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RESUMEN Las anomalías de cuarto arco branquial corresponden a una entidad patológica infrecuente. Para su manejo existen distintas alternativas terapéuticas siendo una de ellas la cauterización endoscópica. Reportamos 3 casos de senos de cuarto arco branquial tratados mediante cauterización endoscópica en el Hospital Regional de Concepción luego de una revisión de fichas clínicas de todos los pacientes con diagnóstico de anomalías de cuarto arco branquial. Se identificaron tres casos de senos de cuarto arco branquial. Todos corresponden a pacientes de sexo masculino que presentaron cuadro de absceso cervical, diagnosticándose 2 de ellos al presentar recurrencia. Todos fueron tratados mediante cauterización endoscópica de la apertura fistulosa en seno piriforme. Estas anomalías representan vestigios de un trayecto que se origina desde el vértice del seno piriforme. La cauterización endoscópica presenta una serie de ventajas con tasas de recurrencia similares a la cirugía abierta de cuello, menores tasas de complicaciones y costo económico. Las anomalias de cuarto arco branquial constituyen una patología infrecuente y el diagnóstico requiere alta sospecha clínica. El manejo endoscópico ha demostrado ser una alternativa segura y efectiva con menor tasa de complicaciones.

Introduction Acute heart failure (AHF) is a frequent epidemic in geriatrics. The main aim of this study was to evaluate the clinical and prognostic differences of very elderly patients with AHF compared to the rest, and evaluate the factors associated with 90-day mortality. Methods We analyzed 3828 patients hospitalized for AHF with an age of >= 70 years. The population was divided into three groups: 70-79, 80-89 and >= 90 years old (nonagenarians). The baseline characteristics of patients nonagenarians were compared with the rest. In the group of nonagenarians, their clinical characteristics were analyzed according to the left ventricular ejection fraction (LVEF) and the factors associated with mortality at 90 days of follow-up. Results Nonagenarians showed higher comorbidity and cognitive deterioration, worse basal functional status, and preserved LVEF. Alternatively, they presented a lower rate of diabetes mellitus, lower incidence of de novo AHF, and lower prescription of angiotensin-converting-enzyme inhibitors, aldosterone blockers, anticoagulants, and statins at hospital discharge. Of the total, 334 patients (9.3%) had died by 90 days. The 90-day mortality rate was highest in nonagenarians (7.1% vs 9.8% vs 17%; p = 0.001). Multivariate analysis showed that renal failure, New York Heart Association (NYHA) functional classifications of III-IV, and a more advanced functional deterioration at baseline are predictors of mortality within 90 days. Conclusions The AHF in patients nonagenarians has a different clinical profile compared to younger patients and a higher mortality. In this subgroup of patients having a worse baseline functional status, higher NYHA classification (III-IV), and renal failure are predictors of 90-day mortality.

The design of a primary electron beam facility at CERN is described. The study has been carried out within the framework of the wider Physics Beyond Colliders study. It re-enables the Super Proton Synchrotron (SPS) as an electron accelerator, and leverages the development invested in Compact Linear Collider (CLIC) technology for its injector and as an accelerator research and development infrastructure. The facility would be relevant for several of the key priorities in the 2020 update of the European Strategy for Particle Physics, such as an electron-positron Higgs factory, accelerator R\&D, dark sector physics, and neutrino physics. In addition, it could serve experiments in nuclear physics. The electron beam delivered by this facility would provide access to light dark matter production significantly beyond the targets predicted by a thermal dark matter origin, and for natures of dark matter particles that are not accessible by direct detection experiments. It would also enable electro-nuclear measurements crucial for precise modelling the energy dependence of neutrino-nucleus interactions, which is needed to precisely measure neutrino oscillations as a function of energy. The implementation of the facility is the natural next step in the development of X-band high-gradient acceleration technology, a key technology for compact and cost-effective electron/positron linacs. It would also become the only facility with multi-GeV drive bunches and truly independent electron witness bunches for plasma wakefield acceleration. A second phase capable to deliver positron witness bunches would make it a complete facility for plasma wakefield collider studies. [...]

In this work, different conditions for Steady-State Visual Evoked Potentials (SSVEP) were evaluated in order to identify the best configuration for electrode and the possibility to differentiate with electroencephalography (EEG) binocular and monocular vision in eighteen healthy volunteers. Screen stimulus and led flickering were used and evaluated for different bipolar channels and vision types. The bipolar channels I1+I2-FCz, P3- FCz and P4-FCz present lower peaks for SSVEP and there is no significant difference between monocular and binocular vision. The results are promising for future studies in patients with neuro-ophthalmology disorders.

Introducción: La tiroidectomía es una de las cirugías más frecuentes realizadas en cabeza y cuello. Existen escasos reportes de experiencia en tiroidectomías en servicios de otorrinolaringología en Chile. Objetivo: Analizar la experiencia clínica con las tiroidectomías totales realizadas en el Servicio de ORL y Cirugía de Cabeza y Cuello de nuestro hospital. Material y método: Estudio descriptivo retrospectivo. Revisión de fichas clínicas de pacientes sometidos a tiroidectomías totales (TT) entre los años 2010 y 2014 en nuestro servicio. Resultados: Se realizaron 271 tiroidectomías totales. La indicación más frecuente fue por tamaño (51%). Los diagnósticos más frecuentes fueron carcinomas papilares (46%) e hiperplasia folicularcoloidea (37%). Se presentaron lesiones transitorias del nervio laríngeo recurrente en 2,9%, y lesiones persistentes en 2,5%. Hipocalcemia transitoria se presentó en el 25% de los pacientes. Discusión: Nuestra serie presenta resultados concordantes con la literatura, presenta una baja tasa de complicaciones, las cuales se observan principalmente en pacientes con vaciamiento cervical y/o en que se observaron 2 o menos paratiroides. Conclusiones: La tiroidectomía total es una técnica quirúrgica segura y nuestra experiencia presenta resultados concordantes a los publicados en la literatura internacional.