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“Abejas nativas sin aguijón” se encuentran en bosques secos de la Reserva de Biosfera del Noroeste Amotapes Manglares, Tumbes, Perú, y poblaciones rurales cercanas. Estas abejas cumplen un rol importante como polinizadoras de cultivos agrícolas, forestales y como proveedoras de miel y polen", siendo Melipona mimética la especie más importante. Los objetivos del estudio fueron: la identificación molecular usando tres locis genéticos distintos (Citocromo c oxidasa, 28S ribosomal RNA y gen 16S rRNA), la Reacción en Cadena de la Polimerasa (PCR) y análisis bioinformático, identificándose a los géneros: Cephalotrigona sp., Geotrigona sp., Lestrimelitta sp., Melipona sp., Nannotrigona sp., Oxytrigona sp., Plebeia sp., Scaptotrigona, sp., Trigona sp. y Trigonisca sp. Y haciendo uso de Metagenómica y secuencias cortas del gen 16s DNAr, comprobado en NCBI, se encontró a especies bacterianas en: huevos 139, larvas 31, pupas 154 y adultos 39, siendo las más importantes Clostridium spp., Lactobacillus camelliae, Lactobacillus fermentum, Lactobacillus manihotivorans, Lactobacillus paracollinoides, Lactobacillus plantarum, Lactobacillus pontis, Lactobacillus reuteri, Lactobacillus sakei, Lactobacillus suebicus, Lactobacillus vaccinostercus, Lactobacillus vaginalis, Pediococcus acidilactici, y a través de técnicas dependiente e independiente de medios de cultivo a: Bacillus subtilis subsp subtilis en larva, Paenibacillus xylanilyticus en pupa y adulto: Humibacter sp., Acinetobacter sp., Acinetobacter nectaris y Fructobacillus sp. La identificación genómica y comunidad bacteriana es relevante, por tratarse del primer estudio de estas especies en Perú.

The effect of the variety, size of the females and sex ratio in the production of eggs of Chitralada (CH: Oreochromis niloticus) and Taiwanese red (TR: O. mossambicus x O. niloticus) in outdoor concrete tanks were evaluated in a fish production unit located in the Andean foothills of the state of Trujillo, Venezuela. A 2x2x3 factorial arrangement design was used: two varieties (CH and TR), two sizes (large and small) and three female male proportions (1:1, 2:1 and 3:1). CH females produced greater volume and mass of eggs, spawned 2.4-fold more and were more fertile than TR (p, Se evaluó el efecto de la variedad, tamaño de las hembras y relación hembra macho en la producción de huevos de tilapias Chitralada (CH: Oreochromis niloticus) y Taiwanesa roja (TR: O. mossambicus x O. niloticus), en tanques de concreto al aire libre, en una unidad de producción piscícola localizada en el Piedemonte Andino del estado Trujillo, Venezuela. Se utilizó un diseño en arreglo factorial 2x2x3: dos variedades (CH y TR), dos tamaños (grades y pequeñas) y tres proporciones hembra macho (1:1, 2:1 y 3:1). Las hembras CH produjeron mayor volumen y masa de huevos, desovaron 2.4 veces más y fueron más fecundas que las TR (p

El estudio tuvo como objetivo evaluar el comportamiento productivo de codornices de engorde (Coturnix coturnix japonica) alimentadas con alimento balanceado y suplementadas con harina de morera (Morus alba). El experimento se desarrolló en el Estado Trujillo, Venezuela, durante seis semanas. Se aplicó un diseño completamente aleatorizado con tres tratamientos (dietas) y cinco repeticiones por tratamiento (4 aves por repetición). Las dietas fueron: T0: 100% alimento balanceado (AB) comercial; T1: 90% AB + 10% de harina de morera (HM); T2: 80% AB + 20% HM. Se determinó el peso final (PF), ganancia diaria de peso (GDP), consumo de alimento, tasa de crecimiento específica (TCE), conversión alimenticia (CA), rendimiento en canal (RC), mortalidad y relación costo beneficio (CB). Los datos fueron procesados mediante el análisis de varianza usando el procedimiento GLM del programa SAS. El PF y la GDP fueron mayores en T1 y T2 (PF: T0: 139.1 ± 1.9; T1: 147.2 ± 2.0; T2: 147.1 ± 1.9 (p, The aim of this study was to evaluate the productive behavior of growing quail (Coturnix coturnix japonica) fed with a commercial balanced feed and supplemented with mulberry meal (Morus alba). The experiment was carried out in Trujillo, Venezuela, for six weeks. A completely randomized design was applied with three treatments (diets) and five repetitions per treatment (4 birds per repetition). The diets were: T0: 100% commercially balanced feed (AB); T1: 90% AB + 10% of mulberry meal (HM); T2: 80% AB + 20% HM. The final body weight (FW), daily weight gain (DWG), feed consumption (DI), specific growth rate (SGR), feed conversion (FC), carcass yield (CY), mortality and cost-benefit ratio were determined (CB). The data were processed by analysis of variance using the GLM procedure of the SAS program. The FW and the DWG were higher in T1 and T2 (PF: T0: 139.1 ± 1.9, T1: 147.2 ± 2.0, T2: 147.1 ± 1.9, (p

Background: There is a great degree of dissatisfaction with the Chilean health care system. Aim: To investigate which are the most relevant perceived factors when the health care system is evaluated. Material and Methods: Analysis of a survey about the Chilean health care system carried out during 2011, 2012 and 2013, involving 2,801 respondents. Results: The response capacity of emergency systems was the main factor considered for the evaluation of public and private health care systems. Respondents who were affiliated to private insurance systems also took into consideration the quality of medical infrastructure. Conclusions: There are different factors considered when public or private health care systems are evaluated.

Background: Problems associated with alcohol consumption are prevalent in Chile, but little is known about the situation in the elderly. Aim: To perform a screening to detect alcohol-related problems and risks in the Chilean older people who travel. Material and Methods: The Alcohol Use Disorders Identification Test (AUDIT) questionnaire was answered by 1,076 travelers aged 60 to 93 years (66% females), who participated in trips organized by the Chilean National Tourism Service (SERNATUR). Results: Seventy six percent of respondents acknowledged to have ingested an alcoholic drink during the last month. The average AUDIT score was of 2.2 ± 2.6. Only 3.7% of the sample had a score equal or higher than eight, considered as risky use. Within this last group, 60% had symptoms of alcohol dependence. A higher alcohol consumption was associated with male gender (p < 0.01), being younger than 75 years of age (p < 0.01), having a medium-low economic income (p < 0.01) and having a higher education level (p = 0.03). There was no significant association with the respondents´ occupation. Conclusions: In this sample of Chilean traveling older people, there was a high prevalence of alcohol consumption, and nearly 4% of respondents had alcohol related problems.

Background: People over 60 years old are at risk of Vitamin D deficiency, which can affect functional performance, since this vitamin is involved in muscle function and protein synthesis. Aim: To measure 25OH vitamin D levels in healthy older people from Santiago de Chile, and evaluate their relationship with functional performance. Subjects and Methods: Healthy subjects aged 60 years or more and living in the community were invited to participate. People with chronic diseases, cognitive impairment, physical disability, smokers and those consuming more than three medications per day were excluded. Hand grip and gait speed were measured and a blood sample was obtained to measure 25OH vitamin D by radioimmunoanalysis. Results: One hundred and four participants aged 60 to 98 years (55% females) were studied. Mean vitamin D levels were 17.3 ± 6.1 ng/mL. Females had lower levels than males (15.6 ± 5.8 and 19.2 ± 6.0 ng/mL respectively p < 0.01). Eighty three percent of females and 55.3% of males had values below 20 ng/mL (the cutoff point for deficiency). Only 3.5% of females and 8.5% of males had values of 30 ng/ml or higher. There was a significant correlation between vitamin D levels, gait speed and grip strength (r = 0.32 and 0.34 respectively, p < 0.01), especially in women over 74 years. Conclusions: Vitamin D deficiency is almost universal in healthy adults over 60 years living in Santiago de Chile, especially in women. This deficiency is associated with a deranged functional performance and is a potentially modifiable risk factor for disability.

La disponibilidad léxica (DL) es el área de investigación lingüística que tiene como objetivo la recogida y el posterior análisis del léxico disponible en una determinada comunidad de hablantes. En este estudio, se presenta los resultados de un proyecto de investigación, que tiene como objetivos cuantificar y describir el léxico disponible en matemáticas de los alumnos de enseñanza media de la ciudad de Concepción-Chile. Para este fin, se utiliza el modelo de disponibilidad léxica a través de un análisis cuantitativo, considerando tres índices: promedio de respuestas (XR), total de palabras diferentes (PD), y el índice de cohesión (IC). La muestra está constituida por 1557 alumnos de la ciudad de Concepción-Chile. Los resultados evidencian un crecimiento del léxico disponible por parte de los alumnos a medida que estos aumentan su nivel de escolaridad. Lexical availability (LA) is the area of linguistic research that aims at the collection and subsequent analysis of the available lexicon of a given speech community. In this study we present the results of a research project, which has among its general objectives to quantify and describe the lexicon in high school math students from the city of Concepción-Chile. To this end, the lexical availability model will be used, through a quantitative analysis, considering three indexes: response average (XR), total of different words (PD), and cohesion index (CI). The sample consists of 1,557 students in Concepción. The results show an increase of vocabulary available for the students as they increase their level of education. This was also observed in students of educational institutions of higher socioeconomic status.

Background: Clinical reasoning is the most important competente in the training process of a physician. Aim: To develop a method for teaching clinical reasoning based on prototypes of clinical cases. Material and Methods: The study was conducted on sixty-four third year medical students. The study and control groups attended lectures and tutorial sessions with patients. The study group attended additionally discussion seminars of prototypical clinical cases. A clinical reasoning test was applied at the start and end of the learning period to both groups. At the end of the study, the opinions of students of the study group were collected in afocus group. Results: After the learning period, both groups significantly increased their clinical reasoning skills. However, the improvement in the study group was more than double than that ofthe control group. The absolute improvement in the study group was 30.9%. Students interviewed in the focus group were unanimous in expressing their satisfaction in each and every aspect discussed. Conclusions: The teaching of clinical reasoning to third year medical students by means of pattern recognition in seminars with clinical cases improved significantly their skills.

Introducción: Las características ideales del docente de postgrado de pediatría de la Facultad de Medicina de la Universidad de Chile no están definidas. Objetivo: Determinar estas características a partir de las percepciones de sus integrantes. Metodología: Investigación cualitativa. En el Campus Oriente se realizó grupos focales de docentes, egresados y alumnos de Programa de Título de Especialista en Pediatría y entrevistas en profundidad a tres autoridades. Con este perfil elaborado se entrevistó a los directores de Departamento de Pediatría de los restantes Campus para su validación. Resultados: Se elaboró un perfil docente diferenciando su rol como persona (comprometido, responsable, honesto, respetuoso, tolerante, acogedor, empático, asertivo, líder, modelo a seguir y capaz de mantener buenas relaciones interpersonales), como profesor (formado en docencia, planificador, evaluador, con tiempo protegido para la docencia, con capacidades de autoevaluación y de autorreflexión, facilitador del aprendizaje, motivador, propiciador de un clima que facilite el aprendizaje, comunicador, con vocación, exigente, accesible, conocedor y utilizador de nuevas tecnologías y con capacidad de revisar el proceso docente) y como clínico (experto en su disciplina, actualizado, investigador, identificado y comprometido con la institución, capaz de trabajar en equipo). Conclusiones: Se construyó un perfil ideal del docente de postgrado de pediatría. Introduction: The ideal characteristics of the Graduate Professor of Pediatrics at the Medical School of the Universidad de Chile are yet not defined. Objective: To determine these characteristics from members' perception. Methodology: Qualitative research. Focus groups for Professors, alumni and Pediatrics students and interviews to three authorities took place at the Campus Oriente. Once the profile was elaborated, Directors of Departments of Pediatrics of other Campuses were interviewed for validation. Results: A teaching profile was elaborated differentiating the role of the professional as a person (committed, responsible, honest, respectful, tolerant, friendly, empathetic, assertive, leader, role model and able to maintain good interpersonal relationships), as a teacher (trained in teaching, planner, evaluator, with protected time for teaching, with capacities for self-reflection and self-assessment, learning facilitator, motivator, facilitator of a climate that encourages learning, communicator, with vocation, challenging, accessible, knowledgeable and user of new technologies and with ability to review the teaching process) and as a clinician (expert in his discipline, updated, researcher, identified and committed to the institution, able to work in a team). Conclusions: An ideal profile of the Graduate Professor of Pediatrics was created.

The speed of growth of the population of older adults has been much faster than expected in every country. In Chile today one out of ten persons is an older adult and in the next twenty years this proportion will duplicate. Population aging is a success of development but also presents a medical and social challenge. The health issues of the National Policy addressing the needs of the older population in Chile are severely delayed in their implementation due to the lack of human resources trained in medicine of older adults and geriatric services. The consensus evidence on how to develop appropriate geriatric health services for older adults should include services coordinated in a continuum, including health promotion and disease prevention targeting older people to achieve "healthy aging" in the majority of the older population; outpatient health care services; acute care in hospitals with physicians trained in geriatrics; special services for geriatric rehabilitation and restoration of function (short term care) and a variety of settings and services offering long term care ranging from home to institutions. To be able to implement this vision of appropriate, coordinated and integrated health and social services for older people, the country needs a minimum number of geriatricians (at least 260), health care teams trained in the basics of geriatrics and continuing development of human resources to meet the increasing demand on health services by the fast growing older population

The speed of growth of the population of older adults has been much faster than expected in every country. In Chile today one out of ten persons is an older adult and in the next twenty years this proportion will duplicate. Population aging is a success of development but also presents a medical and social challenge. The health issues of the National Policy addressing the needs of the older population in Chile are severely delayed in their implementation due to the lack of human resources trained in medicine of older adults and geriatric services. The consensus evidence on how to develop appropriate geriatric health services for older adults should include services coordinated in a continuum, including health promotion and disease prevention targeting older people to achieve "healthy aging" in the majority of the older population; outpatient health care services; acute care in hospitals with physicians trained in geriatrics; special services for geriatric rehabilitation and restoration of function (short term care) and a variety of settings and services offering long term care ranging from home to institutions. To be able to implement this vision of appropriate, coordinated and integrated health and social services for older people, the country needs a minimum number of geriatricians (at least 260), health care teams trained in the basics of geriatrics and continuing development of human resources to meet the increasing demand on health services by the fast growing older population

Heterozygous familial hypercholesterolemia affects one every 400 individuals, is caused by mutations in the LDL receptor gene and is associated with premature coronary artery disease. Nowadays, LDL cholesterol can be efficiently reduced with the new therapies to reduce blood lipids. We report a female patient who consulted in 1975, when she was 46 years old, for severe hypercholesterolemia. In 2003, a sample of leukocyte DNA was obtained and the uncommon 1705 + 1G >A mutation of the LDL receptor gene was detected. No mutations in the apolipoprotein B gene were found. The patient was treated successfully with simvastatin 80 mg/day and ezetimibe 10 mg/day and LDL cholesterol levels were reduced below 200 mg/dl

La aparición de nuevas cepas de Mycobacterium tuberculosis de mayor virulencia y que presentan resistencia a los fármacos antituberculosos ha orientado la investigación al registro de la distribución geográfica mundial de las distintas variantes genéticas del patógeno. Mycobacterium bovis, un patógeno estrechamente relacionado, contribuye con la tuberculosis en humanos y por tanto, es de importancia en países que presentan alta prevalencia de tuberculosis animal. El análisis de espoligotipos es actualmente la estrategia más utilizada para tipificar genéticamente los miembros del complejo M. tuberculosis. En este trabajo, 25 aislados de un total de 41, provenientes de distintos pacientes de la Xª Región de Chile, formaron 15 grupos de espoligotipos. Un 24% correspondió al espoligotipo 53, de amplia distribución mundial. Un número importante de perfiles fueron idénticos a los encontrados en Brasil, seguido de Argentina y España. Aunque los pacientes eran de zonas rurales, no se detectó casos de zoonosis. Para establecer en forma más precisa el número y tipo de variantes genéticas presentes en nuestro país, nuestro laboratorio ha iniciado el análisis de un mayor número de cepas caracterizadas epidemiológicamente con técnicas más sensibles como MIRUS-VNTR The emergence of new virulent and drug resistant strains of Mycobacterium tuberculosis has forced researchers to focus on the worldwide geographical distribution of the genetics variants of this pathogen. Mycobacterium bovis, a close related pathogen, contributes with human tuberculosis and therefore, it is particularly important in countries with significant bovine tuberculosis prevalence. Spoligotyping is currently one of the most widely used strategies for genotyping members of the M. tuberculosis complex. In this work, of a total of 41 isolates, 25 were from different patients from the Xth Region from Chile. These isolates formed 15 clusters of spoligotypes. Twenty four percent of the spoligotypes corresponded to the worldwide distributed spoligotype 53 (SpolDB4). A significant number of spoligotypes were identical to profiles found in Brazil followed by Argentina and Spain. Although the patients where from rural areas, no cases of zoonosis were observed. To establish the geographical distribution, persistence and routes of dissemination of the pathogen, a greater number of epidemiologicaly relevant isolates are being analyzed using the MIRUs-VNTRs

La aspergilosis invasora es una patología grave, con una incidencia en aumento, que generalmente afecta a pacientes con inmunosupresión, existiendo escasa información en pacientes pediátricos inmunocompetentes. Reportamos el caso de un escolar de 8 años, previamente sano, que cursó con una aspergilosis invasora multisistémica de origen abdominal, en relación a una laparotomía contenida, evolucionando hacia una falla orgánica múltiple, con un desenlace fatal, a pesar de recibir terapia con anfotericina B deoxicolato más voriconazol y drenaje quirúrgico amplio. El estudio anátomo-patológico reveló elementos de hifas características dentro de diversos parénquimas e invasión vascular. La aspergilosis invasora debe tenerse presente entre las causas de infecciones emergentes en pacientes críticos, incluso en inmunocompetentes; se asocia a una elevada mortalidad a pesar de un adecuado y oportuno tratamiento Invasive aspergillosis is a severe disease, with an increased incidence in last decades. It occurs mainly in immunocompromised patients and rarely affects immunocompetent hosts. We describe a previously healthy 8 -year-old boy who acquired an invasive aspergillosis of abdominal origin associated with an opened laparotomy; within three weeks the patient progressed to a multiple organic failure syndrome and died despite amphotericin B deoxycolate plus voriconazole treatment and aggressive surgical debridement. Necropsy revealed multiple parenchyma involvement with characteristic findings of angioinvasive aspergillosis. Invasive aspergillosis must be considered an emergent infection in critical pediatric patients, including previously immunocompetent hosts; it is associated with high mortality despite adequate and opportune therapy

Background: The aging speed in developing countries has been faster than predicted. Thus, health care systems must adapt to face this new scenario efficiently. The WHO designed the INTRA study to assess health promotion and protection actions in primary care, for people over 50 years of age. Material and methods: Questionnaries designed by WHO were applied to 1,167 subjects (aged 50-94 years, 68% female) and 117 health care professionals attending and working respectively, at 33 health care centers of the Viña-Quillota Health Service. Results: Twenty percent of subjects were illiterate and 25% had less than 6 years of instruction. Forty three percent could reache the health centre by public transportation and 92% did not need to be accompanied, 39% spended more than one hour to be attended and 71% considered that the service in the centre was good. Sixty seven percent attended regular appointments, 63% did not perform any physical activity and only half of them were advised to start such activity. Weight loss was recommended to 55% but only one third has achieved such goal. Only one third of patients admitted being interrogated about their drinking habits. Among subjects in whom blood pressure was measured, one fourth had abnormal values. Conclusions: Primary health care in Chile, although having health care programs for the elderly, is loosing opportunities to improve health status and quality of life of this age group (Rev Méd Chile 2005; 133: 331-7)

Background: Elderly people (>60 years) in Chile represented 11.4% (n=1.717.478) of the total population in 2002. The group with disabilities or mental problems is increasing and there is no reliable information about the number of institutionalized elderly subjects. Aim: To estimate the number of elderly people living in residences for long term care and their and main characteristics. Patients and methods: Chilean Census does not provide exact information about institutional care, therefore we developed a «proxy» indicator of the percentage of institutionalized elderly (those living in «collective residences with more than 5 elderly persons and in which they represent more than 25% of the residents». This proxy has a R2=0.9859 with the true value of institutionalized persons for those Latin-American countries with exact value in census data at CELADE. Results: Using the proxy we found that institutionalized elderly population had increased from 14,114 (1992) to 26,854 (2002) and is projected to reach 83,500 (2025). In 2002, there were 1.668 institutions (37.4% informal care). In the Metropolitan Area, there were 804 institutions (14.178 elderly persons) and 40.3% of these were registered at the Ministry of Health. The proportion of institutionalized elderly subjects was 1.56% of the total elderly population; this proportion increased from 0.87% in subjects 60-74 years old to 2.5% among subjects aged 75-84 years and 6.1% in subjects 85 years old and over. Among subjects living in institutions, 60.9 were women, 21% were married, 35% were single, approximately 50% receive a pension and around 15% were handicapped. Conclusions: Institutional care affects a small percentage of elderly population, but it will increase in the near future. The main characteristics of institutionalized elderly subjects are not well known. We propose to create a formal Registry of these institutions and to include Nursing Homes and hospitals in type of housing of future Censuses (Rev Méd Chile 2004; 132: 832-8)

Background: There is little information about Chilean elderly residents of long term care facilities, regarding their characteristics and need for resources. Aim: To describe main characteristics and resource utilization of residents of one of the largest nursing homes in Chile, Fundación Las Rosas de Ayuda Fraterna. Material and Methods: In a cross sectional and descriptive study, all residents were evaluated using the RUG T-18 method, that assess activities of daily living and the complexity of their clinical situation. Results: We assessed 1497 subjects 60 years old and over (73% women), with an age range of 60-106 years. Thirty six percent had urinary incontinence, 19% required assistance for feeding, and 38% needed help for walking or moving. Fifty seven percent were in the lowest category of complexity, «Institutionalization». Very few residents were in the most demanding categories, no one classified as «Rehabilitation», and only 0.7% were in «Special Care». Conclusions: This study is an important start point to learn more about elderly subjects living in nursing homes in Chile (Rev Méd Chile 2004; 132: 701-6)

Background: In Chile there is a program named "Vacations for Elderly during Low Season". Aim: To characterize participants of this program and to measure the impact of traveling in their health and wellbeing. Material and methods: Two anonymous and voluntary questionnaires were applied to 4200 participants, before and after a ten days vacation package. Results: Before traveling, questionnaires were answered by 802 subjects, and after traveling by 4057 (69% women, 22% older than 75 years old, 15.8% living alone). The presence and maintaining of good health were most appreciated at this age and 59% classified their health as good or excellent. Twenty five percent referred sensory problems (seeing or hearing), 12% reported urinary incontinence and 21% presented falls in the last three months; depression screening (GDS-5) was positive in 16%. Chronic disease prevalence was similar to the general Chilean elderly population. After traveling they reported significant improvements in the items sociability, wellbeing, mood, appetite, insomnia and ostheoarthritic pain. Conclusions: Elderly who traveled were mainly women, who thought that maintaining good health is the most precious value. After traveling they improved significantly different aspects of wellbeing. Promotion of this kind of recreation programs is an important tool for integration and enhancement of quality of life in elderly subjects in our country (Rev Méd Chile 2004; 132: 573-8).

The number of nonagenarians is rapidly growing in Chile. This age group is mainly female, with higher frailty markers and in higher risk of being placed at nursing homes. Aim: To describe features of nonagenarian women and compare them with a group of women between 60-89 years, both living in nursing homes, in terms of disability and resource use at the institution. Subjects and methods: A total of 230 nonagenarian women and 460 women, aged 60-89 years, were evaluated in the nursing home Fundación Las Rosas de Ayuda Fraterna (only for poor elderly) in Santiago, Chile. The assessment instruments were the Geriatric Assessment instrument FEGAUC, functional and mental evaluation scales of Spanish Red Cross and the Resource Utilization System, RUG T18, an independent diagnostic classification system that allows the determination of resource use in terms of cost and personnel needs. Results: Nonagenarian women had significantly (p

Presentamos el caso clínico de un preescolar con antecedente de malformación pulmonar que 43 días tras una neumonectomía izquierda, ingresó al Hospital Padre Hurtado con fiebre de una semana de evolución. En una TAC pulmonar se demostró una gran colección intrapleural izquierda de la que se aisló Streptococcus grupo anginosus y Prevotella spp. Se efectuó tratamiento antimicrobiano con penicilina más clindamicina. Existe gran confusión en la terminología y clasificación de Streptococcus grupo anginosus. En la actualidad no existe duda que es un grupo que posee tres especies, S. anginosus, S. constellatus y S. intermedius. Son parte de la flora normal de orofaringe, nasofaringe, tracto gastrointestinal y vagina. Este grupo ha sido reconocido como causa de infecciones supurativas en niños y adultos. La mayoría de las cepas se describen como susceptibles a penicilina; sin embargo, existen reportes que sugieren la emergencia de resistencia. Se discuten las recomendaciones actuales para el diagnóstico e informe microbiológicos Left pneumonectomy in a child with congenital pulmonary malformation was performed two months prior to admission. Within one week he had high fever. Chest CT scan showed massive left pleural effusion. Both Streptococcus anginosus group and Prevotella spp. grew from the fluid obtained by pleural punction. Antimicrobial therapy was immediately initiated with clindamycin and penicillin. Streptococus anginosus group is quite confusing in terms of classification and taxonomy. Now it is well recognized that three species belong to this genera: S. anginosus S. constellatus and S. intermedius. They all are considered normal flora of the oropharynx, nasopharynx, gastrointestinal tract and vagina but also they have been identified as agents of suppurative infections in children and adults. Many reports show adequate response to penicillin, however there is some emerging resistance in strains isolated in other studies. In this article we also suggest some diagnostic and microbiologic recommendations

The number of nonagenarians is rapidly growing in Chile. This age group is mainly female, with higher frailty markers and in higher risk of being placed at nursing homes. Aim: To describe features of nonagenarian women and compare them with a group of women between 60-89 years, both living in nursing homes, in terms of disability and resource use at the institution. Subjects and methods: A total of 230 nonagenarian women and 460 women, aged 60-89 years, were evaluated in the nursing home Fundación Las Rosas de Ayuda Fraterna (only for poor elderly) in Santiago, Chile. The assessment instruments were the Geriatric Assessment instrument FEGAUC, functional and mental evaluation scales of Spanish Red Cross and the Resource Utilization System, RUG T18, an independent diagnostic classification system that allows the determination of resource use in terms of cost and personnel needs. Results: Nonagenarian women had significantly (p

El presente artículo trata sobre la importancia del colaborador (trabajador), hoy conocida como el POTENCIAL HUMANO, en el desarrollo organizacional. Visto así, las diversas funciones propias de la gestión del Potencial Humano, concebida en forma sistémica e integral, son vitales para obtener una mejor y mayor productividad, teniendo colaboradores altamente identificados, que garanticen el logro de la Visión y el cumplimiento de la Misión.

Falls are an important cause of disability and mortality among elderly subjects. Aim: To study the features and incidence of falls in institutionalized elderly subjects. Patients and methods: Prospective recording of all falls, occurring in a period of eight months, to 453 subjects older than 60 years, living a home for the elderly. Evaluation of functional status of subjects suffering falls, using the Spanish Red Cross score. One hundred and two subjects living in the same place, but not suffering falls, were considered as controls. Results: One hundred and three subjects, aged 80±6 years (24% of the sample) suffered falls. Most falls were during the day and while walking. Seventy percent of subjects suffering falls did not have a history of previous falls. Nine percent of those falling, suffered a fracture. Compared to controls, falling subjects had a more deteriorated functional and mental status and consumed more benzodiazepines and neuroleptics. Conclusions: There is an association between functional status and psychotropic medication consumption and the incidence of falls in institutionalized elderly subjects

Background: Hip fractures are the most severe complication of osteoporosis, yet patients who suffer hip fracture rarely receive adequate treatment. Aim: To assess diagnosis and treatment of osteoporosis in patients with hip fracture. Patients and methods: a retrospective study in 203 patients admitted for hip fracture surgery at two medical institutions in Santiago, Chile. Clinical data from 101 patients from the Hospital Clínico Pontificia Universidad Católica de Chile (a university tertiary care hospital, HCPUC) and 102 patients from Hospital de Urgencia de la Asistencia Pública (a public emergency hospital, HUAP) were reviewed. We also evaluated incidence of new fractures, further treatment of osteoporosis and functionality, by means of a telephonic survey of 48% of patients (n=99) 12.3±5.3 months after hip fracture in HCPUC and 16.5±3.0 months for HUAP. Results: A previous diagnosis of osteoporosis was present in 2.9% and 1% of cases, and treatment prior to fracture in 3.9% and 0% of cases from HCPUC and HUAP, respectively. None of the patients in HUAP were diagnosed with osteoporosis during hospital stay or given treatment for this condition at discharge, in comparison to 0.9% (n=1) and 2% (n=2), respectively, in HCPUC. Seven and six percent of cases presented prior hip fractures. Telephonic follow up of patients revealed that 75.6% persisted without treatment for osteoporosis. At follow up, 2.9% and 3% of patients in HCPUC and HUAP had presented new hip fractures. At the time of survey 30.9% and 34% of patients, respectively, were considered invalid. Conclusions: Missed diagnosis and failure to treat osteoporosis occurred in over 90% of patients admitted for hip fracture, regardless of the different complexities in the hospitals of admission. The data suggest that lack of medical action on these issues may play a role in failure to prevent new hip fractures (Rev Méd Chile 2003; 131: 773-8)

Background: Falls by older adults are a frequent problem among ambulatory patients in primary care. Aim: To describe the prevalence and features of falls among elders consulting to an ambulatory Geriatric Clinic. Patients and methods: Persons aged 60 years or more were surveyed about the number of falls in the preceding six months, the characteristics and consequences of each falls. Biopsychosocial characteristics were recorded and the Tinetti gait and balance test was performed in all patients reporting falls. Results: In 104 (18.2%) of 571 clinical consultations, one or more falls were reported. Among patients who fell and provided complete data (n=95), 64% reported one fall and 36% reported two or more, totaling 156 falls to analyze. The mean age of the patients with falls was 71.8±6.8 years. The functional and cognitive status was normal in 73 and 71.6% of cases respectively and 38% carried out periodical physical activity. Fifty seven percent of falls occurred outside of home, and an extrinsic factor was a precipitating cause in 55% of the falls. A post-fall syndrome appeared in 21% of cases and 2.6% resulted in fractures. Falling two or more times versus one time during the last six months was statistically associated with an age over 75, an absence of periodic physical activity, functional impairments, three or more chronic diseases, neurological diseases and with living alone, among other variables. Conclusions: Falls among elders occur mainly outside of home, in subjects older than 75 years old, functionally dependent and with an important involvement of extrinsic factors. Physical activity, as well as the control of environmental risks, could be protective factors against recurrent falls (Rev Méd Chile 201; 129: 1021-30).

Introduction: The best approach to improve under-recognition of depression is routine screening, idealy using an instrument that is highly effective and easy to administer. Objective: To test the effectiveness of the 5-item version of the Geriatric Depression Scale (5-GDS) for depression screening in a community-dwelling Chilean elderly population. Participants and Methods: 110 subjects were evaluated at the geriatric outpatient clinic of a university teaching hospital. Patients answered a questionnaire that included the Geriatric Depression Scale (GDS), and demographic information. Using the 15-item GDS score as reference standard to classify subjects as depressed, test characteristics of the 5-GDS were evaluated. Results: Subjects had a mean 15-item GDS score of 5.4; 47% classified as depressed. Depressed and not depressed subjects were similar with regard to demographics, educational level and comorbid conditions. The mean score was 1.9 for the 5-item GDS. Pearson correlation for 15-item and 5-item GDS scores was 0.92, p