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Background: The exposure to stressing situations may play a role in the appearance of vitiligo. Patients with the disease have a greater sensitivity to environmental stress and a lower threshold to generate catecholamine mediated responses., Aim: To evaluate the temperament and character of patients with vitiligo and explore the relationship of the disease with negative life events and life quality impairment., Material and Methods: The study population were 21 patients with vitiligo aged 5 to 12 years, and two control groups (Gl and G2). Gl was composed by 14 healthy siblings of vitiligo patients. G2 was composed by 21 age and gender matched healthy students from two schools in Santiago, Chile. The Junior Temperament and Character Inventory (JTCI), the Qualitative Psychosocial Development Survey (QPDS), the Life Event Checklist (LEC) and the Children's Life Quality index (CDLQI) were applied (LEC only to vitiligo patients)., Result: On the temperament dimensions, vitiligo patients scored high on the "harm avoidance" scale in comparison to G2 (13.7 v/s 10.6). Compared with Gl, QPDS showed in vitiligo patients a higher frequency of fear to strangers (71% and 36%, respectively) and a predominant feeling of fear and shyness in response to changes in a close relative (80% and 8%, respectively). There was a negative correlation (protective factor) between the character dimension "self-directedness" and CDLQI score (r =-0.703)., Conclusions: In this group of patients, we found a possible relationship between a specific temperament dimension, vitiligo and its impact on life quality.

Background: Chest X ray, abdominal ultrasound and bone scintigraphy are usually requested to study a possible dissemination of breast carcinoma., Aim: To study the yield and costs of these exams in the study of dissemination of stage I and II breast carcinoma., Material and Methods: A retrospective analysis of patients operated for a breast carcinoma in a public surgical service. A chest X ray, abdominal ultrasound and bone scintigraphy was requested to all patients in the immediate postoperative period. Age, stage according to pathological TNM and costs per patient were registered., Results: Of 210 women operated, 40 were in stage I (19%) and 85 in stage II (41%). Dissemination study was negative in all stage I patients and in all but two patients in stage II. The yield for detection of distant metastases in these patients was 0.9% for chest X ray, 0% for abdominal ultrasound and 0.9% for bone scintigraphy. The total cost of the study, in Chilean pesos, was $10,369,620 in a public hospital and $16,535,400 in a private clinic., Discussion: Additional exams to detect distant metastases in early stages of breast carcinoma have a low yield and high costs.