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PubMedDate not supplied

[Evaluation of vectors of Chagas' disease eradication programs in Chile by serological study of children under 10 years old].

Chagas' disease is a parasitic zoonosis with high prevalence in Chile. It is distributed in rural and periurban section in the northern most seven out of thirteen regions in which the country is divided, and affects about 142,000 individuals dispersed in most of the 165 counties sited in the chagasic zone. Triatoma infestans--intradomiciliary species--is the main and practically exclusive vector of Trypanosoma cruzi. Diverse tools may be utilized in order to interrupt the domestic cycle of transmission of T. cruzi: health education, housing improvement and elimination of vectors by dwelling insecticide sprayings. This last resource has received priority in Chile in the last 12 years. To evaluate the effectivity of the programs for eliminating T. infestans a serological study for Chagas' disease--comprising 8,767 children less than 10 years old from 27 rural counties insecticide sprayed in the last 12 years--was carried out. A global total of 125 (1.4%) children resulted positive, figure significantly lower than 5.4% found in 1982-1990 in the same age group. Distribution by regions of positive individuals showed a decrease of prevalence in each of them: III Region, from 9.8 to 1.0%, IV Region, 7.2 to 2.0%, V Region, 5.2 to 1.9%, and Metropolitan Region, 1.4% to 0.6. Even though positive children have still been found in 46.7% of localities of the studied counties, it is possible to affirm that the vector control programs have been effective and must be maintained, and increased in those localities with T. cruzi infection in children under 10 years of age, with the general aim of eradicate Chagas' disease transmission in Chile before 2000.

Animals↗
PubMed1996

[Phenotypic and molecular features of Vibrio cholerae isolated in Chile, Peru and Bolivia. Comparison with environmental reservoirs].

BACKGROUND: Since 1991, a massive cholera epidemic started in Peru and involved most Central and South American Countries. In Chile, 147 cases were registered, the last one in 1995. AIM: To study the phenotypic and molecular features of Vibrio cholerae strains isolated from patients in Perú, Bolivia and Chile and from environmental reservoirs in Santiago, Chile. MATERIALS AND METHODS: The phenotype, biotype and susceptibility to nine antimicrobials was determined for each isolated strain. Also, the genes of cholera and termolabile toxins were determined using DNA probes and a chromosomal restriction profile was done using HindIII, EcoRI and NotI enzymes. RESULTS: Features studied were similar in the 53 strains isolated from patients. Those isolated from environmental reservoirs had different antimicrobial susceptibility, showing ampicillin resistance, and the GT gene was detected in one of 20 strains, compared to clinical samples were it was present in all. Strains isolated from patients and environment had similar chromosomal restriction profiles. CONCLUSIONS: The chromosomal restriction profile gives an image of bacterial genome and it is a useful and reliable tool for the epidemiological surveillance of cholera.

Bolivia↗
PubMed1997

[A tribute to Germán Schneider, MD, first editor of Revista Médica de Chile].

Germán Schneider was born in 1820 in Magdeburg, Germany, and graduated as M.D. at the University of Bonn. In 1848, caught by the political and intellectual reformist movement in Europe, he was exiled in Paris. As part of a large group of German immigrants, he arrived in Valdivia, Chile, in 1851. Later on he moved to Santiago and in 1871 he was nominated Professor of Clinical Medicine at the University of Chile school of Medicine. An active participant in the academic activities organized by Sociedad Médica de Santiago (a scientific society that evolved into the chilean Society of Internal Medicine) he was the leader of a six-men team who founded Revista Médica de Chile, in 1872. As first Editor of this medical journal, he established the basis for its continuous success and devotion to medical progress and education. Dr. Schneider died in 1884, leaving several distinguished pupils who followed his path, and a medical journal that now stands as one of the oldest in the world.

Chile↗
PubMed1997

[Ecology and health in Chile: present and future development].

In response to the progressive environmental deterioration, the Ecological Society of America has made a proposal, called "Sustainable Biosphere Initiative", to do research, teaching and decision making processes on biodiversity, global change and the effects of human activities on environment. The goal of appropriate environmental protection and welfare for mankind includes health and quality of life. Presently, Chile faces a number of environmental problems such as pollution, excessive urban growth, loss of agricultural areas, disposal of solid waste and species extinction. The lack of education and information in Chile, on these problems, is worrisome. The role of universities to overcome this deficit should be crucial in the future sustainable development of Chile.

Chile↗
PubMed1997

[The situation of the elderly in Chile].

Chile is experiencing a demographic transition and the causes of death and diseases of elders are similar to those of developed countries. However, these facts do not reflect the real problems that elderly people must face in this country, since they frequently suffer of not well diagnosed or assessed chronic diseases or functional limitations, that render them dependent or prostrated. If Chile wants to improve the physical and mental well being of elders, a global policy towards them must be developed and the financing of health services must be assured. In March 1996, a National Policy for Elderly People, aiming to improve the quality of life of these individuals, was approved by the government. We must successfully prevent and retard functional impairment and divulge the integral geriatric focus, encouraging global assessment, preventing disabilities and protecting functional independence. We must develop specialized Geriatric services in general hospitals, day care centers and rehabilitation units. We must teach the general principles of geriatric practise to health teams. Chile has a few trained specialists in geriatric medicine that must train other professionals. Thus, Medical Schools should expand research and post graduate training programs in geriatrics.

Aged↗
PubMed1997

[Iodine nutrition in school children of four census areas of Chile].

BACKGROUND: Although endemic goiter is an easily controlled chronic disease, it continues to be a serious global public health problem. AIM: To study iodine nutrition in school age children from different areas of Chile. SUBJECTS AND METHODS: Thyroid gland was palpated in 4181 school age children from Calama, Santiago, Temuco and Punta Arenas. Urinary iodine excretion was measured to 9% of these children and iodine concentration in salt for human consumption obtained in each of these areas was determined. RESULTS: A 9% goiter prevalence in boys and 11% prevalence in girls was detected. The prevalence of goiter Ia was 6.5% and the figure in different geographic areas was similar. Iodine concentration in salt for human consumption was adequate according to Chilean legislation (82.6, 95.7, 96.8 and 93.2 micrograms ugI/g salt in Calama, Santiago, Temuco and Punta Arenas respectively). Urinary iodine excretion in boys and girls was 1695 and 1802 micrograms l/g creatinine in Calama, 680 and 732 in Santiago, 574 and 690 in Temuco, 570 and 528 in Punta Arenas. These values are well above recommendations. CONCLUSIONS: Endemic goiter is no longer a problem in Chile. The importance of a continuous surveillance of iodine nutrition in Chile and the reduction of salt iodine concentration required by Chilean legislation is underscored.

Censuses↗
PubMed1998

[A tribute to professor Héctor Croxatto Rezzio: setting up science in Chile. "Nature is always more amazing than our imagination can conceive"].

Héctor R. Croxatto, M.D., has recently celebrated his 90th anniversary, fully active in scientific research and in other academic activities. Along his productive life, he has contributed with original observations on the role of certain peptides in the pathogenesis of arterial hypertension. Furthermore, he has been a leader in the development of biological research in Chile and the mentor or teacher of several prominent disciples who have had, or are having, their own brilliant careers in medicine and in science in Chile and other Latinamerican countries. Although most of his scientific productivity has been published in top journals in the international field, several of his papers have been published in Revista Médica de Chile. In this issue, the journal pays a tribute to this outstanding scholar, his exceptional personality and fruitful academic career. The tribute includes this Editorial, a Letter to the Editor and its reply, and his most recent manuscript, all testifying the exceptional virtues of a great man.

Biological Science Disciplines↗
PubMed1964

A CONTROLLED TRIAL OF LIVER-VIRUS VACCINE AGAINST MEASLES IN CHILE.

In view of the high mortality from measles in Chile, it was decided to undertake a double-blind, controlled trial of the Enders Edmonston B strain of live measles vaccine in that country as part of a WHO-sponsored programme to obtain information on reactions to that vaccine strain and on the antibody response elicited in children.Between July and December 1962, some 530 children 8 months to 3 years old received inoculations of vaccine, with or without gamma-globulin, or were given a placebo injection. The reactions were generally of moderate intensity and were not appreciably reduced in either frequency or intensity by gamma-globulin. Serological conversion was achieved in about 90% of the vaccinated.On the basis of this experience, it was decided to institute a large-scale immunization in Chile with the same vaccine; the campaign began in May 1963.

Child↗
PubMed2005

[Epidemiology of HIV/AIDS in Chile. December 2003].

From 1984, when the first case of AIDS was diagnosed in Chile, to December 2003, 6.060 patients with AIDS and 6.514 with asymptomatic HIV infection have been notified to a passive national surveillance system; around 3,800 have died due to the infection. Magnitude of the under reporting is discussed. Assumed routes of the infection have been: sexual (94.1%), blood--largely intravenous drug use--(4.3%) and vertical transmission (1.6%). According to analysis performed by the National Commission on AIDS (CONASIDA), a governmental office, HIV/AIDS epidemic in Chile is characterized by: predominance in male homo/bisexuals, urban and rural distribution, impoverishment of the affected people, diagnosis made mainly during adulthood and a steady trend to affecting more women and heterosexuals at large. Since 2001 there has been a continuous increase in access to standard antiretroviral therapy (HAART) for those cared for by the public health system, reaching free coverage for 100% of this population by 2003, which has determined a significant decrease in the rate AIDS-associated clinical manifestations while reaching an stop of the previously increasing lethality of the infection (from a 15% increase from 1993-1997 to 0.2% from 1998-2003).

Acquired Immunodeficiency Syndrome↗
PubMed1980

Descriptive epidemiology of Creutzfeldt-Jakob disease in Chile.

Descriptive epidemiological data are presented from a survey of 35 cases of Creutzfeldt-Jakob disease (CJD) that occurred in Chile in the period 1955 to 1977. The average mortality in Chile (0.31 deaths per 1 million) and in urban Santiago (0.73 deaths per 1 million) is compared with data reported from other countries. An increasing incidence in recent years is probably related to a greater awareness of the disease. The familial occurrence of CJD in nine patients from five affected families is described, and its analysis suggests a genetically determined susceptibility with incubation periods of more than 30 years. Horizontal transmission of the disease may have occurred in one patient in whom the disease developed 13 years after the patient married into a family with seven other affected members.

Adult↗
PubMed1986

Ophthalmology in Chile.

The practice of ophthalmology in Chile does not differ much from that in the United States. Basic ophthalmologic knowledge is the same, and common clinical problems are solved in the same way. The difference becomes evident in the more complex clinical problems. We have the knowledge and ability to perform the treatment but come up against the problem of high cost of technical instruments. Vitreous surgery, intraocular lens surgery, and laser treatments are performed, but we have to overcome the obstacles of obtaining the expensive and limited number of instruments. Perhaps, a US ophthalmologist will not understand this problem because, as I became aware during my stay as a fellow at The Wilmer Institute, Baltimore, and at other times when I have visited the United States, these difficulties do not arise. Lasers are bought, instruments are ordered by telephone, and manufacturers swamp the doctors with propaganda and offers of "call toll free for 30 days on trial." On the other hand, we know that, due to our efforts and using the means at our disposal, we have managed to keep the specialty at a high level, solving health problems and making the practice of ophthalmology pleasant in this beautiful country. Chilean ophthalmology has great prestige in South America. It has been the forerunner in the instruction of ophthalmologists, creating a method of teaching and of systematic specialization that has been unique in Latin America. It is an example to other branches of medicine in Chile. Although ophthalmologists are badly distributed in the country, considering our particular geographic and economic conditions, they fulfill their objectives in providing adequate visual health care for the population. This has come about through the combined effort of all Chilean ophthalmologists based on the example of their predecessors. Also, there has been a sense of solidarity among us, with responsibility and enthusiasm shown in practicing and in communicating ophthalmic precepts altruistically to the coming generations.

Chile↗
PubMed2005

Reduction of birth prevalence rates of neural tube defects after folic acid fortification in Chile.

To verify whether the decreasing neural tube defects birth prevalence rates in Chile are due to folic acid fortification or to pre-existing decreasing trends, we performed a population survey using a network of Estudio Colaborativo Latino Americano de Malformaciones Congenitas (ECLAMC, Latin American Collaborative Study of Congenital Malformations) maternity hospitals in Chile, between the years 1982 and 2002. Within each maternity hospital, birth prevalence rates of spina bifida and anencephaly were calculated from two pre-fortification periods (1982-1989 and 1990-2000), and from one fortified period (2001-2002). There was no historical trend for spina bifida birth prevalence rates before folic acid fortification, and there was a 51% (minimum 27%, maximum 66%) decrease in the birth prevalence rates of this anomaly in the fortified period. The relative risks of spina bifida were homogeneous among hospitals in the two period comparisons. There was no historical trend for the birth prevalence of anencephaly comparing the two pre-fortified periods, but the relative risks were heterogeneous among hospitals in this comparison. There was a 42% (minimum 10%, maximum 63%) decrease in the birth prevalence rate of anencephaly in the fortified period as compared with the immediately pre-fortified period, with homogeneous relative risks among hospitals. Within the methodological constraints of this study we conclude that the birth prevalence rates for both spina bifida and anencephaly decreased as a result of folic acid fortification, without interference of decreasing secular trends.

Anencephaly↗
PubMed1993

Seronegative spondyloarthropathies and diffuse idiopathic skeletal hyperostosis in ancient northern Chile.

Bioarchaeological research of ancient Amerindians was undertaken to test the hypothesis that seronegative spondyloarthropathies (SNS) and diffuse idiopathic skeletal hyperostosis (DISH) existed in prehistoric South Americans. An osteological-radiographic model was developed from clinical literature and systematically applied to 504 archaeological human remains housed at the Universidad de Tarapacá in Arica, Chile, to search for evidence of these arthritides. The results showed that SNS existed with an average frequency of 7% for the adult sample and DISH averaged 4% in individuals over 40 years old. It was found that the antiquity of SNS date back at least 5,000 years in both New World and Old World populations. In contrast, the antiquity of DISH in the Americas is not clear because no previous studies have dealt with this subject; however, this research finds mild DISH cases dating back 4,000 years in northern Chile. It was also found that SNS and DISH exhibit a trend of increasing incidence with the advent of agro-pastoral activities and village formation.

Arthritis↗
PubMed1983

Association of coronary artery disease and valvular heart disease in Chile.

This study analyzes the prevalence of coronary artery disease (CAD) among patients with rheumatic valvular heart disease (VHD) in Chile. Coronary angiography was performed in all patients referred to cardiac catheterization with VHD who were over age 50 years and who had angina or ECG signs of ischemia. A total of 100 patients entered the study. Significant CAD (greater than 50% obstruction) was found in 14% of the cases: 7% in patients with mitral valve disease (MVD), 18% in aortic valve disease (AVD), and 21% in combined mitral and aortic valve disease (MAVD). Angina was present in 14% of the patients with MVD, 63% with AVD, and 53% with MAVD. Only 57% of patients with CAD had angina pectoris; 20% with angina had CAD. Hemodynamic parameters and left ventricular ejection fraction were not correlated with the presence or absence of CAD. We conclude that in patients with valvular heart disease, the incidence of CAD is lower in Chile than previously reported in the English literature. We confirmed the fact that angina is often not associated with CAD, and that CAD is often present in the absence of angina.

Aged↗
PubMedDate not supplied

Increasing incidence of type 1 diabetes in population from Santiago of Chile: trends in a period of 18 years (1986-2003).

UNLABELLED: STUDY OBJECTIVE AND SETTING: The aim of this study is to determine the incidence rate of type 1 diabetes in the metropolitan region of Santiago, Chile from 1 January 1986 to 31 December 2003. DESIGN: Population-based incidence study. PARTICIPANTS: A case must fulfill the following requirements to be included in this study: age at onset: 0 to 14 years, diagnosed with diabetes and placed on insulin, diagnosed within the defined time period, and to be a resident of the metropolitan region of Santiago at the time of the diagnosis. The population 'at risk' is the population less than 15 years of age. RESULT: The overall rate of type 1 diabetes was estimated as 4.02 cases per 100 000 children per year (95% confidence interval: 2.98-4.83). CONCLUSION: The incidence of type 1 diabetes in Santiago, Chile has increased during the last years. This data are concordant with the observation that the incidence of type 1 diabetes is increasing in Latin America and worldwide.

Adolescent↗
PubMed2003

Oogenesis and plasma levels of sex steroids in cultured females of brown trout (Salmo trutta linnaeus, 1758) in Chile.

Naturalized brown trout populations in Chile are a valuable genetic resource with aquaculture potential. The oogenesis of a three-year-old brown trout cultured population was studied in southern Chile. Gonadosomatic index (GSI), oocyte growth, gonadal microscopic characteristics, and plasma levels of estradiol-17beta (E2), testosterone (T), and 17alpha-hydroxyprogesterone (17alpha-HP) were measured bimonthly for a nine-month period before spawning. The maximum GSI level (22%) was similar to that described for other salmonids, although it was reached in May, more than one month before the population started spawning. Oocyte growth increases strongly from January when diameter reaches more than 1 mm. The vitellogenic period (six-seven months) is consistent with the long vitellogenesis, described for salmonid females maturing at three years old. E2 shows a slow increase from November, reaching its peak value in March (65.2+/-0.7 ng/ml), during maximal vitellogenic activity. T increases as oogenesis progresses, reaching a maximum of 90+/-20 ng/ml during May, and falling considerably during ovulation. Following a typical pattern of progestogens in salmonid oogenesis, 17alpha-HP stays at basal levels during most of oogenesis, but experiences a strong surge (2.0+/-0.4 ng/ml) just before ovulation.

17-alpha-Hydroxyprogesterone↗
PubMed2004

Seroprevalence of human herpesvirus-8 in blood donors from different geographical regions of Argentina, Brazil, and Chile.

Human herpesvirus-8 (HHV-8) causes Kaposi's sarcoma (KS) and lymphoproliferative disorders in both HIV-infected and uninfected patients. HHV-8 has a worldwide occurrence but infection rates vary according to a combination of geographic and behavioral risks. The main transmission route seems to be sexual, nevertheless, nasal secretions, saliva, blood, and organ graft have been proposed. HHV-8 was postulated as a new infectious agent for screening in blood donors. The aim of this study was to evaluate the prevalence of antibodies against HHV-8 antigens in blood donors of South America. Serum samples from 2,470 blood donors from Argentina, Brazil, and Chile corresponding to five geographic regions were studied by indirect immunofluorescence assay (IFA). Seroprevalence rate was 3.7% (92/2,470; 95% CI 2.9-4.5) in the entire blood donor population distributed as follows: Argentina, 4.0% (Buenos Aires city, 4.3%; Bahia Blanca, 2.4%; and Córdoba, 4.0%), Campinas (Brazil), 2.8%; and Santiago de Chile, 3.0%. There was no difference (P>0.05) between men and women or age related, except in Brazil where positive cases were 30-49-year-old males. The present study, which includes different geographical areas of multiple countries from South America, has not been done before. The results show similar prevalence rates among the studied zones corresponding to low-prevalence regions. South America is a large sub-continent with a wide spectrum of population and geographical characteristics, thus, more HHV-8 prevalence studies should be necessary to establish possible regional differences.

Adolescent↗
PubMed1992

Comparison of two self administered psychiatric questionnaires (GHQ-12 and SRQ-20) in primary care in Chile.

The General Health Questionnaire (GHQ-12) and the Self Report Questionnaire (SRQ-20) were simultaneously validated against the criterion of the Revised Clinical Interview Schedule (CIS-R) in a primary care clinic in Santiago, Chile. A Relative Operating Characteristic (ROC) analysis was used to determine the optimal threshold point for case definition and to compare the performance of these two questionnaires. The validation coefficients for the GHQ-12 and the SRQ-20 were, respectively: sensitivity 76% and 74%; specificity 73% and 77%; overall misclassification rate: 26% and 25%. Misclassification by these questionnaires was significantly associated with education and sex, males being more likely than females to be misclassified as false negatives and poorly educated respondents as false positives. The symptom response profile of both questionnaires showed that the most prevalent items were psychological complaints of anxiety and depression. Both instruments seem to have a similar ability to identify minor psychiatric disorders in primary care in Chile.

Adult↗