Abstract The image of a typical family has changed in recent years, as the makeup of households in Chile is no longer the same as decades ago. While gender and sexual diverse families in our country have always existed, there is a scarcity of reliable data. We review the evolution of the makeup of these diverse families in Chile and their access to assisted reproduction techniques. We also review national policies and health insurance coverage by both governmental and private carriers (Fonasa and Isapres) and how changes in legislation over the years have facilitated the constitution of these families. We outline barriers to access assisted reproduction techniques and the need for further legislative action to guarantee access to all citizens regardless of their marital status, sexual orientation, or gender identity.

Resumen El concepto de familia ha cambiado con los años y la constitución de los hogares en Chile ya no es la misma que hace un siglo. Las familias diversas en nuestro país han existido durante toda la vida, pero el conocimiento de cómo se han constituido y la existencia de un catastro en Chile son escasos. El objetivo de esta revisión es mostrar cómo se han constituido las familias diversas en Chile, cómo ha sido el acceso de estas a las técnicas de reproducción asistida, cuál ha sido la política del Estado y las aseguradoras de salud (Fonasa e Isapres) en las coberturas, y qué ha pasado con la legislación a lo largo de los años que ha facilitado la constitución de nuevas familias. Por otra parte, se pretende mostrar cuáles son las barreras al acceso por parte de las familias diversas y la necesidad de una ley de reproducción asistida que permita el acceso a todas las personas independientemente de su estado civil, orientación sexual o identidad de género, y que proteja a todos los nacidos chilenos por igual.

CONTEXT: Adhesion molecule deficiency type 1 is a rare disease that should be suspected in any patient whose umbilical cord presents delay in falling off, and who presents recurrent severe infections. Early diagnostic suspicion and early treatment improve the prognosis. CASE REPORT: The case of a four-month-old boy with recurrent hospitalizations because of severe bronchopneumonia and several episodes of acute otitis media with non-purulent drainage of mucus and positive bacterial cultures is presented. His medical history included neonatal sepsis and delayed umbilical cord detachment. Laboratory studies showed marked leukocytosis with predominance of neutrophils and decreased CD11b and CD18. These were all compatible with a diagnosis of leukocyte adhesion deficiency type I [LAD type 1].

CONTEXTO: El deficit de moleculas de adhesión tipo 1 es una enfermedad rara que debe ser sospechada en todo paciente que presente un retardo en la caída del cordón unmbilical, además de infecciones graves a repetición. Un sospecha diagnóstica precoz y un tratamiento oportuno mejorarán el pronóstico. INFORMES DE CASO: Se presenta el caso de un niño de cuatro meses de edad, con hospitalizaciones recurrentes a causa de bronconeumonía severa y varios episodios de otitis media aguda con drenaje mucoso, no purulento, y cultivos bacterianos positivos. Su historial médico incluye la sepsis neonatal y el desprendimiento tardío del cordón umbilical. Los estudios de laboratorio mostraron leucocitosis marcada con predominio neutrofílico y disminución de CD11b y CD18, todos compatibles con el diagnóstico del tipo de deficiencia de adhesión leucocitaria 1 [tipo LAD 1].

Background: Delayed motherhood is a common phenomenon in the developed world, where the age at frst delivery is around 30 years. In Chile the National Institute of Statistics established that this age has remained around 23 years for more than two decades. Motherhood postponement may be modulated by socioeconomic status. Aim: To determine whether the age at frst delivery is higher in a private clinic compared to a public hospital. Patients and Methods: Two cohorts of primiparous women delivering in 1998 and 2008 in the public hospital San Borja Arriarán (HSBA) and a private setting Clínica Las Condes (CLC), were analyzed. Results: The age of all delivering women was significantly lower in HSBA than in CLC in both study periods (26.3 ± 0.8 and 25.7 ± 0.9 compared to 31.6 ± 0.1 and 32.7 ± 0.1 years, respectively). Likewise, the frequency of adolescent pregnancy was significantly higher in HSBA than CLC in both study periods (38.8 and 42.2% compared to 1.7 and 1.6% respectively). The age at frst delivery was significantly lower in both periods in HSBA (21.8 and 21.3 years compared to 28.6 and 30.6 years, respectively). Excluding primiparous women of less than 20 years, the difference in age was smaller, but remained still significant (24.6 and 24.2 versus 29.9 and 31.0 years, respectively). Conclusions: In Santiago, the postponement of motherhood is more marked among women of high socioeconomic status.

A case is presented of a complicated interstitial pregnancy. It is emphasized in the opportune diagnosis and treatment and the relevance of the clinic. In addition it is described the appearance of pulmonary embolism during the postoperative period

Se presenta un caso de embarazo cornual complicado; se hace énfasis en el diagnóstico y manejo quirúrgico oportuno e importancia del cuadro clínico. Se describe la complicación de tromboembolismo pulmonar bilateral durante el post operatorio