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Background: Stroke is the third largest single cause of death in Chile, responsible for 7.3% of all deaths in 2019. Large declines in stroke mortality rates in most Latin American countries in recent decades have been reported. Aim: To analyze the trend in stroke mortality in Chile between 1980 and 2015. Material and Methods: We extracted data for age-standardized death rate (ASDR) stroke mortality per 100,000 inhabitants in Chile for the period 1980-2015from the WHO Mortality Database. Joinpoint regression analysis was used to analyze the trend and compute the average annual percent change (AAPC) by gender in Chile. Results: The ASDR from stroke decreased from 92.8 per 100,000 in 1980 to 34.4 per 100,000 in 2015. The AAPC was −2.8% (-3.5, −2.1), with two jointpoints, 2008 and 2012. By gender, the AAPC was −2.4% and −2.9% in men and women, respectively. Conclusions: Stroke mortality rate decreased significantly between 1980 and 2015 in Chile, mainly in women.

Resumen Introducción: La Hipertensión Intracraneal Idiopática (HICI) es un síndrome neurológico caracterizado por un aumento de la presión intracraneal en ausencia de lesión estructural o hidrocefalia. Los síntomas incluyen cefalea, tinnitus pulsátil, oscurecimientos visuales transitorios y pérdida visual. Dentro de los signos destacan diplopía por parálisis del VI par, edema de papila y disminución de la agudeza visual. Los pacientes no tienen compromiso de conciencia ni signos neurológicos focales. La principal complicación es la pérdida visual que puede ser irreversible. La asociación entre HICI y nitrofurantoína (NTF) se reportó en 1974. Caso clínico: Mujer de 42 años, con sobrepeso, que desarrolló una HICI aproximadamente 18 meses posterior al inicio de nitrofurantoína profiláctica. Consultó por cefalea frontal, opresiva que aumentaba con la maniobra de Valsalva, asociada a disminución fluctuante de la agudeza visual y episodios de oscurecimiento. Al examen destacó edema de papila bilateral, sin déficit neurológico focal. La presión del líquido cefalorraquídeo (LCR) fue de 25,5 cm de agua. La resonancia magnética mostró signos de aumento de la presión del LCR, sin lesiones estructurales ni hidrocefalia. El cuadro se recuperó concomitantemente a la suspensión de la NTF y el uso de topiramato. No se constató daño visual permanente. Conclusiones: Se debe sospechar la HICI en mujeres en edad fértil con sobrepeso. Dentro de los gatillantes del síndrome destacan varios fármacos, entre ellos la NTF. El principal objetivo del tratamiento de la HICI es preservar la función visual.

Background: Stroke is a time-dependent emergency. Most patients with acute ischemic stroke are excluded from reperfusion therapies due to late consultation. Aims: To estimate the arrival times of patients with stroke to the Emergency Room (ER) of a public hospital. To identify factors associated with early consultation. Material and Methods: A convenience sample, 583 patients aged 71 ± 13 years (55% males) consulting for stroke at an emergency room was analyzed in terms of delay between onset of symptoms and arrival to the ER, demographics and etiology of stroke. Results: The admission diagnoses were ischemic stroke in 76%, intracerebral hemorrhage in 12%, transient ischemic attack in 9% and subarachnoid hemorrhage in 3%. The median time of arrival was 8 hours and 11 minutes after the onset of symptoms. Nineteen percent of consultations for ischemic stroke occurred within 3 hours of symptom onset, and 38% within 6 hours. In the logistic regression analysis, having an address near the hospital and the severity of stroke were associated with early consultation with a combined odds ratio of 5.97 (95% confidence intervals 3.23-11.04). Conclusions: There were significant differences in the arrival times of patients with stroke. Only a low proportion of patients with ischemic stroke consulted within the window for reperfusion therapies. Severe strokes and living near the hospital were associated with early consultation.

Resumen Antecedentes: El ataque cerebrovascular (ACV) es una urgencia tiempo-dependiente. La mayoría de los pacientes con infarto cerebral quedan excluidos de las terapias de reperfusión por consultar tardíamente. Se desconocen los factores asociados a llegada y evaluación precoz de pacientes con ACV agudo en nuestra población. Objetivos: Identificar los factores asociados, llegada y evaluación precoz de pacientes con ACV agudo. Pacientes y Métodos: Muestra por conveniencia de las consultas por ACV realizadas en el Turno N° 1, del SU del Hospital Dr. Hernán Henríquez de Temuco, entre enero de 2016 y diciembre de 2017. El análisis estadístico se realizó con el software STATA 14.0. Resultados: Se registraron 584 consultas por ACV. La mediana del tiempo de llegada fue de 8 h y 11 min. La mediana del tiempo para la evaluación por neurólogo(a) fue de 66 min. Tener domicilio en Temuco-Padre Las Casas y una mayor severidad del ACV se asociaron a consultar precozmente con un OR = 5,97 (3,23-11,04). Para evaluación dentro de una hora, las variables severidad, llegada en ambulancia y consulta en menos de 3 h, fueron estadísticamente significativas, con un OR combinado de 10,86 (IC 95%: 5,15-22,94). Conclusiones: Los factores más fuertemente asociados a llegada y evaluación precoz incluyen residir en comunas cercanas al hospital y presentar síntomas más severos de ACV. Se sugiere implementar estrategias para aumentar el grado de reconocimiento de síntomas de ACV y para disminuir las barreras de acceso a hospitales que traten a este tipo pacientes.

De novo GRIN variants, encoding for the ionotropic glutamate NMDA receptor subunits, have been recently associated with GRIN-related disorders, a group of rare paediatric encephalopathies. Current investigational and clinical efforts are focused to functionally stratify GRIN variants, towards precision therapies of this primary disturbance of glutamatergic transmission that affects neuronal function and brain. In the present study, we aimed to comprehensively delineate the functional outcomes and clinical phenotypes of GRIN protein truncating variants (PTVs)-accounting for ~20% of disease-associated GRIN variants-hypothetically provoking NMDAR hypofunctionality. To tackle this question, we created a comprehensive GRIN PTVs variants database compiling a cohort of nine individuals harbouring GRIN PTVs, together with previously identified variants, to build-up an extensive GRIN PTVs repertoire composed of 293 unique variants. Genotype-phenotype correlation studies were conducted, followed by cell-based assays of selected paradigmatic GRIN PTVs and their functional annotation. Genetic and clinical phenotypes meta-analysis revealed that heterozygous GRIN1, GRIN2C, GRIN2D, GRIN3A and GRIN3B PTVs are non-pathogenic. In contrast, heterozygous GRIN2A and GRIN2B PTVs are associated with specific neurological clinical phenotypes in a subunit- and domain-dependent manner. Mechanistically, cell-based assays showed that paradigmatic pathogenic GRIN2A and GRIN2B PTVs result on a decrease of NMDAR surface expression and NMDAR-mediated currents, ultimately leading to NMDAR functional haploinsufficiency. Overall, these findings contribute to delineate GRIN PTVs genotype-phenotype association and GRIN variants stratification. Functional studies showed that GRIN2A and GRIN2B pathogenic PTVs trigger NMDAR hypofunctionality, and thus accelerate therapeutic decisions for this neurodevelopmental condition.

Stroke is the third largest single cause of death in Chile, responsible for 7.3% of all deaths in 2019. Large declines in stroke mortality rates in most Latin American countries in recent decades have been reported.To analyze the trend in stroke mortality in Chile between 1980 and 2015.We extracted data for age-standardized death rate (ASDR) stroke mortality per 100,000 inhabitants in Chile for the period 1980-2015from the WHO Mortality Database. Joinpoint regression analysis was used to analyze the trend and compute the average annual percent change (AAPC) by gender in Chile.The ASDR from stroke decreased from 92.8 per 100,000 in 1980 to 34.4 per 100,000 in 2015. The AAPC was -2.8% (-3.5, -2.1), with two jointpoints, 2008 and 2012. By gender, the AAPC was -2.4% and -2.9% in men and women, respectively.Stroke mortality rate decreased significantly between 1980 and 2015 in Chile, mainly in women.

Resumen: Introducción: Las cardiopatías congénitas (CC), la malformación congénita más frecuente, han experimentado un aumento de sobrevida y crecimiento exponencial de la población de adolescentes y adultos portado res de CC. Para el éxito a largo plazo urgen intervenciones que optimicen la transición de cuidados de salud desde los servicios pediátricos a los de adulto. Objetivo: Describir el conocimiento y manejo de la enfermedad, autoeficacia y calidad de vida en adolescentes y jóvenes con CC en periodo de transfe rencia en dos hospitales en Santiago de Chile. Pacientes y Método: Estudio no experimental, descrip tivo, de corte transversal. Se aplicó: a) Encuesta de datos sociodemográficos, conocimiento y manejo de su enfermedad y uso de servicios de salud; b) Escala Con-Qol de Calidad de Vida Relacionada con Salud (CVRS) en pacientes con CC y c) Escala de Autoeficacia Generalizada (EAG). Resultados: Se obtuvo una muestra de 51 pacientes, 53% hombres, edad promedio de 17 ± 2,49 años. El 22% de las CC fue de complejidad simple, 29% moderada y 49% alta. Presentaron alta autoeficacia y buenos niveles de calidad de vida, sin embargo, mostraron escaso conocimiento y manejo de su enfermedad cardiaca. Conclusiones: Destaca la poca preparación para lograr una transición exitosa a servicios de adultos y jóvenes portadores de CC, siendo fundamental implementar programas de transición centrados en educación, autocuidado y automanejo de la enfermedad. Abstract: Introduction: Congenital heart defects (CHD), the most frequent congenital malformations, have shown an in creased survival and exponential growth of the adolescent and adult population living with CHD. Interventions that optimize the transition of patients from pediatric to adult health care services are essential for ensuring positive long-term outcomes. Objective: To describe the knowledge and management of this disease, self-efficacy, and quality of life of young people with CHD during the transition period in two hospitals in Santiago, Chile. Patients and Method: Non-experimental, des criptive, cross-sectional study. Patients completed: a) a survey of socio-demographic data, knowledge and management of their condition, and use of health services; b) the Health-Related Quality of Life (Con-HRQoL) Scale in patients with CHD; and c) the Generalized Self-Efficacy (GSE) Scale. Re sults: We obtained a sample of 51 patients, 53% of them were men, and the mean age was 17 ± 2.49 years. The complexity of the CHD was mild in 22%, moderate in 29%, and high in 49%. Although patients reported high self-efficacy and good levels of quality of life, there was a lack of knowledge and self-management of their heart disease. Conclusions: The study showed that adolescents and young people with CHD are not prepared to achieve a successful transition to adult health care services, and there is a need for the implementation of transition programs focused on education, self-care, and self-management of the disease.

This paper compares and quantifies the energy, environmental and economic benefits of various control strategies for recovering heat from a supermarket’s CO2 booster refrigeration system. There covered heat is used for space heating, with the goal of displacing natural gas fueled boilers. A theoretical model with thermal storage is presentedbased on a previous validated model from an existing refrigeration system in a food-retail building located in the UK. Sixheat recovery strategies are analysed by modifying thermal storage volumes and pressure levels in the gas-cooler/condenser. The model shows that a reduction of 30-40% in natural-gasc onsumption is feasible by the installation of a de-superheater and without any advanced operating strategy, and 40-50% by using a thermal storage tank. However, the CO2 system can fully supply the entire space-heating requirement by adopting alternative control strategies, albeit by penalising the coefficient of performance (COP) of the compressor. Results show that the best energy strategy can reduce total consumption by 35%, while the best economic strategy can reduce costs by 11%. Findings from this work suggest that heat recovery systems can bring substantial benefits to improve the overall efficiency of energy-intensive buildings,although trade-offs need to be carefully considered and further analysed before embarking on such initiatives.

The elderly form a very heterogeneous group in relation to their general health state, degree of dependence, comorbidities, performance status, physical reserve and geriatric situation, so cancer treatment in the older patient remains a therapeutic challenge. The physiological changes associated with aging increase the risk of developing a serious toxicity induced by chemotherapy treatment, as well as other undesirable consequences as hospitalizations, dependence and non-compliance with treatment, that can negatively affect survival, quality of life and treatment efficacy. The use of hematopoietic growth factors and other active supportive interventions in the elderly can help prevent and/or alleviate these toxicities. However, we have little data on the efficacy and tolerance of support treatments in the older patient. The objective of this work is to review the most frequent toxicities of oncological treatments in the elderly and their management.

Echeveria subrigida is native to Mexico and its methanol extract (ME) shows relevant biological activities for human health, including the α-glucosidase inhibitory (αGI) activity that suggests its antidiabetic potential. Fractionation of the ME based on the αGI activity (IC50 in µg/mL) showed that quercetin-3-O-β-glucoside (131.1), isorhamnetin-3-O-β-glucoside (166.4), and dimers to heptamers proanthocyanidins (9.6) were among the main responsible of αGI activity in the ME. The purified compounds showed better activity than acarbose (IC50 = 4426 µg/mL).

Background: Stroke is a time-dependent emergency. Most patients with acute ischemic stroke are excluded from reperfusion therapies due to late consultation. Aims: To estimate the arrival times of patients with stroke to the Emergency Room (ER) of a public hospital. To identify factors associated with early consultation. Material and Methods: A convenience sample, 583 patients aged 71 ± 13 years (55% males) consulting for stroke at an emergency room was analyzed in terms of delay between onset of symptoms and arrival to the ER, demographics and etiology of stroke. Results: The admission diagnoses were ischemic stroke in 76%, intracerebral hemorrhage in 12%, transient ischemic attack in 9% and subarachnoid hemorrhage in 3%. The median time of arrival was 8 hours and 11 minutes after the onset of symptoms. Nineteen percent of consultations for ischemic stroke occurred within 3 hours of symptom onset, and 38% within 6 hours. In the logistic regression analysis, having an address near the hospital and the severity of stroke were associated with early consultation with a combined odds ratio of 5.97 (95% confidence intervals 3.23-11.04). Conclusions: There were significant differences in the arrival times of patients with stroke. Only a low proportion of patients with ischemic stroke consulted within the window for reperfusion therapies. Severe strokes and living near the hospital were associated with early consultation.

Congenital heart defects (CHD), the most frequent congenital malformations, have shown an in creased survival and exponential growth of the adolescent and adult population living with CHD. Interventions that optimize the transition of patients from pediatric to adult health care services are essential for ensuring positive long-term outcomes.To describe the knowledge and management of this disease, self-efficacy, and quality of life of young people with CHD during the transition period in two hospitals in Santiago, Chile.Non-experimental, des criptive, cross-sectional study. Patients completed: a) a survey of socio-demographic data, knowledge and management of their condition, and use of health services; b) the Health-Related Quality of Life (Con-HRQoL) Scale in patients with CHD; and c) the Generalized Self-Efficacy (GSE) Scale. Re sults: We obtained a sample of 51 patients, 53% of them were men, and the mean age was 17 ± 2.49 years. The complexity of the CHD was mild in 22%, moderate in 29%, and high in 49%. Although patients reported high self-efficacy and good levels of quality of life, there was a lack of knowledge and self-management of their heart disease.The study showed that adolescents and young people with CHD are not prepared to achieve a successful transition to adult health care services, and there is a need for the implementation of transition programs focused on education, self-care, and self-management of the disease.

Across cultures, people associate colours with emotions. Here, we test the hypothesis that one driver of this cross-modal correspondence is the physical environment we live in. We focus on a prime example – the association of yellow with joy, – which conceivably arises because yellow is reminiscent of life-sustaining sunshine and pleasant weather. If so, this association should be especially strong in countries where sunny weather is a rare occurrence. We analysed yellow-joy associations of 6625 participants from 55 countries to investigate how yellow-joy associations varied geographically, climatologically, and seasonally. We assessed the distance to the equator, sunshine, precipitation, and daytime hours. Consistent with our hypotheses, participants who live further away from the equator and in rainier countries are more likely to associate yellow with joy. We did not find associations with seasonal variations. Our findings support a role for the physical environment in shaping the affective meaning of colour. © 2019

espanolEn zonas aridas la perdida de biodiversidad, cobertura y biomasa vegetal son problemas ambientales permanentes. En condiciones naturales aridas, las semillas de especies silvestres suelen germinar irregularmente y en tiempo prolongados, lo que hace dificil usar estas especies en procesos productivos. Se evaluaron condiciones adecuadas para optimizar y masificar la produccion desde semillas de especies silvestres arboreas del valle de Copiapo; usando tratamientos de escariacion e induccion hormonal de la germinacion con GA3. Se determino el tratamiento para cada especie y la capacidad de produccion efectiva de plantulas. La produccion de plantas aumento 83,8% sobre la produccion normal en vivero antes del proyecto, por incremento de la germinacion. Usando el protocolo de produccion de diferentes especies se llego a obtener 25.000 plantas (diferentes especies) semanales, con una proyeccion anual que permitiria manejar la produccion artificial de especies silvestres. La propagacion masiva de plantas puede ser una herramienta para conservar poblaciones naturales de especies silvestres y potenciar su uso en procesos productivos. EnglishIn arid zones the loss ofbiodiversity, plant cover and biomass are permanent environmental problems. Under arid natural conditions, seeds of wild species usually germinate in irregular periods and in long time, making it difficult to use these species in productive processes. Suitable conditions for optimizing and producing massively wild trees from seeds of species from the Copiapo Valley were evaluated, using treatments of reaming and hormonal induction ofgermination with GA3. The induction conditions for each tree species and the effective plant production capacity was determined. Plant production increased 83.8% on the production of plants in nurseries before the project, by increasing of the germination. Using the production protocol, 25,000 plants from different species by week were produced, with a annual projection which would be possible to control the artificial production of wild plant species. The massive propagation ofplants could be a tool to conservation of natural populations of wild species and give potential to use it in production process.

open access article Economic decision making refers to the process of individuals translating their preference into subjective value (SV). Little is known about the dynamics of the neural processes that underpin this form of value-based decision making and no studies have investigated these processes outside of controlled laboratory settings. The current study investigated the spatio-temporal dynamics that accompany economic valuation of products using mobile electroencephalography (EEG) and eye tracking techniques. Participants viewed and rated images of household products in a gallery setting while EEG and eye tracking data were collected wirelessly. A Becker-DeGroot-Marschak (BDM) auction task was subsequently used to quantify the individual’s willingness to pay (WTP) for each product. WTP was used to classify products into low, low medium, high medium and high economic value conditions. Eye movement related potentials (EMRP) were examined, and independent component analysis (ICA) was used to separate sources of activity from grand averaged EEG data. Four independent components (ICs) of EMRPs were modulated by WTP (i.e., SV) in the latency range of 150–250 ms. Of the four value-sensitive ICs, one IC displayed enhanced amplitude for all value conditions excluding low value, and another IC presented enhanced amplitude for low value products only. The remaining two value-sensitive ICs resolved inter-mediate levels of SV. Our study quantified, for the first time, the neural processes involved in economic value based decisions in a natural setting. Results suggest that multiple spatio-temporal brain activation patterns mediate the attention and aversion of products which could reflect an early valuation system. The EMRP parietal P200 component could reflect an attention allocation mechanism that separates the lowest-value products (IC7) from products of all other value (IC4), suggesting that low-value items are categorized early on as being aversive. While none of the ICs showed linear amplitude changes that parallel SV’s of products, results suggest that a combination of multiple components may sub-serve a fine-grained resolution of the SV of products.

Stroke is a time-dependent emergency. Most patients with acute ischemic stroke are excluded from reperfusion therapies due to late consultation.To estimate the arrival times of patients with stroke to the Emergency Room (ER) of a public hospital. To identify factors associated with early consultation.A convenience sample, 583 patients aged 71 ± 13 years (55% males) consulting for stroke at an emergency room was analyzed in terms of delay between onset of symptoms and arrival to the ER, demographics and etiology of stroke.The admission diagnoses were ischemic stroke in 76%, intracerebral hemorrhage in 12%, transient ischemic attack in 9% and subarachnoid hemorrhage in 3%. The median time of arrival was 8 hours and 11 minutes after the onset of symptoms. Nineteen percent of consultations for ischemic stroke occurred within 3 hours of symptom onset, and 38% within 6 hours. In the logistic regression analysis, having an address near the hospital and the severity of stroke were associated with early consultation with a combined odds ratio of 5.97 (95% confidence intervals 3.23-11.04).There were significant differences in the arrival times of patients with stroke. Only a low proportion of patients with ischemic stroke consulted within the window for reperfusion therapies. Severe strokes and living near the hospital were associated with early consultation.

open access article The detection of a human face in a visual field and correct reading of emotional expression of faces are important elements in everyday social interactions, decision making and emotional responses. Although brain correlates of face processing have been established in previous fMRI and electroencephalography (EEG)/MEG studies, little is known about how the brain representation of faces and emotional expressions of faces in freely moving humans. The present study aimed to detect brain electrical potentials that occur during the viewing of human faces in natural settings. 64-channel wireless EEG and eye-tracking data were recorded in 19 participants while they moved in a mock art gallery and stopped at times to evaluate pictures hung on the walls. Positive, negative and neutral valence pictures of objects and human faces were displayed. The time instants in which pictures first occurred in the visual field were identified in eye-tracking data and used to reconstruct the triggers in continuous EEG data after synchronizing the time axes of the EEG and eye-tracking device. EEG data showed a clear face-related event-related potential (ERP) in the latency interval ranging from 165 to 210 ms (N170); this component was not seen whilst participants were viewing non-living objects. The face ERP component was stronger during viewing disgusted compared to neutral faces. Source dipole analysis revealed an equivalent current dipole in the right fusiform gyrus (BA37) accounting for N170 potential. Our study demonstrates for the first time the possibility of recording brain responses to human faces and emotional expressions in natural settings. This finding opens new possibilities for clinical, developmental, social, forensic, or marketing research in which information about face processing is of importance.

Background: Neurological emergencies constitute 10-15% of medical emergencies. Doctor Hernán Henríquez Aravena Hospital has in house neurologists present permanently at the Emergency Room since July 2013. Aim: To estimate the waiting times for neurological consultations; to compare the waiting times between neurovascular (UV) and non-vascular (UNV) emergencies; and to compare the waiting times of two prioritization (triage) models. Material and Methods: A convenience sample of the consultations made during shift # 1 at the emergency room between January and December 2016, was analyzed. Results: There were 859 consultations in the period, 570 for UNV and 289 for UV. Mean age of consultants was 57 years and 52% were women. The median time for having an evaluation by a neurologist was 106 min (132 and 81 min for UNV and UV respectively). Twenty seven percent of patients were evaluated in less than one hour (23 and 36% of UNV and UV, respectively). The change of the prioritization model decreased the waiting time by 81 and 32 min for UNV and UV, respectively. Conclusions: There were significant differences in waiting times between neurovascular and non-vascular emergencies. Most patients were not evaluated in less than 60 minutes. The change in the initial stratification model was associated with a significant reduction in the waiting times for neurological emergencies.

Background: Neurological emergencies constitute 10-15% of medical emergencies. Doctor Hernán Henríquez Aravena Hospital has in house neurologists present permanently at the Emergency Room since July 2013. Aim: To estimate the waiting times for neurological consultations; to compare the waiting times between neurovascular (UV) and non-vascular (UNV) emergencies; and to compare the waiting times of two prioritization (triage) models. Material and Methods: A convenience sample of the consultations made during shift # 1 at the emergency room between January and December 2016, was analyzed. Results: There were 859 consultations in the period, 570 for UNV and 289 for UV. Mean age of consultants was 57 years and 52% were women. The median time for having an evaluation by a neurologist was 106 min (132 and 81 min for UNV and UV respectively). Twenty seven percent of patients were evaluated in less than one hour (23 and 36% of UNV and UV, respectively). The change of the prioritization model decreased the waiting time by 81 and 32 min for UNV and UV, respectively. Conclusions: There were significant differences in waiting times between neurovascular and non-vascular emergencies. Most patients were not evaluated in less than 60 minutes. The change in the initial stratification model was associated with a significant reduction in the waiting times for neurological emergencies.

Although approximately 50% of cancer patients are 70 years of age or older, cancer treatment in the elderly remains a therapeutic challenge. The elderly form a very heterogeneous group in relation to their general health state, degree of dependence, comorbidities, performance status, physical reserve and geriatric situation, for which therapeutic decisions must be made in an individualized manner. In addition, changes in pharmacokinetics and pharmacodynamics of the drugs occur with age, as well as the tolerance of the tissues, leading to a narrowing of the therapeutic margin and an increase in toxicity. In the general population, Performace Status (PS) has traditionally been used to estimate tolerance to chemotherapy, but in the elderly population it is not useful. In this review we summarize the current knowledge about the pharmacology of antineoplastic drugs in the elderly and the tools available to help us identify risk of chemotherapy toxicity in these patients.

Neurological emergencies constitute 10-15% of medical emergencies. Doctor Hernán Henríquez Aravena Hospital has in house neurologists present permanently at the Emergency Room since July 2013.To estimate the waiting times for neurological consultations; to compare the waiting times between neurovascular (UV) and non-vascular (UNV) emergencies; and to compare the waiting times of two prioritization (triage) models.A convenience sample of the consultations made during shift # 1 at the emergency room between January and December 2016, was analyzed.There were 859 consultations in the period, 570 for UNV and 289 for UV. Mean age of consultants was 57 years and 52% were women. The median time for having an evaluation by a neurologist was 106 min (132 and 81 min for UNV and UV respectively). Twenty seven percent of patients were evaluated in less than one hour (23 and 36% of UNV and UV, respectively). The change of the prioritization model decreased the waiting time by 81 and 32 min for UNV and UV, respectively.There were significant differences in waiting times between neurovascular and non-vascular emergencies. Most patients were not evaluated in less than 60 minutes. The change in the initial stratification model was associated with a significant reduction in the waiting times for neurological emergencies.

Siguiendo las recomendaciones de la Organización Mundial de la Salud (OMS) y el Centro para el Control de las Enfermedades (CDC) en la protección de los trabajadores de la salud contra la hepatitis viral tipo B (VHB), en 1993 el Instituto Peruano del Seguro Social (hoy ESSALUD), 1993 orientó la vacunación del personal de riesgo en los 4 Hospitales Nacionales, utilizando la vacuna cubana Heberbiovac HB (20mg, esquema 0. 1. 2 meses). Nos propusimos evaluar la persistencia de los anticuerpos en los vacunados después de seis años de la inmunización y la posible existencia de marcadores de infección por el virus B. Se estudiaron los sueros de 144 trabajadores de la salud, para una cobertura de 70,24 % con relación a los 203 seroprotegidos en el estudio inicial. Para la detección de los marcadores en el suero se emplearon métodos inmunoenzimáticos comerciales. El antecedente fue el HBsAg y el anti-HBc fueron negativos en todas las muestras serológicas, por lo que afirmamos que en ninguno de los vacunados hubo evidencias de infección por este virus. Luego de 6 años antiHBs fue positivo estando todos seroconvertidos, con seroprotección e hiperrespuesta de 91,6 y 43,7% respectivamente. Si bien el tiempo de vida media del antiHBs (t 1/2) es de 3 años, pronosticándose que los niveles de anticuerpos serán superiores a 10 UI/L hasta después de 15 años de finalizado el esquema. Los menores de 40 años tuvieron niveles de seroprotección e hiperrespuesta significativamente mayores; manteniendose las mujeres en categorías de respuesta superiores. Se recomienda evaluar la memoria post-refuerzo en los casos seroconvertidos, no seroprotegidos, y extender el trabajo de vacunación con ESSALUD a otros hospitales del país. Given the importance attributed to the protection of health care workers against viral Hepatitis B (VHB) by the World Health Organization (WHO) and the Center for Disease Control (CDC), in 1993, the Instituto Peruano del Seguro Social (Social Security Peruvian Institute), today known as ESSALUD, ruled the vaccination of personnel in risk working in the 4 national hospitals, using Cuban vaccine Heberbiovac HB (20mg, schedule 0, 1, 2 months). Our purpose was to evaluate the antibody persistence in the vaccinated individuals after six years from immunization, and the possible presence of HB virus infection markers. Sera from 144 health care workers were studied, for a 70.24% coverage, in relation to the initially seroprotected in the 1993 study. For markers detection, commercial immunoenzymatic methods were used. HBsAg and anti-HBc were negative in all the serology samples studied, thus we conclude that no evidence of infection by this virus was found in any of the vaccinated subjects. AntiHBs was positive, being all of them seroconverted, with seroprotection and hyperresponse as of 91.6% and 43.7% respectively. The mean life time of antiHBs (t 1/2) is three years, predicting that the antibodies' level will be over 10 IU/l until after 15 years from the end of the schedule. The subjects under 40 had significantly higher levels of seroprotection and hyperresponse, being the females those that stayed in the upper categories of response. Evaluation of the post-reinforcement memory in the seroconverted, not protected cases, is recommended, as well as extend the work with ESSALUD to other hospitals in the country.