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PubMed2005

[75th anniversary of the Pontifical Catholic University of Chile School of Medicine].

The Pontifical Catholic University of Chile founded its School of Medicine in 1930, preceded by the Schools of Medicine of the University of Chile (founded in 1833) and the University of Concepción (founded in 1924). The founders of the new School were prominent members of the Catholic Church, advised by distinguished Chilean physicians and scientists, most of them already full Professors at the University of Chile. During the first decades, only a small number of full-time faculties could be recruited and the academic team included mostly part-time teachers, generally shared with the already established Medical Schools, as well as practising physicians with little or no previous teaching experience. Along 75 years of fruitful existence, this Medical School has evolved to become one of the leading organizations in graduate and post-graduate medical education in Latin America, with high standards in teaching methodology and a superb productivity in clinical and biomedical research. The history of this Medical School stands as an example to the currently nascent Medical Schools founded by private universities in Chile. The standards of high quality medical education should be maintained for the well-being of our population so that these new Medical Schools can become respected and accepted as peers by the entire community of Chilean Universities.

Chile↗

PubMed2006

[First finding of Chagas disease vectors associated with wild bushes in the Metropolitan Region of Chile].

BACKGROUND: Insects of the subfamily triatominae are the biological vectors of Trypanosoma cruzi, the causal agent of Chagas disease. AIM: To search for wild colonies of triatomines in the Metropolitan Region of Chile. MATERIAL AND METHODS: Ad hoc traps were placed in two endemic zones of the Metropolitan Region of Chile, during 30 nights. The dejections of 16 T infestans and 43 M spinolai specimens were examined under the microscope, searching for live metacyclic trypomastigotes. A polymerase chain reaction (PCR) was performed in macerates of all insects looking for T cruzi DNA. RESULTS: A total of 269 bugs were captured. Forty four were Triatoma infestans and 225 were Mepraia spinolai. They were not syntopic, since T infestans was restricted to a Southern zone (Calera de Tango) while M spinolai was only found in the Northern zone (Til-Til). Both species were found associated to terrestrial bromeliads (Puya sp) but M spinolai was also detected in stony grounds. Microscopic examination of dejections yielded a trypano-triatomine index of 56.3 and 32.6 for T infestans and M spinolai, respectively. PCR detected T cruzi DNA in 41 and 43% of T infestans and M spinolai specimens, respectively. CONCLUSIONS: The finding of T infestans in a wild habitat is noticeable. This is the first report of such phenomenon in Chile. The high infection rates with T cruzi, explains the maintenance of Chagas disease wild cycle in Chile.

Animals↗

PubMed2000

Bat rabies in urban centers in Chile.

One hundred and five rabies isolates obtained from domestic animals and insectivorous bats in Chile between 1977 and 1998 were molecularly characterized by limited sequence analysis of their nucleoprotein genes. These isolates were compared with viruses isolated from known domestic and wildlife rabies reservoirs in the Americas to identify potential reservoirs of rabies in Chile. The phylogenetic analyses showed that none of the Chilean isolates segregated with viruses from the terrestrial reservoirs. No non-rabies lyssaviruses were found in this study. The Chilean samples were not related to viruses of the sylvatic cycle maintained by the common vampire bat (Desmodus rotundus) in Latin America. Five genetic variants were identified from insectivorous bats in Chile. The Brazilian free-tailed bat (Tadarida brasiliensis) was identified as the reservoir for the rabies genetic variant most frequently isolated in the country between 1977 and 1998. The close association of a group of viruses obtained from a domestic dog (Canis familiaris), Brazilian free-tailed bats, and a red bat (Lasiurus borealis) with viruses maintained by Lasiurus spp. in North America implicated species of this genus as the possible reservoirs of this particular genetic variant in Chile. Reservoirs for the other three variants remain unknown.

Animals↗

PubMed2000

[Adult mortality in Chile].

BACKGROUND: The study of mortality of human groups is important to judge the health conditions of population. AIM: To study the main mortality features among Chilean adults. MATERIAL AND METHODS: Information about mortality in Chile from the Instituto nacional de Estadísticas and The World Health Organization, was analyzed. Data was expressed mainly as rates. RESULTS: Annual mortality risk among Chileans is 812 per 100,000 inhabitants and is low compared to the rest of Latin America. In the last 30 years it has decreased systematically at a rate of 1% per year in both genders. The risk of mortality caused by cerebrovascular disease, coronary heart disease, hepatic cirrhosis, gastric cancer and tuberculosis has decreased. On the other hand, the risk of mortality caused by diabetes, hypertension and lung, gallbladder, prostate and colorectal cancer has increased. Mortality varies from 604 per 100,000 in Atacama to 934 per 100,000 in Valparaiso. The most factor that influences this variation is population aging. Mean survival at the start of adulthood is 54 years in men and 61 years in women. At 60 years, the expectancy is 19 and 24 years respectively. Mean age of death in Chile was 71.5 years in 1998. Seventy six percent of deaths occurs in the elderly and 33%, in people of 80 years or more. CONCLUSIONS: Chile is one of the four Latin American countries with lower mortality risk. In the last 30 years, the main causes of deaths among adults, with exception of pneumonia, have decreased. Therefore health care of the adult is in the correct track (Rev Méd Chile 2000; 128: 1144-49).

Adult↗

PubMed2001

[ECLAMC: 30-year study of epidemiological surveillance of neural tube defects in Chile and Latin America].

BACKGROUND: There is an urgent need to assess the impact, on the incidence of neural tube defects, of the recently implanted flour fortification with folic acid in Chile. The Collaborative Study of Congenital Malformations in Latin America (ECLAMC) has carried out an uninterrupted register of congenital malformations in the last thirty years. AIM: To assess the epidemiology of neural tube defects in Chile and determine the most adequate base period to evaluate the effects of Folic acid fortification. MATERIAL AND METHODS: Analysis of ECLAMC database that has registered all births over 500 g from 1967. RESULTS: From 1967 to 1999, there were 434.624 births in 18 hospitals in Chile and 3.586.569 births in 155 hospitals in the rest of Latin America. The rate of neural tube defects in Chile was 17.03 per 10.000, significantly higher than the rest of ECLAMC (14.88 per 10.000). The prevalence of neural tube defects has a statistically significant secular tendency to increase in the study period and is higher among stillbirths, newborns with a birth weight of less than 1500 g, women and offspring of mothers aged less than 19 years old. CONCLUSIONS: The period 1982-1999 is considered the best period for reference comparisons of the effects folic acid supplementation.

Adult↗

PubMed2002

[Current epidemiological situation of trichinosis in Chile. 1991-2000].

BACKGROUND: Human and animal trichinosis has been recorded in Chile since the late XIX century and is irregularly distributed along the country. From high rates of infection in the early 1900, the frequency of this parasitosis in man has progressively decreased. AIM: To describe and discuss the epidemiological situation of trichinosis in Chile during the decade 1991-2000. MATERIAL AND METHODS: Human infection was assessed using annual incidence and lethality reports provided by the Ministry of Health, periodic photostrichinoscopies in corpses of non selected individuals autopsied at the Medico Legal Service and periodic national serologic surveys. The advise of one of the authors in an epidemic that occurred in 1999 in the VIII Region was also used. Animal infection was assessed using the annual prevalence of infection in pigs slaughtered in abattoirs, furnished by the Ministry of Health. RESULTS: A total of 631 clinical cases with 4 deaths (0.6%) was recorded. A decline in the incidence, from 0.7 x 100,000 in 1991 to 0.2 x 100,000 in 2000 was recorded. The higher frequency of the parasitosis was observed in the Metropolitan, VI, VIII and X regions. Although human trichinosis has been observed in all seasons, its frequency increases in close relation with the higher pork consumption in cold seasons (45.8% in winter and 37.5% in spring). There has been a decrease of infection rates in pigs from 0.17@1000 in 1991 to 0.04@1000 in 1998-2000. CONCLUSIONS: The incidence and prevalence of trichinosis shows a constant decline in Chile. Considering the geographical characteristics of Chile, it is possible that an undetermined number of pigs are home reared and butchered without veterinary control, constituting an important source of human trichinosis.

Adolescent↗

PubMed2002

[Epidemiological situation of foodborne diseases in Santiago, Chile in 1999-2000].

BACKGROUND: Foodborne diseases are becoming an important cause of morbidity in Chile. In the Metropolitan Region of Chile, the Environmental Health Service started a surveillance program for foodborne diseases in 1994. In 2000, this program was complemented with an etiologic study of individuals involved in outbreaks. AIM: To report the incidence of foodborne outbreaks in the Metropolitan Region of Chile and its causative agents. RESULTS: One hundred ninety outbreaks of foodborne diseases were reported in 1999 and 260 in 2000. The Southern Metropolitan health service had the higher incidence rates (7.5 in 1999 and 8.2 in 2000). The mean attack rates were 25% in both periods, affecting 1248 individuals in 1999 and 1774 in 2000. In 18% of outbreaks, a pathogen was identified; the most frequent agents were Salmonella Spp, Staphylococcus aureus and Shigella. In 15% of subjects, the cause was histamine or chemical agents. In the rest of the cases, the cause was not identified. The foods with higher risk of causing foodborne diseases were hot prepared dishes, home made goat cheese and meats. CONCLUSIONS: The incidence rates of foodborne disease in Metropolitan Area of Chile are high and maybe underestimate, only in a low rate of outbreaks was possible to have samples for etiologic studies. For a better understanding of this problem, timely notification of foodborne diseases must be encouraged and educational campaigns about the proper manipulation of food items must be implemented.

Adolescent↗

PubMed1992

[Genetic evidence corroborates Negme's hypothesis about the greater mildness of American trypanosomiasis in Chile].

Chagas disease is present in northern and central Chile. Not more than 25% of infected individuals have had a pathologic condition presumably due to Trypanosoma cruzi. The majority of individuals with chronic infectious Chagas disease in Chile are asymptomatic in contrast to what has been observed in other South American countries. Historic and paleopathologic evidences suggest that this particular behavior could be explained by a genetic adaptation of Chilean aborigines to T cruzi. Associations between ethnic admixture, presence of Chagas disease, associated cardiac pathology and 4 blood groups (ABO, MNSs, Rh and Duffy) were investigated among inhabitants of San Pedro de Atacama in northern Chile. Cardiac pathology was determined by positive serologic reactions in individuals with abnormal electrocardiographic findings. Individuals with negative serologic results had a significantly greater aboriginal admixture (88%) compared to those with positive serology (66%). This findings supports the hypothesis of genetic adaptation explaining mildness of Chagas disease in Chile.

Adaptation, Physiological↗

PubMedDate not supplied

[Demographic-epidemiologic transition in Chile, 1960-2001].

BACKGROUND: In Chile, the demographic structure and the causes of morbidity and of mortality among the population have undergone major changes within a relatively short period of time. These changes have taken place within a framework of processes referred to respectively as demographic transition and epidemiological transition. This study is aimed at providing evidence as to the demographic transition and epidemiological transition which took place in this country within the 1960-2001 period. METHODS: This is a time-series study gathering demographic and death rate-related information from Chile throughout the 1960-2001 period. The data was taken from the Demographic Yearbooks of the National Institute of Statistics, from information produced by the Department of Prospective Studies under the Ministry of Planning and Cooperation and the Chilean Ministry of Health. RESULTS: In 1960, 39.6% of the population had less than 14 years old, natality rate was 36.3 per 1000, general mortality rate 12.3 per 1000 and Infant Mortality rate 120 per 1000. 44% of causes of decreases were by infectious and newborn's diseases. In 2001, 28% of the population has less than 14 years old, natality rate is 18.3 per 1000, General Mortality rate 5.4 per 1000 and Infant Mortality rate 8.9 per 1000. 68% of causes of diseases are by chronic diseases. CONCLUSIONS: Based on the results, it can be said that Chile is currently in a late stage of demographic transition as well as epidemiological transition. Ascertaining Chile's actual situation will provide information to those Latin American countries which are currently in early stages of these types of transitions.

Adolescent↗

PubMed1982

Descriptive epidemiology of cancer in Chile: 1973-78.

Review of detailed Chilean cancer mortality data for 1973-78 reveals that gastric cancer overshadows all other sites, with Chile second in the world in age-adjusted mortality rate. An excess of male deaths is seen for all cancer sites combined except in 2 age groups, i.e., 30-39 and 40-49 years, in which more female deaths occur. Stomach, lung, and esophageal cancers show a male:female ratio up to 4.7. Females experience higher mortality than males from gallbladder cancer; Chile has the highest death rate in the world from this cancer and also from other gallbladder diseases. In addition, Chile also has the highest death rate in the world for cancer of the cervix. An excess of female deaths is seen for colorectal cancer, whereas figures for cancer of the pancreas reveal only a slight excess of male deaths. This varied picture makes Chile an excellent setting in which one can study the epidemiology of cancer sites.

Adolescent↗

PubMed1994

[Characterization of Neisseria meningitidis isolated fron systemic infections. Chile, 1992-1993].

BACKGROUND: in Chile, all systemic infections caused by Neisseria meningitidis must be reported and the bacterial strain must be sent to a Reference Laboratory at the Instituto de Salud Pública de Chile (ISP). AIM: to report the characterization of strains of N. meningitidis isolated during systemic infections in Chile during the years 1992 and 1993. METHODS: the serogroup, serotype, subtype and antimicrobial susceptibility of every strain of N. meningitidis received at the ISP during 1992 and 1993 was studied. RESULTS: six hundred twenty eight strains of N. meningitidis were confirmed during 1992 and 1993. B serogroup was responsible of 91.1% and 94.7% of confirmed cases during 1992 and 1993 respectively. Serotypes and subtypes most frequently associated to B serogroup were B: 15: P1.3 (63.2%) in 1992 and 51.8% in 1993) and B:NT:P1.3 (11.7% in 1992 and 21.3% in 1993). In 1992, all strains were susceptible to penicillin, chloramphenicol, ceftriaxone and rifampicin. During 1993, 7 (2%) strains were found, for the first time in Chile, moderately susceptible to penicillin and rifampicin MIC90 increased fourfold in respect of 1992, although all strains continued to be susceptible to this antimicrobial. CONCLUSIONS: the increasing frequency of NT (non typified strains) isolation will demand the use of molecular biology techniques for their identification. The appearance of penicillin resistant strains in our country is worrisome.

Chile↗

PubMed1993

[The "protomedicat" in the kingdom of Chile: the first independent court (1786)].

This work is part of a study that analyzes the performance and significance of protomedicato during the colonial period in Chile. The Royal protomedicus is a medical term for "physician in chief". The documents that were contemporarily generated with the event and the general secondary bibliography about the medical profession in Chile have been analyzed. All this historiographical material is mainly kept at the National Archives of Chile. Along the manuscript, the arduous task of the sanitary authorities of the moment is made evident. They struggled to obtain a court, that was considered essential to improve the Kingdom's health. However, in spite of their efforts, they were not rewarded promptly and had to wait four years to obtain some results. The slowness of the process was a consequence of the institutions ineffectiveness and huge bureaucracy of that times and not due to the distance between the Kingdom of Chile and the Metropolis.

Chile↗

PubMed1994

Biological sciences in Chile and South America, 1981-1991: a citationist perspective. Output data and specialty area impact trends.

The purpose of this report is to examine the biological sciences in Chile and South America in bibliographic terms -the number of papers each nation published from 1981-1991 and the number of citations to them in the international research literature. The database consists of 34,600 biological science papers from Argentina, Brazil, Chile, and Venezuela in the 1981-1991 Science Citation Index files of the Institute for Scientific Information. Twelve specialty areas were selected to represent the biological sciences of special interest to Chile: animal sciences, biochemistry/biophysics, environmental sciences, experimental biology/medicine, immunology, microbiology/cell biology, molecular biology/genetics, neurosciences, pharmacology, physiology, plant sciences, and reproductive sciences. Data are reported on the number of papers in these fields, combined, by authors based in Chile and other South American nations. In addition, time-series trends in the impact (average citations per paper) of Chilean research relative to South America as a whole, overall and in each specialty, are presented and discussed.

Bibliometrics↗

PubMed1996

[Medical subspecialties in Chile: current status].

There is no reliable registry of medical subspecialists in Chile According to the records of the Autonomous National Corporation for Certification of Medical Specialties (CONACEM), the largest number of certifications is in internal medicine (n = 681), followed by cardiology (n = 153), respiratory medicine (n = 106), gastroenterology (n = 93), endocrinology (n = 77), rheumatology (n = 55), hematology (n = 50) nephrology (n = 50), and infections diseases (n = 31). Over 55% of those certified in internal medicine and 70% of those certified in medical subspecialties (except nephrology) live in the metropolitan area of Santiago. Almost 80% of university-trained internists have received their training at the University of Chile (1952-1995), whereas 52% of university-trained subspecialists have been trained at the Catholic University of Chile. A sizeable number of nonofficial specialist-training programs are conducted at some universities at variance with their own official training policies. In internal medicine, a larger number of specialists have been trained by the universities than are certified by CONACEM, whereas the converse is true for medical subspecialists. More than 80% of the internists in Chile work for the Ministry of Health, who cares for 70% of the country's population. The best internist: population ratio is in Arica and Valdivia, and the poorest one in Arauco and in Viña del Mar/Quillota. According to estimations done by the Santiago Medical Society (Chilean Society of Internal Medicine) and its subspecialty affiliate societies, an adequate proportion of internists would be 1 for every 10,000 inhabitants, and for subspecialists, 1 for every 100,000 inhabitants. More information is needed about the ideal number of specialists and subspecialists required, and about their ideal distribution throughout the country. CONACEM needs to be strengthened, the universities should be able to certify non-university training centers, and the migration of subspecialists out of Santiago should be encouraged.

Chile↗

PubMed1997

[125th anniversary of Revista Médica de Chile].

The first issue of Revista Médica de Chile was printed in July, 1872. Since then, it has been published monthly, interrupted only for a few months during a Chilean civil war (1891). This medical journal has been devoted mainly to clinical topics in internal medicine, but currently it includes an increasing proportion of research papers in other biomedical and preclinical subjects. This journal is included in the most important international indexes of biomedical publications. Most issues cover also medical education, public health, the ethics of clinical and experimental research, medical administration and the history of medicine. The evolution of medicine in Chile along 125 years is clearly reflected in the contents of this journal. Revista Médica de Chile is one of the oldest medical journals in the world, particularly among those published in Spanish, and a top ranking biomedical publication in Chile.

Chile↗

PubMed1987

Household treatment for "chile burns" of the hands.

In New Mexico, chile peppers (Capsicum annum) are prepared by roasting and manually removing the skin from the fruit. Peeling is often done barehanded and may cause prolonged burning pain, irritation, and erythema but not vesication. In a survey of elderly Hispanic women, treatment with oils or cool tap water were frequently used home remedies. Twenty female subjects immersed their hands in a standardized slurry of green chile for 40 minutes, afterwards one hand was placed in cool tap water and the other in vegetable oil for a total of 75 minutes. Pain was scored using a visual analog scale while the hands were immersed in the chile slurry, test baths, and after drying. The difference in pain score was calculated for each subject. Analysis was by pooled regression. Cool tap water immersion initially provided more relief while vegetable oil provided better long-term relief from the pain of "chile burns".

Adult↗

PubMed2006

mtDNA microevolution in Southern Chile's archipelagos.

The genetic variability of four predominantly Indian populations of southern Chile's archipelagos was examined by determining the frequencies of four mitochondrial DNA haplogroups that characterize the American Indian populations. Over 90% of the individuals analyzed presented Native American mtDNA haplogroups. By means of an unweighted group pair method with arithmetic mean (UPGMA) dendrogram, a principal component analysis (PCA) derived from a distance matrix of mtDNA, and the exact test of population differentiation, we are able to prove the existence of a North-South cline. The populations in the northern part of the archipelagos are genetically similar to the Huilliche tribe, while the groups from the South are most closely related to the Fueguino tribe from the extreme South of Chile, and secondarily to the Pehuenche and Mapuche, who are found to the North and East of Chiloé archipelago. These results are consistent with a colonization of the southern archipelagos from Tierra del Fuego. We evaluate the evolutionary relationships of the population of the Chiloé area to groups from other geographic areas of Chile, using analysis of molecular variance (AMOVA). Three Amerindian clusters are identified: one formed by the Aymará and Atacameño, a second by the Huilliche, and a third including the Mapuche, Pehuenche, and Fueguino tribes, and the population inhabiting the South of the Chiloé arcipelago. These groups exhibit a North-South gradient in the frequency of haplogroup B, confirmed by F(ST) tests.

Chile↗

PubMed1988

Frequency of gallbladder cancer in Chile, a high-risk area.

We report an autopsy study of gallbladder cancer prevalence in Chile, where the risk of this disease is among the highest reported world-wide. In 14,768 autopsy protocols obtained from 3 university hospitals, 45% of women and 20% of men older than 20 years had gallstone disease (the major known risk factor for gallbladder cancer). The prevalence of gallbladder cancer in Chileans was compared to that found in a Swedish-Czechoslovakian autopsy study previously published. These countries were chosen because of their high frequency of gallstone disease. The comparison was performed by using logistic regression models adjusting for possible differences in the age-sex structure or the true incidence of gallstones in both populations. We found that the most important single risk factor for gallbladder cancer in Chile was gallstone disease, with an estimated effect on the logistic scale meaning that the cancer risk for subjects with gallstones is seven times higher than for those without the disease. Second in importance was the risk for sex, women being 2.8 times higher than for men. The estimated difference in the sex composition and the incidence of gallstones resulted in 17.9% higher odds of cancer in Chile than in Sweden and Czechoslovakia. However, this difference was not significant. This study suggests that the major etiologic factors of gallbladder cancer in Chileans, Swedes and Czechoslovakians are primarily related to gallstone disease.

Adult↗