puerto Aysen. In the second RADAR screening campaign, 3 months later, 90% of the cases no longer presented suicide risk. Conclusion: These results show the high proportion of ado lescents at risk of suicide who are not visible by the health system and the feasibility of implementing RADAR in the community as an effective suicide prevention intervention.

Resumen: Objetivo: Dar a conocer los resultados preliminares del programa comunitario RADAR (Red para la Atención y Derivación de Adolescentes en Riesgo suicida). Método: Durante el 2016, RADAR fue implementado como prueba de concepto en dos colegios de Puerto Aysén de la Región de Aysén, Chile. Se capacitó un total de 409 participantes (entre alumnos, profesores de los colegios, apoderados y profesionales de la salud) para la pesquisa y derivación de adolescentes en riego de suicidio. Resulta dos: De un total de 144 alumnos que pasaron los sistemas de pesquisa de RADAR, se detectaron 29 casos en riesgo suicida (20%) y 27 fueron derivados oportunamente al Servicio de Urgencia del Hos pital de Puerto Aysén. En la segunda campaña de pesquisa de RADAR, 3 meses después, el 90% de los casos ya no presentaba riesgo suicida. Conclusión: Estos resultados muestran la alta proporción de adolescentes en riesgo suicida que no son visibilizados por el sistema de salud y la factibilidad de implementar RADAR en la comunidad como una intervención preventiva efectiva.

Background: A symptom questionnaire must be able to detect minimal changes after treatment to be clinically useful. Aim: To evaluate the responsiveness of the Spanish-Chilean version of the ICIQ-SF questionnaire after medical and surgical procedures for the treatment of urinary incontinence (UI) in women consulting at a public Chilean Hospital. Material and Methods: Data of 124 women aged 59 ± 10 years who were treated for UI and in whom ICIQ-SF questionnaire was applied in two opportunities (before and after medical or surgical treatment), was analyzed. The sign test for paired samples was used to compare the response of each item of the questionnaire. Responsiveness of the total severity score for UI was assessed by changes of slopes estimated by Generalized Estimating Equations. Slopes of change for every type of treatment were also compared. Results: Sixty two percent of the women underwent surgical treatment. The slope of the total severity score for medical treatment was -4.4 (p-value < 0.001 for change) and 12.6 (p-value < 0.001 for change) for surgical treatment. Changes in surgical treatment were significantly higher than those of medical treatment (p-value < 0.001). Conclusions: The Spanish-Chilean version of the ICIQ-SF questionnaire was able to detect changes as a result of surgical and medical treatment for urinary incontinence in the study population, fulfilling the validity of responsiveness criterion.

Background: The global fertility rate (GFR) is defined as the mean number of children that a woman could have in a hypothetical cohort, not exposed to death during the fertile period. GFR has fallen from 3.4 to 1.9 children per women in the period 1970-2010. Aim: To explore the relationship between the fall in GFR and the incorporation of women to work in the period 1960-2011. Material and Methods: Data from the National Statistics Institute was used. GRF was calculated using specific fertility rates for each year considering women aged 15 to 49 years. Work rates were obtained from yearly vital statistics reports. Results: Between 1960 and 2011, GRF decreased from 5.5 to 1.9 in Chile. The first inflection occurred in 1970. In the same period, female workforce increased from 22.4 to 40.2%. Conclusions: To motivate the participation of female workforce without decrease the GRF allowing population replacement, it is suggested the need to create new public policies with benefits and support from the state.

Objective To describe changes in periodontal clinical status of patients according to systemic statin use prescribed by a cardiologist. Material and methods A descriptive study was performed on patients with chronic periodontitis referred from the Department of Cardiovascular Diseases of Dávila Clinic. A group of them began statin therapy. Clinical measurements of periodontal probing depth (PD), clinical attachment level, bleeding index, periodontal inflamed surface area, and gingival index, were performed at baseline (before starting statin therapy) and 6 months later. Data were analyzed using descriptive statistics. Results A total of 10 patients participated in the study, and five of them received statin therapy. The statin group compared to the group without statins, showed a mean decrease in: PD (0.4 mm versus 0.13 mm); percentage of PS sites ≥ 5 mm (4.16% versus 1.09%); clinical attachment level (0.5 mm versus 0.2 mm), bleeding index (27.16% versus 8.8%), and periodontal inflamed surface area (305.68 versus 121.35 mm2). Conclusions These results suggest that patients with chronic periodontitis may benefit from systemic therapy with statins. Randomized clinical trials with optimal sample size are required to check the effect and impact of statins on the periodontal status.

Objetivos Describir los cambios del estado clínico periodontal de pacientes según el consumo sistémico de estatinas por indicación del cardiólogo. Material y método Se realizó un estudio descriptivo en el cual se reclutaron pacientes con periodontitis crónica derivados desde cardiología de la Clínica Dávila. Un grupo de ellos iniciaría terapia de estatinas. Se realizaron mediciones clínicas periodontales de profundidad al sondaje (PS), nivel de inserción clínico, índice de sangrado, área de superficie periodontal inflamada, e índice gingival, al inicio (antes de comenzar la terapia de estatinas) y 6 meses después. Los datos fueron analizados utilizando estadística descriptiva. Resultados Diez pacientes participaron del estudio, 5 con indicación de estatinas. El grupo con estatinas en comparación con el grupo sin estatinas presentó una disminución en promedio: de PS (0,4 mm versus 0,13 mm); porcentaje de sitios con PS ≥ 5 mm (4,16% versus 1,09%); de nivel de inserción clínico (0,5 mm versus 0,2 mm), índice de sangrado (27,16% versus 8,8%) y área de superficie periodontal inflamada (305,68 mm2 versus 121,35). Conclusiones Estos resultados sugieren que pacientes con periodontitis crónica podrían obtener beneficios de la terapia sistémica con estatinas. Se requiere de estudios clínicos con asignación aleatoria y el óptimo tamaño muestral que comprueben el efecto e impacto de las estatinas sobre el estado periodontal.

Pregunta de la investigación ¿Serán factores de riesgo para migraña con aura y sin aura, todos los mencionados en la literatura (psicológicos, hormonales, alimentarios, ambientales, sueño, fármacos) que puedan presentarse en estudiantes universitarios comprendidos entre los 18 a 35 años de edad de la Facultad de Medicina? Objetivos General Determinar si son factores de riesgo para migraña el tipo de alimentación, la altura de 3600 o 4100 m.s.n.m, cambios hormonales, aspectos psicológicos, el sueño y factores ambientales en los estudiantes universitarios de 18 a 35 años de edad pertenecientes a la Facultad de Medicina. Diseño o tipo de estudio Diseño de Casos y Controles de casos incidentes Material y métodos El tamaño de muestra es de 212 pacientes, estudiantes universitarios comprendidos entre los 18 a 35 años, cursantes de tercero a quinto año de la Carrera de Medicina, los cuales fueron elegidos a través de un muestreo probabilístico a los que se aplicaron un cuestionario con preguntas específicas sobre los posibles factores de riesgo para migraña planteados anteriormente, con criterios de selección y definición de casos y controles, en base a todas las referencias bibliográficas disponibles y válidas para tal efecto. Se realizó el examen clínico para identificar los pacientes con migraña y los que no presentan la enfermedad. Resultados Se presentarán los resultados en función a los objetivos planteados, variables operacionalizadas del cuestionario que evalúan los factores de riesgo y antecedentes generales. El análisis de los datos fue realizado en el programa estadístico STATA versión 10 para su validación y posterior análisis. Se ajustó un modelo de regresión logística considerando todos los posibles candidatos del análisis univariado controlando por las covariables sexo, consumo de medicamentos y diferenciación de migraña, para esto se usó el método "stepwise" que evalúa el efecto de los factores tanto al entrar como al salir del modelo. Para evaluar el aporte significativo de cada factor al modelo se usó el estadístico de Wald con valor p<0.05.. Se evaluó la bondad de ajuste y supuesto del modelo y finalmente la capacidad predictiva del mismo. Cómo citar este artículo: Navia BMP, Urquidi BC. Factores de riesgo y asociados a migraña en estudiantes universitarios IINSAD,Bolivia. Cuad Hosp Clin.2014;55:1

Research questions Will they be factors of risk for migraine with aura and without aura, all the mentioned ones in the literature (psychological, hormonal, food, environmental, dream, medicaments) that could appear in university students understood between the 18 to 35 years of age of the Faculty of Medicine? Objectives To determine if they are factors ofrisk for migraine the type ofsupply, hormonal changes, psychological aspects, the dream and environmental factors in the university students from 18 to 35 years of age belonging to the Faculty of Medicine. Design of Cases and Controls of incidental cases Design Design of Cases and Controls of incidental cases Material and methods The size of sample belongs 212 patients, university students understood between the 18 to 35 years, students of the Career of Medicine, which were chosen across a sampling probabilístic to which a questionnaire was applied by specific questions on the possible factors of risk for migraine raised previously, by criteria ofselection and definition of cases and controls, on the basis ofall the bibliographical available and valid references to such an effect. The clinical examination fulfilled to identify the patients with migraine and those who do not present the disease. Results They will present the results in function to the objectives, variable of the questionnaire who evaluate the factors of risk and general precedents. The analysis ofthe information was realized in the statistical program STATA version 10 for his validation and later analysis. There adjusted a model of logistic regression considering all the possible candidates of the analysis univariado controlling for the covariables sex, consumption of medicines and Differentiation of migraine, for this the method used "stepwise" that evaluates the effect of the factors so much on having entered like on having gone out of the model. To evaluate the significant contribution of every factor to the model the statistician of Wald was used by value p <0.05. There was evaluated the contribution of possible interactions and possible factors that cause confusion in the association. There was evaluated the goodness of fit and supposition of the model and finally the predictive capacity of the same one across the construction of the curve ROC.

Background: The interests that motivate medical students to study this career are diverse and they may change during the seven years of study. In Chile, 22 universities offer medicine and the number of graduated students has increased by more than 50% over the last 10 years. Aim: To determine the motivational profile of medical students at admission, and at the end of their career. Subjects and Methods: A voluntary anonymous survey was applied to 275 first and 140 seventh year medical students from one traditional public and two private schools. Results: The main reason for applying to medical school was social interest (68.7%), followed by interest in science and academia. Thirty six percent of students from seventh year would not study medicine again. In the seventh year, the interest in medical care persists in 88% of students, followed by academic interests in 64%. Only 24% had research interests. Fifty nine and 57% of students projected their medical work in private and public hospital settings, respectively. Only 11% projected themselves as doing research. Sixty nine percent of students would like to receive more information about post graduate education. Conclusions: There is a low interest in research and a high percentage of seventh year students that would not apply to medicine again. Medical schools should perform a systematic analysis of students' interests to improve faulty areas.

Objetive: To determine the prevalence of anemia in children from three health centers of La Paz city. Design: Descriptive study. Methods: 114 children with ages between 6 to 24 months were enrolled. Capillary blood samples were obtained from a finger Prick with de use of aseptic standardized techniques; hemoglobin concentrations were measures immediately with a portable HemoCue. A cut off point adjusted for altitude was determinate for diagnosis (13.6 g/dl). Results: The prevalence of anemia in all of the health centres was 86.6%. In Bella Vista there was an 8% severe anemia, 10%) Modérate anemia and 19% of mild anemia. In Chasquipampa 6% severe anemia, 11% and 12%> modérate anemia and mild anemia respectively. In Villa Nuevo Potosí, 4% severe anemia, 9% modérate and 20% mild anemia. The Índex of correlation of Spearman between the indicator tall for age and levéis of hemoglobin was 0.2 (p=0.048). Conclusions: The high prevalence of anemia in children smaller than 2 years oíd, independently of gender, nutritional status and health center which they attend. Although the anemia has many causes, this high prevalence is suggestive that the diverse programs implemented for its control have not been effective

Objetivo: Determinar la prevalencia de anemia en tres centros de salud. Diseño: Estudio descriptivo. Métodos: 114 niños de 6 a 24 meses de edad ingresaron al estudio, concurrentes a tres centros de salud de la ciudad de La Paz dependientes del Ministerio de Salud. Se midieron los niveles en sangre capilar con técnicas y personal estandarizado, muestras que fueron procesadas inmediatamente con el sistema fotómetro portable HemoCue. Para el diagnóstico de anemia se utilizó un punto de corte ajustado para la altura de 13,6 g/dl. Resultados: La prevalencia de anemia en los tres centros de Salud fue del 86,6%. En el centro de Bella Vista se registró un 8% de anemia severa, 10% de anemia moderada y 19% de leve. En Chasquipampa, 6% de anemia severa, 11% y 12% de anemia moderada y leve respectivamente. En Villa Nuevo Potosí, 4% de severa, 9% de moderada y 20% de anemia leve. El índice de correlación de Spearman entre el indicador "talla para la edad" y niveles de hemoglobina fue de 0,2 (p = 0,048). Conclusiones: Existe una alta prevalencia de anemia en niños menores de 2 años, independientemente del género, estado nutricional o centro de salud al que asisten. Aunque la causa de anemia es multifactorial, la alta prevalencia es sugerente de que diversos programas implementados para su control, no han sido del todo efectivos

Objetivos: evaluar según el porcentaje de respuesta, la adherencia al tratamiento de la anemia con microgránulos de fumarato ferroso. Diseño: ensayo clínico aleatorio controlado. Intervención: gotas de sulfato ferroso y microgránulos de fumarato ferroso. Métodos: 124 niños con valores de hemoglobina menores a 13.7 g/dL y de 6 a 24 meses de edad ingresaron al estudio, fueron aleatorizados en dos grupos, el grupo control con sulfato ferroso y el grupo experimental de los microgránulos con fumarato ferroso. Se midió los niveles de hemoglobina antes y después del tratamiento y otras variables de cumplimiento. Resultados: el porcentaje de niños que pasaron al estado no anémico en el grupo fumarato ferroso fue de54% y en el grupo control 22% (p< 0.05). El porcentaje de respuesta positiva al tratamiento en el grupo fumarato fue de 91% y en el grupo control del 71% (p< 0.05). La media de hemoglobina final del grupo experimental fue de 13.5 g/dL y de 12.6 g/dL en el control (p< 0.05). El porcentaje de cumplimento fue significativamente en el grupo experimental fue de 78% y en el control del 55%, (p< 0.05). Conclusiones: el uso del fumarato ferroso microencapsulado, produce una reducción significativa de la prevalencia de anemia en una población pediátrica de alto riesgo por presentar mejor adherencia a este. La aplicación de la nueva intervención en los programas de salud, aumentaría en un 33% los beneficios obtenidos por el nuevo suplemento.

Objective: to evaluate the adherence to treatment of anemia through the percentage of response with ferrous fumarate, in comparison to ferrous sulfate drops after two months of treatment. Study Design: randomized controlled clinical trial. Intervention: ferrous sulfate drops and microencapsulated ferrous fumarate sprinkles. Methods: 128 Children (age-6-24 months) were enrolled and randomized to ferrous sulfate drops group or ferrous fumarate group. Capillary blood samples taken at the baseline and final visits were obtained from a finger prick in order to asses hemoglobin values. Compliance was also measured. Results: successful treatment of anemia (hemoglobin > 13.6 g/dL) occurred in 54 % of the sprinkles group and in 22% of the drops group (p<0.05). The positive response to treatment was higher in the experimental group (91%) than the control group (71%) (p<0.05). The rate of compliance was 55 % in the control group and 76 % in the experimental group. The mean hemoglobin levels increases significantly in each group from baseline to the final visit. Conclusion: the use of microencapsulated ferrous fumarate increased the adherence to treatment and reduced the rates of anemia significantly in high risk pediatric population. The implementation of the new intervention by programs health would enhance over 33% the benefits.

Objetivo: determinar la prevalencia de anemia en tres centros de salud. Diseño: estudio descriptivo Métodos: 114 niños de 6 a 24 meses de edad ingresaron al estudio, concurrentes a tres centros de salud de la ciudad de La Paz dependientes del Ministerio de Salud. Se midieron los niveles en sangre capilar con técnicas y personal estandarizado, muestras que fueron procesadas inmediatamente con el sistema fotómetro portable Hemocue. Para el diagnóstico de anemia se utilizó un punto de corte ajustado para la altura de 13.6 g/dl Resultados: la prevalencia de anemia en los tres centros de salud fue del 86.6%. En el centro de Bella Vista se registró un 8% de anemia severa, 10% de anemia moderada y 19% de leve. En Chasquipampa, 6% de anemia severa, 11% y 12 % de anemia moderada y leve respectivamente. En Villa Nuevo Potosí, 4% de severa, 9% de moderada y 20% de anemia leve. El índice de correlación de Spearman entre el indicador “Talla para la edad” y niveles de hemoglobina fue de 0.2 (p=0.048). Conclusiones: Existe una alta prevalencia de anemia en niños menores de 2 años, independientemente del género, estado nutricional o centro de salud al que aisten. Aunque la causa de anemia es multifactorial, la alta prevalencia es sugerente de que diversos programas implementados para su control, no han sido del todo efectivos.

Objetive: to determine the prevalence of anemia in children from three health centers of La Paz city. Design: descriptive study Methods: 114 children with ages between 6 to 24 months were enrolled. Capillary blood samples were obtained from a finger prick with de use of aseptic standardized techniques; hemoglobin concentrations were measures immediately with a portable Hemocue. A cut off point adjusted for altitude was determinate for diagnosis (13.6 g/dL). Results: The prevalence of anemia in all of the health centers was 86.6%. In Bella Vista there was an 8% severe anemia, 10% moderate anemia and 19% of mild anemia. In Chasquipampa 6% severe anemia, 11% and 12% moderate anemia and mild anemia respectively. In Villa Nuevo Potosí, 4% severe anemia, 9% moderate and 20% mild anemia. The index of correlation of Spearman between the indicator Tall for Age and levels of hemoglobin was 0.2 (p=0.048). Conclusions: The high prevalence of anemia in children smaller than 2 years old, independently of gender, nutritional status and health center which they attend. Although the anemia has many causes, this high prevalence is suggestive that the diverse programs implemented for its control have not been effective.