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PubMed2002

[A epistemometric view of some biological disciplines in Chile].

During the last decade the articles published by Chilean Research Centers grew 1,73 which compares to the 2.34 fold increase of mainstream research articles registered as a whole in Latin America. However, the relative impact of the Chilean publications surpassed that of Latin America. In Biological Sciences, traditionally the strongest research area within Chile, Latin America also shows a steeper slope of growth. Qualitatively, biological disciplines in Chile are comparable to those published in Latin America although in Chile there are specialties as Physiology that surpass the average world's impact. The scientometric data is consistent with the fall in individual grants that the Chilean Research Fund (FONDECYT) has been allocating during the last decade.

Bibliometrics↗
PubMed2001

Evaluation of a Triatoma infestans elimination program by the decrease of Trypanosoma cruzi infection frequency in children younger than 10 years, Chile, 1991-1998.

Chagas disease is widespread in Chile, distributed in rural and periurban areas in the 7 most northern regions of the country. The principal vector of Trypanosoma cruzi is Triatoma infestans. The interruption of the domestic cycle of transmission of T. cruzi has been attempted by health education, human housing improving, and elimination of the vector by means of systematic insecticide spraying of human dwellings. Spraying with insecticides has been supported by Chile's health authorities and has been carried out for the last 12 years. A total of 13,280 children (aged up to 10 years) were randomly selected from 47 counties in the area of Chile endemic for Chagas disease, and blood samples were collected to determine the levels of antibodies to T. cruzi by indirect hemagglutination and enzyme-linked immunosorbent assay tests. The results of the tests were analyzed to determine the changes that occurred after 12 years of insecticide spraying of dwellings to eliminate T. infestans infestation. A total of 142 (1.1%) samples of children showed antibodies to T. cruzi. This rate is significantly lower than the data generated in similar studies conducted in 1982-1985. The following reduction in prevalence rates were observed in each of the 7 endemic regions of the country: region I, 5.5-0.3%; region II, 6.6-0.3%; region III, 9.8-1.0%; region IV, 7.2-2.0%; region V, 5.2-1.9%, Metropolitan region, 1.4-0.6%; and region VI, 1.4-0.4%. Serovigilance of T. cruzi antibodies level represents a novel approach that may allow the evaluation of the impact of the vector elimination program. The results identify regions that need to strengthen the efforts to reduce the insect infestation of dwellings.

Animals↗
PubMed1999

[Molecular epidemiology of the human immunodeficiency virus type 1 in Santiago, Chile].

BACKGROUND: Most of the studies of HIV-1 infection in South America have been limited to Brazil and little is known about the viral variants that are causing disease elsewhere in the continent. AIM: To determine the characteristics of the viral variants present in Chile as well as patterns of viral transmission. MATERIAL AND METHODS: Viral sequences were obtained from 21 HIV-1 infected people from Santiago, Chile who were infected either via sexual contact or intravenous drug use. Cloned sequences obtained from both the third variable and conserved regions of the envelope as well as the viral protease were evaluated. RESULTS: We found only clade B subtype viruses in Santiago. An evaluation of the envelope gene revealed no evidence that the sequences were monophyletic by risk group. A number of the protease sequences were predicted to encode amino acid substitutions commonly found during selection for protease inhibitor resistance. CONCLUSIONS: The HIV-1 strains studied in Chile, belong to the subtype B. There is no molecular evidence of separate introductions of the virus into the different risk groups. A number of substitutions in the protease gene that may confer resistance to protease inhibitors were found in patients with no previous exposure to this class of drugs.

Acquired Immunodeficiency Syndrome↗
PubMed1999

[Availability of physicians in Chile and its medium-term projection. 5 years later].

According to a prospective study performed in 1993, Chile had 14,400 active physicians (excluding those over 70 years of age) and a physician/inhabitant ratio of 1:960. The estimated projection for 1998 was of 16,244 physicians and a ratio of 1:921. However, during the present decade, the number of medical schools in Chile has duplicated, increasing by 38.4% the number of available posts in Medical schools. Also, 1,297 physicians graduated abroad, have been incorporated. Therefore, previous projections must be revisited. The present study shows that in 1998, Chile has 17,441 physicians (1:850), will have 20,610 (1:765) in 2003 and 24,449 in 2008. This last figure means a physician/inhabitant ratio of 1:679, similar to that of countries with a consolidated market economy. The foreseen medical population increase rate of 3.5% doubles the general population increase rate. To assure the quality of medical training, a Medical School accreditation process is being held. This study highlights the need to review bilateral agreements subscribed with five countries, that recognize the physician degree without assessing the medical skills of foreign graduates.

Chile↗
PubMedDate not supplied

[Human hydatidosis in Chile. Seroprevalence and estimate of the number of infected people].

Chile is located in the southwestern border of South America. The country is 4,329 km long and 96-342 wide. From north to south it is divided into five marked different biogeographical zones: deserts, steppes, bushes, forests (cattle raising) and austral (sheep raising). Population (June 1999) 15,017,760 (14.6% rural). Human hydatidosis is endemic in Chile. According to Ministry of Health information about 320 cases are registered each year. In order to find out the likely prevalence of human hydatidosis in Chile, a series of serosurveys was carried out in 1988-1997 throughout the total country. By using the indirect hemagglutination reaction and ELISA for hydatidosis (tests with good sensibility and specificity) 60,790 unselected apparently healthy persons: 41,399 from urban areas (16,428 blood donors, 13,894 delivering mothers and 11,077 middle grade schoolchildren) and 19,361 from rural areas--from randomly selected family groupings--were studied. A total individuals 82 (136/100,000) resulted positive: 36 (87/100,000) urban and 46 (241/100,000) rural, being the prevalence higher in rural areas, particularly in the southern austral zone (mean 1068/100,00). These figures agree with those observed in clinical epidemiological studies. In conformity with the present results, in the whole country 17,002 individuals should have hydatidosis: 10,318 urban and 6,784 rural. All these possible infected people, not necessarily should present pathology in the future, as it has been observed in autopsies from unselected individuals, performed at the Medico-Legal Service in Santiago, in whom 71.3% of diagnosed hydatosis with hydatid cysts in many different locations, was an autopsy finding.

Adolescent↗
PubMed2001

[Incidence of the cleft lip and palate in the University of Chile Maternity Hospital and in maternity Chilean participating in the Latin American Collaborative Study of Congenital Malformations (ECLAMC)].

BACKGROUND: ECLAMC is a registry, aimed to assess the incidence of congenital malformations, that started in 1967 and Chile incorporated to it in 1969. AIM: To report the incidence of cleft lip/palate, updated to 1999 in the University of Chile Maternity Hospital and other Chilean hospitals participating in the ECLAMC. PATIENTS AND METHODS: A review of the ECLAMC database that registers all births or stillbirths of more than 500 g. RESULTS: The incidence of orofacial cleft, at the University of Chile Maternity Hospital, in the period 1991-1999 was 17.8 per 10,000 (12.6 for cleft lip and 5.2 for cleft palate). The incidence in the rest of participating hospitals was 12.04 and 4.6 respectively. Males had a higher incidence of cleft lip and 80% of children with cleft palate, had other malformations, most of them as part of a syndrome (13 and 18 trisomy, holoproscencephalia, Pierre Robin, Apert en EE syndromes, anencephaly etc). In three of 12 children with cleft lip but without cleft palate, there was a relative with the same malformation. CONCLUSIONS: It is proposed that both entities, cleft lip with or without cleft palate and cleft palate without cleft lip, are two etiopathogenically different conditions.

Chi-Square Distribution↗
PubMed2001

[Central nervous system malformations in a Clinical Hospital of Universidad de Chile and in Chilean maternity hospitals that participated in the Latin American Collaborative Study of Congenital Malformations (ECLAMC)].

BACKGROUND: In Chile, the rates of central nervous system congenital malformations at birth remain high, when compared with the rest of the world. AIM: To report the rates of central nervous system congenital malformations in Chilean hospitals. MATERIAL AND METHODS: Using the ECLAMC protocol, every malformed newborn or stillbirth, weighing more than 500 g at birth is registered using a standard protocol, and the next non malformed child of the same sex born in the same hospital is assigned as control. RESULTS: The rates of central nervous system congenital malformations are higher at the University of Chile Clinical Hospital than in the rest of Chilean hospitals or Latin American Hospitals. There are significantly higher rates of anencephalia in Concepcion and spina bifida in Valdivia, Rancagua and Concepcion. In the University of Chile Clinical Hospital, global annual rates have a negative slope of -0.0259 per 1000 born alive, with a correlation coefficient of -0.125 (p < 0.05). The slope is positive among children born alive, with an annual rate increase of 0.071. Among stillbirths, the slope is -0.47 per 1000 born alive. Sixty two percent of malformed children were female. Among children with neural tube defects, 30% had a malformed relative and, of these, 66% had the same malformation. CONCLUSIONS: Family clustering of neural tube defects, supports the influence of a genetic factor influencing their appearance.

Adolescent↗
PubMed2002

[The Revista Médica the Chile and medical education].

With this issue, Revista Médica de Chile will have been published uninterruptedly, for 130 years. Formal medical education had an early development since Chile became independent from Spain (1817). The first Medical Sciences Course was organized in 1833 by the Irish physician William C Blest. The Santiago Medical Society was founded in 1869 and its journal-Revista Médica de Chile--in 1872. Its first director was Dr. German Schneider. Revista Medica is the oldest serial publication in South America and the second oldest in the Spanish speaking world. This is a remarkable fact for a comparatively young country. With the creation of the Medical Society and Revista Medica, a process of continuous medical education was started and they became a real Graduate School. The Journal has adopted the main changes in knowledge and technology. Some important milestones of its development, during the second half of the 20th century, were the definition of its objectives and structure, the incorporation of peer review of manuscripts (even with foreign reviewers) the adoption of international guidelines for publication, its incorporation into the main biomedical journal indexes, the modernization of its printing process, the making of a computer generated index of all papers published since 1872, its incorporation into a digital library in INTERNET and the active participation of its editors in the World Association of Medical Journal Editors. The success of the journal is influenced by the independence that the Medical Society has conferred to the editors (all outstanding University Professors), as well as to the characteristics of an educational campus "invisible and without tumult" (Ingelfinger).

Chile↗
PubMed1989

[Spanish, Italian, and Portuguese immigration: Chile 1860-1930].

"The paper refers to the amount and some characteristics of the Spanish, Italian and Portuguese immigration to Chile during the period 1860-1930. It is compared with [movements to] Argentina, Brazil, Cuba and Uruguay.... Different information sources are used and in spite of data weakness, the low preference for Chile of the European migratory flows is ratified as compared with those to Argentina.... It is pointed out that the migratory flows to Latin America, in particular to Chile, are associated, on the one hand, with the favourable... European [immigration] policy in this country and on the other hand with the huge European emigration overseas during that period." (SUMMARY IN ENG)

Americas↗
PubMed2003

[Serologic evidence for human Ehrlichiosis in Chile].

BACKGROUND: Ehrlichiosis is a non contagious infectious disease, mainly transmitted by thick bites. In 1998, this infection was detected in dogs, for the first time, in Chile. AIM: To establish if there is human exposure to Ehrlichia sp in Chile. MATERIAL AND METHODS: Blood samples from 17 dogs with ehrlichiosis and 19 humans who had contact with them were studied to determine human exposure to Ehrlichia equi and Ehrlichia chaffeensis in Chile. Samples were analyzed by indirect immunofluorecence and by polymerase chain reaction (PCR). RESULTS: Six dogs had positive titers against both species of ehrlichia; 2 with titers of 1/256; 3 with titers over 1/512 to Ehrlichia equi and titers of 1/256, 1/128 and 1/64 to Ehrlichia chaffeensis respectively, and 1 with titers of 1/256 to Ehrlichia equi and titers of 1/128 to Ehrlichia chaffeensis. Two of the 19 humans, had positive titers against both antigens (1/128). PCR reactions were negative in both human and canine sera. CONCLUSIONS: These results confirm that human exposure to Ehrlichia sp. Epidemiological surveillance for human ehrlichiosis should be implemented in the country.

Animals↗
PubMed2003

Decentralization and equity of resource allocation: evidence from Colombia and Chile.

OBJECTIVE: To investigate the relation between decentralization and equity of resource allocation in Colombia and Chile. METHODS: The "decision space" approach and analysis of expenditures and utilization rates were used to provide a comparative analysis of decentralization of the health systems of Colombia and Chile. FINDINGS: Evidence from Colombia and Chile suggests that decentralization, under certain conditions and with some specific policy mechanisms, can improve equity of resource allocation. In these countries, equitable levels of per capita financial allocations at the municipal level were achieved through different forms of decentralization--the use of allocation formulae, adequate local funding choices and horizontal equity funds. Findings on equity of utilization of services were less consistent, but they did show that increased levels of funding were associated with increased utilization. This suggests that improved equity of funding over time might reduce inequities of service utilization. CONCLUSION: Decentralization can contribute to, or at least maintain, equitable allocation of health resources among municipalities of different incomes.

Chile↗
PubMed2003

[Infectious endocarditis: morbi-mortality in Chile. Results of the National Cooperative Study of Infective Endocarditis (1998-2002)].

BACKGROUND: Infective endocarditis is a severe condition, with a mortality that fluctuates between 16 and 25% in the Metropolitan area of Chile. AIM: To perform a prospective assessment of clinical and microbiological features of patients with infective endocarditis in Chile. MATERIAL AND METHODS: Collaborative study of regional hospitals in the whole country and teaching hospitals in Santiago. Patients with a possible or definitive infective endocarditis, according to Duke's criteria, were included in the protocol and a structured data entry form was completed. RESULTS: Three hundred twenty one patients (65% male, mean age 49 +/- 16.5 years) were studied. According Duke's criteria, 89% had a definitive and 11% a possible endocarditis. The subacute form occurred in 64% of patients. The most frequent predisposing cardiopathies were rheumatic in 25%, prosthetic valves in 15% and congenital in 13%. There was no evidence of cardiopathy in 20%. Twenty percent of patients were on hemodialysis, 11% were diabetic and only one patient abused intravenous drugs. The most frequent complication was cardiac failure in 59% of cases, followed by renal failure in 32% and embolism in 28%. The most frequent causing organism was coagulase positive Staphylococcus in 35%. Blood cultures were negative in 28% of cases from the metropolitan region, in 56% of cases from the north and 38% of cases from the south. Echocardiographic diagnosis was done in 92% of cases. Aortic valve was involved in 42% and mitral valve in 29%. Successful antimicrobial treatment was achieved in 59% of patients. Thirty five percent of patients were subjected to surgical procedures with a 78% survival. Overall mortality was 29%. Univariate analysis identified sepsis, an age over 60 years and the presence of cardiac or renal failure as prognostic indicators of mortality. On multivariate analysis, the identified prognostic indicators were the presence of sepsis, renal failure, mitroaortic involvement associated to combined surgery and failure of antimicrobial treatment not associated to surgery. CONCLUSIONS: Subacute form is the most common presentation of infective endocarditis and rheumatic valve disease is the most common underlying cardiac lesion. Intravenous drugs users infective endocarditis is exceptional in Chile. The most frequent causing agent is coagulase positive Staphylococcus and the most frequent complication is cardiac failure. Surgical and overall mortality were 22 and 29% respectively. Sepsis, renal failure, combined surgical procedures, failure of medical treatment were identified as prognostic indicators of mortality.

Adolescent↗
PubMed2003

[Chronic lymphoproliferative syndromes in Chile. A prospective study in 132 patients].

BACKGROUND: Chronic lymphoproliferative disorders include a variety of diseases which are often a diagnostic problem for clinical hematologists. AIM: To study prospectively the distribution and incidence of chronic lymphoproliferative disorders in Chile and compare them with those of other Western, Latin American and Oriental countries. PATIENTS AND METHODS: A group of 132 patients were studied in a 36 months period (1999-2001), with a panel of monoclonal antibodies. A score for chronic lymphocytic leukemia was employed to differentiate it from other B-cell disorders. RESULTS: The median age was 63 years old (range 32-94). Most patients had B-cell tumors (109) and the rest (23), T-cell tumors (82% vs 18%). Forty five percent of patients with B-cell tumors had a chronic lymphocytic leukemia (CLL), while the others were disseminated lymphomas. The incidence of T-cell tumors was slightly higher than that of other Western countries. Noteworthy is that the most common of these disorders was adult T cell leukemia/lymphoma (ATLL), in concordance with the high HTLV-1 seroprevalence in Chile. CONCLUSIONS: A morphologic, immunophenotypic and pathological study in a large number of patients with chronic lymphoproliferative disorders in Chile, shows a relatively low incidence of CLL when compared to other chronic B-cell tumors and a high representation of ATLL associated to HTLV-1 infection, compared with other Western countries. The lower incidence of CLL in our study might be due to patient's selection and/or underdiagnosis of this disease as a substantial proportion of CLL are asymptomatic.

Adult↗
PubMed2003

[The University of Chile School of medicine : 170 years serving the country].

The first course on Medical Sciences in Chile was inaugurated in 1833, being its director William C Blest, MD, an Irish physician graduated in Edinburgh University. Therefore, Dr. Blest can be considered the founder of Chilean formal medical education. When the University of Chile was established (in 1842), among its five initial Faculties was included Medicine, on the basis of the Medical Sciences course created ten years before. By then, the medical profession was not yet socially reputed and the initial years of the Faculty were difficult. During the 19th Century and until the second decade of the 20th century, this was the only medical school in the country. Its development was slow but sustained, reaching its apogee in the middle of the 20th Century, when it had outstanding clinical and basic sciences teachers and investigators. Clinical research, postgraduate teaching and medical specialization had a great development during that period. Nowadays, it is a complex Faculty that teaches eight health sciences courses leading to different professional titles, gives higher academic degrees in biomedicine and public health and certifies different medical specialties. It has a modern, well equipped library and a unique Museum of Medicine. Besides the traditional Departments in Medical Faculties, it has Departments of Medical Teaching, Bioethics and Medical Humanities. It provides continuing medical education programs and distance teaching has recently experienced a great development. The community is also favored with specific teaching programs. The academic promotion of its faculty members is based in a strict evaluation. During its existence, the Faculty has graduated a large number of physicians and other health care professionals. Our country should be grateful to the University of Chile Faculty of Medicine, in its 170th birthday, for its outstanding contribution to the development, welfare and happiness of Chilean society.

Chile↗
PubMedDate not supplied

[Chagasic infection in blood donors from hospitals in endemic regions of Chile (1982-1987). Epidemiological impact of the problem].

Chagas' disease, produced by Trypanosoma cruzi and transmitted by hematophagous triatomine bugs, exists in the Western Hemisphere from the south-western United States to central Chile and Argentina. It exists in rural and periurban sections of the northern half of Chile, with a prevalence of 16.9%. Constant rural-urban migrations have contributed to its spreading to urban sections. In order to investigate the impact of these migrations on the population susceptible of being blood donors and the probable increasing of the risk of T. cruzi transmission by blood transfusion, epidemiological surveys were carried out in donors from 22 hospitals located in the northern half of Chile. By means of an indirect hemagglutination test for Chagas' disease 16,841 blood donors were examined, arising a 2.7% of positivity, percentage that permitted to estimate that 126,477 potential blood donors infected with T. cruzi should be in the urban sections studied. These facts strengthen the need that serology for Chagas' disease must be routinely performed in endemic regions of the country, to adopt or reinforce the pertinent preventive measures.

Adolescent↗
PubMed1992

[Microbiology in Chile: development through a century of existence].

Microbiology starts in Chile at the end of the XIXth century as part of the effort to develop basic sciences at the University of Chile Medical School. Publications by Vicente Izquierdo on gonorrheae and Alejandro del Río on the organisms of dysenteriae were pioneer works in this area. The field was progressively developed in the Schools of Medicine, Dentistry, Pharmacy, Veterinary Medicine, Institute of Hygiene and Public Health and different hospitals. Many scientists have been trained in the United States, Canada or Europe. Post graduate training in Chile led to the first Masters degree in 1975 and the first doctoral degree in 1987. Although there is a shortage of well trained scientists and specialists, the field remains active as evidenced by publications, meetings and the existence of 3 specialized journals.

Chile↗
PubMedDate not supplied

[Perception of the impact of Bipolar Disorder and its diagnosis in health centers in Argentine and Chile].

OBJECTIVE: Early detection and treatment of Bipolar Disorder (BD) determine a significant relief in the considerable burden this disease implies. In order to adequately plan the strategies to guarantee access to treatment, it is useful to consider data which reflect the everyday vicissitudes the people affected by this pathology have to deal with. People on treatment for BD in centres in Argentina and Chile were surveyed, collecting data on their access to diagnosis and treatment. The centre surveyed in Chile, unlike those in Argentina, operates as a specialized unit. METHODOLOGY: An anonymous assisted survey was carried out; a random sample of people assisted in the participating centres with a diagnosis of BD type I or II, and stabilized for a period no shorter than 12 months, was assessed. RESULTS: 100 people were surveyed in Argentina and 69 in Chile (70% women, age 45.2 +/- 14.7, average schooling 12 years). Seventy one percent began symptoms at adult age (28,43 +/- 13 years), 14% during childhood. Age at first consultation was: 30 +/- 12.5; 85% reported having suffered psychotic symptoms, 46.4% suicide attempts, 71% hospitalisations for BD. Sixty-nine percent reported diagnostic delays longer than a year (median 8 years), 75% reported having received other diagnosis prior to their BD diagnosis (62% unipolar depression, 41% schizophrenia). Forty-one percent reported being unemployed. Delays and diagnostic errors were associated to a significant increase in the functional impact reported. CONCLUSION: Approximately 7 out of 10 people report difficulties in the access to a BD diagnosis. These difficulties magnify the already important impact of the disease.

Argentina↗
PubMed2003

[Iodine nutrition in school children of four areas of Chile during the year 2001].

BACKGROUND: In Chile, the recommendation for salt iodination was reduced from 100 to 40 ppm, after detecting high urinary iodine excretion in school age children. AIM: To assess iodine nutrition in school age children after the modification of salt iodination. SUBJECTS AND METHODS: Iodine nutrition was studied in 3712 school age Chilean children of primary level in 4 areas (Calama, Santiago, Temuco and Punta Arenas) through palpation of thyroid gland, urinary iodine excretion and iodine concentration in salt for human consumption of the surveyed areas. RESULTS: A 6.4% goiter prevalence was found (5.9% in boys and 6.8% in girls). Grade Ia goiter was more common (5.0%), without detecting differences between areas (7.3% in Calama, 5.9% in Santiago, 5.9 in Temuco and 6.7 in Punta Arenas). Iodine concentration in salt for human consumption of the areas was adequate according to the recent modification of Chilean legislation (25.4 mgI/g salt in Calama, 36.2 in Santiago, 27.7 in Temuco and 33.4 in Punta Arenas). Urinary iodine excretion was very high according to recommendation in boys and girls (2838 and 2852 mgI/g salt in Calama, 700 and 837 in Santiago, 1318 and 1438 in Temuco, 407 and 312 in Punta Arenas). CONCLUSIONS: Endemic goiter is not longer a problem in Chile. Salt iodination is in agreement with present legislation. However, urinary iodine excretion increased in Calama and Temuco, did not change in Santiago and decreased only in Punta Arenas in spite of the changes in the legislation. It is necessary to investigate the causes of the high urinary iodine excretions detected in school age children, and it is very important to have a continuous surveillance of iodine nutrition in Chile.

Child↗