With or without a COVID19 pandemic, cancer is and will continue to be one of the greatest health challenges on the planet. In Chile, during 2016, this disease was the second cause of death in the country and during 2019, it was the first cause in seven Chilean regions, surpassing cardiovascular diseases. With the advent of precision medicine as a powerful tool for cancer control, it is necessary to have genomic, proteomic, and molecular data in general, ideally on a population scale. This is essential for decision-making, for example in public and private oncology, to be as cost-effective as possible. Chile has a mass of high-quality researchers in cancer. However, until today the investment in research and development is far below the peers in the OECD. In this work we put into perspective the role of precision medicine and omic sciences as essential tools for public health. We offer a brief national diagnosis of the knowledge collected to date by the local scientific community regarding onco-genomic data from our own population. We finally discuss the potential behind the strengthening of this scientific knowledge, aiming to optimize the comprehensive management of cancer.

Abstract Introduction: As a result of COVID-19, many hospitals underwent a conversion for the care for this disease Objective: To analyze COVID-19 hospital epidemiological behavior from March to August 2020. Methods: Through a series of cases, COVID-19 epidemiological behavior at the hospital was analyzed, for which simple case rates, percentages and incidence of COVID-19 per 100 hospital discharges were estimated. Results: Out of 491 subjects who tested positive for SARS-CoV-2, 156 (31.7 %) were hospitalized for clinical data of moderate to severe disease. Average age was 59.1 years; 121 cases (75 %) were discharged due to improvement, and 32 (20.5 %), due to death. Average age of those who died was 69.7 years, and the most affected age group was 60 to 80 years (45.4 %). Calculated lethality was 20.5 per 100 hospital discharges, while that calculated taking into account positive patients (outpatients and hospitalized patients) was 6.5. Conclusions: COVID-19 epidemiological behavior was similar to that described in other studies; however, lethality and mortality are above national average. The analysis of this and of the factors that favored it in our population is pending.

Resumen Introducción: A consecuencia de COVID-19, numerosos hospitales sufrieron una reconversión para la atención de esta enfermedad. Objetivo: Analizar el comportamiento epidemiológico hospitalario de COVID-19 entre marzo y agosto de 2020. Métodos: En una serie de casos se analizó el comportamiento epidemiológico de COVID-19 en un hospital de tercer nivel, para lo cual se estimaron frecuencias simples de casos, porcentajes e incidencia por cada 100 egresos hospitalarios. Resultados: De 491 sujetos con prueba positiva para SARS-CoV-2, 156 (31.7 %) fueron hospitalizados por datos clínicos de enfermedad moderada a grave. La edad promedio fue de 59.1 años; 121 casos (75 %) egresaron por mejoría y 32 (20.5 %), por defunción. El promedio de edad de quienes fallecieron fue de 69.7 años y el grupo etario más afectado fue el de 60 a 80 años (45.4 %). La letalidad calculada fue de 20.5 por 100 egresos hospitalarios, mientras que la calculada tomando en cuenta los pacientes positivos (ambulatorios y hospitalizados) fue de 6.5. Conclusiones: El comportamiento epidemiológico de COVID-19 fue similar al descrito en otros estudios; sin embargo, la letalidad y la mortalidad están por encima de la media nacional. Está pendiente el análisis de estas y de los factores que las favorecieron en nuestra población.

ABSTRACT The synthesis and characterization of copper nanoparticles supported in carbon nanotubes is reported. Copper nanoparticles were obtained by the CLD (chemical liquid deposition) method consisting of reduced pressure evaporation of metals and subsequent low-temperature condensation (77K) of these vapors, with organic solvent vapors. From the reactions obtained by this method, copper colloids of concentrations 10-3 and 10-4 were synthesized in the organic solvents 2-propanol, 2-mercaptoethanol, 2-methoxyethanol and 2-ethoxyethanol. The support of copper nanoparticles in the carbon nanotubes was made by SMAD method with 24 hours under agitation and nitrogen atmosphere before collecting, obtaining copper nanoparticle solids supported in carbon nanotubes by evaporating the solvent either 2-mercaptoethanol or 2-ethoxyethanol. Colloidal and solid dispersions were characterized by diverse techniques, for colloidal dispersions UV-Vis spectrophotometry, electrophoretic mobility, electron transmission microscopy (TEM), electron diffraction and stability over time was used. Far-medium infrared spectroscopy (FT-IR) and thermogravimetry (TGA) were used for solids. These analyses show that Cu colloids are relatively stable in the solvents used, the most stable dispersion was synthesized in 2-mercaptoethanol and the less stable is synthesized in 2-methoxyethanol, which is demonstrated in UV spectra. By TEM, particle sizes were studied, between 5.2 and 17.2 nm. Electron diffraction confirms the presence of copper. Analysis of active solids shows in the case of FTIR that solvents are incorporated into copper particles, and in the case of thermograms it is shown that the solids synthesized in the solvent had greater thermal stability 2-mercaptoethanol. It was impossible to obtain electron diffraction from the copper nanoparticles visualized because they are incorporated in the multiwall nanotubes.

Abstract: In this work, control charts have been designed in order to detect anomalies in the infant mortality data of the urban area in Ecuador. In order to design these charts, negative binomial regression models were constructed for the annual mortality rate of boys and girls aged between one and less than five years. With the constructed models, two types of control charts were prepared: the first one, an EWMA (Exponentially Weighted Moving Average) version of the deviance residues of the constructed models and the second, a chart that monitors the average number of deaths through the estimate obtained by the regression model. For both charts, an approximate 95 per cent confidence level has been considered. The EWMA chart was more efficient in detecting the sub-records that usually occur in the deaths of urban children in Ecuador

Resumen: En este trabajo se han diseñado gráficos de control con el objetivo de detectar anomalías en los datos de mortalidad infantil del área urbana en Ecuador. A fin de diseñar estos gráficos, se construyeron modelos de regresión binomial negativa para la tasa de mortalidad anual de niños y niñas con edades comprendidas entre uno y menos de cinco años. Con los modelos construidos se elaboraron dos tipos de gráficos de control: el primero, una versión EWMA (Exponentially Weighted Moving Average) de los residuos de desviación de los modelos construidos y el segundo, un gráfico que monitorea la media de muertes a través de la estimación obtenida por el modelo de regresión. Para ambos gráficos se ha considerado un nivel de confianza aproximado de 95 por ciento. El gráfico EWMA fue más eficiente en detectar los sub-registros que suelen presentarse en las muertes de niños del área urbana de Ecuador.

Introduction: Phyllodes tumor is a rare entity, with a high tendency to local recurrence and a malignancy rate of 5-10%. The basis of its treatment is the surgical resection. Materials and Method: We report a 32-year-old woman who was diagnosed of a malignant Phyllodes tumor who had previously underwent conservative breast surgery and expander placement in another center. Two subsequent lumpectomies due to local recurrences were necessary. She was referred to our Hospital for she presented a new large-sized recurrence (9.2 cm) at the retroarelor area for assessment of new surgical treatment. Results: Surgical resection of the tumor (remnant of mammary tissue and pectoralis major muscle) and removal of the expander with immediate breast reconstruction with latissimus dorsi flap was performed. At the present time, the patient is pending radiotherapeutic treatment. Conclusions: Malignant Phyllodes tumor is a rare entity whose therapeutic management is based on margin-free surgical excision. Adjuvant chemoradiotherapy might be administered. It is very important to carry out a multidisciplinary and individualized management of each case to offer the best possible forecast.

Resumen Introducción: El tumor Phyllodes mamario es una entidad muy poco frecuente, con tendencia a la recidiva local y una tasa de malignización de 5-10%. La base de su tratamiento es la resección quirúrgica. Material y Métodos: Mujer de 32 años diagnosticada de un tumor Phyllodes maligno en mama derecha sometida en otro centro a cirugía conservadora con colocación de expansor y a dos tumorectomías posteriores por recidiva local. Fue referida a nuestro Hospital al presentar una nueva recidiva de gran tamaño (9,2 cm) para valoración de intervención quirúrgica. Resultados: Se realizó exéresis del tumor (remanente de tejido mamario y músculo pectoral mayor) y retirada del expansor con reconstrucción mamaria con colgajo de dorsal ancho en el mismo tiempo quirúrgico. En el momento actual la paciente se encuentra pendiente de iniciar tratamiento radioterápico. Conclusiones: El tumor Phyllodes maligno es una entidad poco frecuente y cuyo manejo terapéutico se basa en la resección quirúrgica con márgenes. De forma adyuvante se puede administrar quimiorradioterapia. Es de gran importancia realizar un manejo multidisciplinar e individualizado de cada caso para ofrecer el mejor pronóstico.

Abstract: Objective: To describe the rationale and the methodology of a multicenter project to study the etiology of breast cancer in young Latin American women. Materials and methods: The International Agency for Research on Cancer has established an international collaborative population-based case-control study in four countries in Latin America: Chile, Colombia, Costa Rica, and Mexico (the PRECAMA study). Standardized methodologies were developed to collect information on reproductive variables, lifestyle, anthropometry, diet, clinical and pathological data, and biological specimens. The study will be extended to other countries in the region. Conclusion: PRECAMA is unique in its multidisciplinary approach that combines genetics, genomics, and metabolomics with lifestyle factors. The data generated through this project will be instrumental to identify major risk factors for molecular subtypes of breast cancer in young women, which will be important for prevention and targeted screening programs in Latin America.

Resumen: Objetivo: Describir la justificación y la metodología para el establecimiento de un proyecto multicéntrico sobre el cáncer de mama en mujeres jóvenes de América Latina. Material y métodos: La Agencia Internacional para la Investigación del Cáncer (IARC) ha establecido un estudio colaborativo internacional de casos y controles con base poblacional en cuatro países de América Latina: Chile, Colombia, Costa Rica y México (el estudio PRECAMA). Se han desarrollado metodologías estandarizadas para recolectar información sobre variables reproductivas, estilos de vida, antropometría y dieta, datos clínicos y patológicos y muestras biológicas. Conclusión: PRECAMA es único en su enfoque multidisciplinario. Los datos generados a través de este proyecto serán fundamentales para identificar los principales factores de riesgo del cáncer de mama en mujeres jóvenes. Los hallazgos serán relevantes para la prevención y los programas de detección oportuna en América Latina, con beneficios clínicos inmediatos.

Abstract: Objective: To describe the rationale and the methodology of a multicenter project to study the etiology of breast cancer in young Latin American women. Materials and methods: The International Agency for Research on Cancer has established an international collaborative population-based case-control study in four countries in Latin America: Chile, Colombia, Costa Rica, and Mexico (the PRECAMA study). Standardized methodologies were developed to collect information on reproductive variables, lifestyle, anthropometry, diet, clinical and pathological data, and biological specimens. The study will be extended to other countries in the region. Conclusion: PRECAMA is unique in its multidisciplinary approach that combines genetics, genomics, and metabolomics with lifestyle factors. The data generated through this project will be instrumental to identify major risk factors for molecular subtypes of breast cancer in young women, which will be important for prevention and targeted screening programs in Latin America.

Resumen: Objetivo: Describir la justificación y la metodología para el establecimiento de un proyecto multicéntrico sobre el cáncer de mama en mujeres jóvenes de América Latina. Material y métodos: La Agencia Internacional para la Investigación del Cáncer (IARC) ha establecido un estudio colaborativo internacional de casos y controles con base poblacional en cuatro países de América Latina: Chile, Colombia, Costa Rica y México (el estudio PRECAMA). Se han desarrollado metodologías estandarizadas para recolectar información sobre variables reproductivas, estilos de vida, antropometría y dieta, datos clínicos y patológicos y muestras biológicas. Conclusión: PRECAMA es único en su enfoque multidisciplinario. Los datos generados a través de este proyecto serán fundamentales para identificar los principales factores de riesgo del cáncer de mama en mujeres jóvenes. Los hallazgos serán relevantes para la prevención y los programas de detección oportuna en América Latina, con beneficios clínicos inmediatos.

INTRODUCTION: The South American country Chile now boasts a life expectancy of over 80 years. As a consequence, Chile now faces the increasing social and economic burden of cancer and must implement political policy to deliver equitable cancer care. Hindering the development of a national cancer policy is the lack of comprehensive analysis of cancer infrastructure and economic impact. OBJECTIVES: Evaluate existing cancer policy, the extent of national investigation and the socio-economic impact of cancer to deliver guidelines for the framing of an equitable national cancer policy. METHODS: Burden, research and care-policy systems were assessed by triangulating objective system metrics -epidemiological, economic, etc. - with political and policy analysis. Analysis of the literature and governmental databases was performed. The oncology community was interviewed and surveyed. RESULTS: Chile utilizes 1% of its gross domestic product on cancer care and treatment. We estimate that the economic impact as measured in Disability Adjusted Life Years to be US$ 3.5 billion. Persistent inequalities still occur in cancer distribution and treatment. A high quality cancer research community is expanding, however, insufficient funding is directed towards disproportionally prevalent stomach, lung and gallbladder cancers. CONCLUSIONS: Chile has a rapidly ageing population wherein 40% smoke, 67% are overweight and 18% abuse alcohol, and thus the corresponding burden of cancer will have a negative impact on an affordable health care system. We conclude that the Chilean government must develop a national cancer strategy, which the authors outline herein and believe is essential to permit equitable cancer care for the country.

Our laboratory has implemented an in vitro assay to estimate the response to chemotherapy in ovarian cancer cells pertaining to individual patients. In two selected patients, we determined the correlation between an in vitro assay of cells from suspected ovarian cancer ascites, with the clinical chemotherapy response. Cancer cells isolated from peritoneal fluid with suspected ovarian cancer were tested for cytotoxicity with corresponding chemotherapy regimens. Circulating Cal25 levels and attending physician consultation determined clinical course and response to chemotherapy. The in vitro assay result correlated with Cal25 levels, progression free survival and attending physician evaluation. The assay predicted correctly the failure of two successive chemotherapy regimes in the first patient, while predicting a favorable clinical response in the second subject.

Este estudo transversal comparou a percepção dos companheiros de usuários de drogas em uma amostra de estudantes universitários da América Latina. Os estudantes de nove universidades, localizadas em cinco países (Brasil, Chile, Colômbia, Honduras e Peru) responderam questionário que abordou questões sobre o tagagismo, álcool, maconha e cocaína. A análise foi focalizada na comparação da percepção e da realidade dos atuais usuários de drogas. Os resultados confirmaram, de forma geral, a ideia de que os estudantes superestimam o uso de drogas. Resultados inesperados foram identificados em relação ao uso de álcool. Enquanto os estudantes geralmente superestimam o uso de tabaco, maconha e cocaína, entre seus pares, estimaram com bastante precisão ou subestimaram o uso de álcool entre seus pares. Apesar desse resultado inesperado, este estudo mostra que a percepção do uso de drogas entre estudantes universitários da América Latina se comporta de maneira similar ao uso de drogas em outras localidades. Os resultados também apóiam a sugestão de que intervenções, usando retroalimentação normativa, seriam úteis para fortalecer os programas de prevenção ao uso de drogas, dirigidos aos jovens da América Latina.

This cross-sectional study compared perceived peer drug use and actual drug use in a sample of Latin American university students. Students from nine universities in five countries (Brazil, Chile, Colombia, Honduras and Peru) completed a questionnaire that addressed the use of tobacco, alcohol, marijuana and cocaine. Analysis focused on comparing perceptions to actual drug use. The findings largely, but not completely, confirmed the idea that students overestimate peer drug use. The unexpected findings were those relating to alcohol. While students generally overestimated peer use of tobacco, marijuana and cocaine, they accurately estimated or underestimated peer use of alcohol. Apart from the anomalous findings with regard to alcohol, this study shows that perceived drug use relates to actual drug use in Latin America as it does elsewhere. The results also support the suggestion that interventions using normative feedback would be useful to strengthen drug use prevention programs aimed at youth in Latin America.

Este estudio transversal se comparó la percepción que se tiene del consumo de los pares con el uso real de drogas, en una muestra de estudiantes universitarios de América Latina. Los estudiantes de nueve universidades en cinco países (Brasil, Chile, Colombia, Honduras y Perú) respondieron a un cuestionario que abordaba el uso de tabaco, alcohol, marihuana y cocaína. El análisis se concentró en la comparación de la percepción y el consumo real de drogas. Los resultados en gran medida, aunque no completamente, confirmaron que los estudiantes sobreestiman el uso de drogas entre sus pares. Los resultados inesperados fueron los relacionados con el alcohol. Mientras que los estudiantes generalmente sobrestimaron el consumo de tabaco, marihuana y cocaína entre sus pares, los mismos estimaron con bastante precisión o subestimaron el uso de alcohol entre sus pares. Además de los resultados inesperados en relación al alcohol, este estudio muestra que la percepción del uso de drogas en América Latina se comporta de manera similar a otros lugares. Los resultados también apoyan la sugerencia respecto a que la retroalimentación normativa sería útil para fortalecer los programas de prevención de drogas dirigidos a jóvenes en América Latina.

This cross-sectional study compared perceived peer drug use and actual drug use in a sample of Latin American university students. Students from nine universities in five countries (Brazil, Chile, Colombia, Honduras and Peru) completed a questionnaire that addressed the use of tobacco, alcohol, marijuana and cocaine. Analysis focused on comparing perceptions to actual drug use. The findings largely, but not completely, confirmed the idea that students overestimate peer drug use. The unexpected findings were those relating to alcohol. While students generally overestimated peer use of tobacco, marijuana and cocaine, they accurately estimated or underestimated peer use of alcohol. Apart from the anomalous findings with regard to alcohol, this study shows that perceived drug use relates to actual drug use in Latin America as it does elsewhere. The results also support the suggestion that interventions using normative feedback would be useful to strengthen drug use prevention programs aimed at youth in Latin America.

Este estudio transversal se comparó la percepción que se tiene del consumo de los pares con el uso real de drogas, en una muestra de estudiantes universitarios de América Latina. Los estudiantes de nueve universidades en cinco países (Brasil, Chile, Colombia, Honduras y Perú) respondieron a un cuestionario que abordaba el uso de tabaco, alcohol, marihuana y cocaína. El análisis se concentró en la comparación de la percepción y el consumo real de drogas. Los resultados en gran medida, aunque no completamente, confirmaron que los estudiantes sobreestiman el uso de drogas entre sus pares. Los resultados inesperados fueron los relacionados con el alcohol. Mientras que los estudiantes generalmente sobrestimaron el consumo de tabaco, marihuana y cocaína entre sus pares, los mismos estimaron con bastante precisión o subestimaron el uso de alcohol entre sus pares. Además de los resultados inesperados en relación al alcohol, este estudio muestra que la percepción del uso de drogas en América Latina se comporta de manera similar a otros lugares. Los resultados también apoyan la sugerencia respecto a que la retroalimentación normativa sería útil para fortalecer los programas de prevención de drogas dirigidos a jóvenes en América Latina.

Este estudo transversal comparou a percepção dos companheiros de usuários de drogas em uma amostra de estudantes universitários da América Latina. Os estudantes de nove universidades, localizadas em cinco países (Brasil, Chile, Colômbia, Honduras e Peru) responderam questionário que abordou questões sobre o tagagismo, álcool, maconha e cocaína. A análise foi focalizada na comparação da percepção e da realidade dos atuais usuários de drogas. Os resultados confirmaram, de forma geral, a ideia de que os estudantes superestimam o uso de drogas. Resultados inesperados foram identificados em relação ao uso de álcool. Enquanto os estudantes geralmente superestimam o uso de tabaco, maconha e cocaína, entre seus pares, estimaram com bastante precisão ou subestimaram o uso de álcool entre seus pares. Apesar desse resultado inesperado, este estudo mostra que a percepção do uso de drogas entre estudantes universitários da América Latina se comporta de maneira similar ao uso de drogas em outras localidades. Os resultados também apóiam a sugestão de que intervenções, usando retroalimentação normativa, seriam úteis para fortalecer os programas de prevenção ao uso de drogas, dirigidos aos jovens da América Latina.