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Four-corner fusion (4CF) is a surgical option for refractory scapholunate advanced collapse and scaphoid nonunion advanced collapse wrist arthritis. Preoperative range of motion (ROM) predicts outcomes in many orthopedic procedures. This study investigates ROM in a cohort of 4CF patients to examine the relationship between preoperative and postoperative motion and identifies different clinical patterns.We performed a retrospective review of 4CF patients. Patients with a history of inflammatory arthritis and radiographic characteristics of inflammation were excluded. Demographics, prior wrist surgery history, and ROM data were collected at preoperative and postoperative intervals after cast removal at 8 weeks, 3 months, and 8 months. Regression analysis compared the motion before and after 4CF. Subsequent cluster analysis to reduce confounding compared postoperative motion differences in the top 20% to the bottom 20% of patients by preoperative motion.We included 148 patients; 27 had prior surgery on the ipsilateral wrist. Preoperative arc averaged 86° ± 28° (flexion 46° ± 17°, extension 40° ± 15°); 8-week arc 43° ± 19° (flexion 19° ± 12°, extension 24° ± 12°); 3-month arc 62° ± 17° (flexion 30° ± 12°, extension 32° ± 11°); and 8-month arc 74° ± 17° (flexion 36° ± 11°, extension 37° ± 12°). Preoperative and final arcs were (r = 0.39). Clustering by the preoperative arc, the top 20% (mean 124° ± 15°) achieved a mean final arc of 81° ± 16°, while the bottom 20% (mean 47° ± 16°) achieved a mean final arc of 65° ± 19°. Intercluster differences were statistically significant. The bottom 20% gained motion postoperatively. Most patients in the middle 60% did not differ significantly in postoperative motion.Although wrist motion following 4CF correlates positively with preoperative motion, most patients do not differ significantly in postoperative motion. Patients with substantial preoperative motion deficits gain motion after 4CF. This information is important when counseling patients, determining the timing of surgical intervention, and managing expectations related to motion outcomes.Prognostic II.

La pandemia de COVID-19 ha significado una importante crisis sanitaria y social a nivel mundial, con más de 200 millones de casos y 4 millones de fallecidos. Las medidas preventivas y de control implementadas han incluido medidas de higiene, distanciamiento físico, uso de mascarillas y restricciones de movilidad. En pandemias anteriores se describe reducción de transmisión de otros agentes infecciosos que comparten vías de transmisión y medidas de prevención. Objetivo: Describir y comparar los resultados de vigilancia de algunos agentes sujetos a vigilancia de laboratorio por el ISP durante el año 2020 en Chile con su mediana 2015-2019. Materiales y métodos: Estudio ecológico. Se analizaron los resultados de vigilancia de laboratorio publicados por el sistema interactivo y los resultados de vigilancia de virus respiratorios del ISP. Resultados: En el año 2020 se registró una disminución en la confirmación de todos los agentes respiratorios y de transmisión sexual, tanto bacterianos como virales, respecto a la mediana del quinquenio anterior. No obstante, la confirmación de agentes entéricos como Salmonella spp. aumentó, mientras Shigella spp. y Listeria monocytogenes no registraron cambios. Conclusión: Durante el 2020 se observaron importantes disminuciones en los resultados de vigilancias de laboratorio en Chile comparado con el periodo prepandémico, consistente con lo descrito por evidencia internacional. Por último, es esencial mantener una vigilancia de laboratorio que permita el análisis epidemiológico durante y posterior a la pandemia por COVID-19.

BACKGROUND In Chile, cystic echinococcosis is endemic throughout the country and hyperendemic in some regions such as La Araucania and Aysen and continues to be a neglected public health problem. AIM To estimate the risk of human hydatidosis in Aysen, studying the relationship of notifications and hospital discharge rates with social and environmental factors, such as population, multidimensional poverty index, urbanization, average temperature, average rainfall and sheep population. METHODS Poisson regressions were used to study the factors associated with notifiable diseases and hospital discharge rates and the Besag-York-Mollie model for relative risk. RESULTS AND CONCLUSIONS Aysen has a high risk, between 2 and 19 times that expected for the region. A significant underreporting of cases was found. The model of hospital discharges had a good fit showing the positive influence of the human and bovine population and the positive effect of temperature. An effect of the multidimensional poverty index was also detected, which is mainly affected by education and working conditions. Excepting one locality, the areas of greatest risk correspond to the eastern cordon of the Aysen region.

Background: The Micheli technique for anterior cruciate ligament (ACL) reconstruction (ACLR) has proven to be a reliable method with a minimal risk for growth disturbance among skeletally immature patients. Purposes: To evaluate the Micheli technique of iliotibial band (ITB) graft passage for ACLR using cadaveric knee models and to measure the distance between the surgical instrument tip and the neurovascular bundle in the posterior knee joint: specifically, the peroneal nerve, tibial nerve, and popliteal artery. Study Design: Descriptive laboratory study. Methods: Gross dissection was performed on 17 pediatric cadaveric knees (12 male and 5 female) aged between 4 and 12 years. To simulate ITB graft passage, we passed a curved-tip hemostat clamp through the posterior capsule, with the knee flexed from 90° to 100°. Next, clinical photographs were taken, and digital imaging software was used to measure the distance in centimeters from the clamp tip to each respective neurovascular structure. Results: The mean distances from the clamp tip to the tibial nerve, popliteal artery, and peroneal nerve were 0.875 cm (range, 0.468-1.737 cm), 0.968 cm (range, 0.312-1.819 cm), and 1.149 cm (range, 0.202-2.409 cm), respectively. Mean values were further calculated for age groups of ≤8, 9-10, and 11-12 years. The mean distance from the clamp tip to the peroneal nerve was 1.400 cm larger for 11- to 12-year-old specimens than for ≤8-year-old specimens (95% CI, 0.6-2.2 cm; P = .005). Conclusion: The neurovascular structures in the posterior knee were in close proximity to the path of graft passage, with distances Clinical Relevance: As the incidence of ACL tears is continuously increasing within the pediatric population, there are a larger number of ACLR procedures being performed. Although neurovascular injuries during ACLR are rare, this study clarifies the close proximity of neurovascular structures during ITB graft passage using the Micheli technique of ACLR.

Automatic geocoding methods have become popular in recent years, facilitating the study of the association between health outcomes and the place of living. However, rather few studies have evaluated geocoding quality, with most of them being performed in the US and Europe. This article aims to compare the quality of three automatic online geocoding tools against a reference method. A subsample of 300 handwritten addresses from hospital records was geocoded using Bing, Google Earth, and Google Maps. Match rates were higher (> 80%) for Google Maps and Google Earth compared with Bing. However, the accuracy of the addresses was better for Bing with a larger proportion (> 70%) of addresses with positional errors below 20m. Generally, performance did not vary for each method for different socioeconomic status. Overall, the methods showed an acceptable, but heterogeneous performance, which may be a warning against the use of automatic methods without assessing quality in other municipalities, particularly in Chile and Latin America. Resumen: Los métodos automáticos de geocodificación se han convertido en algo popular durante los últimos años para facilitar el estudio de la asociación entre resultados de salud y lugar para vivir. No obstante, más bien pocos estudios han evaluado la calidad de la geocodificación, siendo realizados la mayoría de ellos en EE.UU. y Europa. El objetivo de este artículo es comparar la calidad de tres herramientas automáticas de geocodificación en línea frente a un método de referencia. La submuestra de 300 direcciones escritas a mano, procedentes del registro hospitalario, se geocodificaron usando Bing, Google Earth y Google Maps. Los porcentajes de coincidencia fueron mayores (> 80%) en el caso de Google Maps y Google Earth comparados con Bing. Sin embargo, la precisión de las direcciones fue mejor con Bing, en una proporción más grande (> 70%) de direcciones que tenían errores de posición por debajo de 20m. En general, el rendimiento no varió en cada método para diferentes niveles estatus socioeconómico. En general, los métodos mostraron un rendimiento aceptable, pero heterogéneo. Esto previene contra el uso de métodos automáticos sin evaluar la calidad en otras ciudades, particularmente en Chile y Latinoamérica. Resumo: Os métodos de geocodificação automática se tornaram populares nos últimos anos para facilitar o estudo da associação entre desfechos de saúde e lugar de residência. Entretanto, poucos estudos avaliaram a qualidade da geocodificação, e a maioria dos estudos existentes foi realizada nos Estados Unidos e Europa. O estudo teve como objetivo comparar a qualidade de três ferramentas de geocodificação eletrônica automática em relação a um método de referência. Foi geocodificada uma subamostra de 300 endereços anotados à mão em prontuários hospitalares, usando Bing, Google Earth e Google Maps. As taxas de correspondência dos registros foram mais altas (> 80%) com Google Maps e Google Earth, comparado com Bing. Entretanto, a acurácia dos endereços foi melhor com Bing, com uma proporção maior (> 70%) de endereços com erros de localização menores que 20 metros. Em geral, o desempeno não variou para cada método de acordo com condição socioeconômica. Os métodos apresentaram desempenho geral aceitável, porém heterogêneo. Os resultados servem de alerta contra o uso de métodos automáticos sem avaliar a qualidade em outras cidades, particularmente no Chile e no resto da América Latina.

Resumen Introducción: Las zoonosis son enfermedades o infecciones causadas por todo tipo de agentes etiológicos transmisibles desde animales vertebrados a humanos. Durante las últimas décadas, el riesgo para la salud ocasionado por diferentes zoonosis, ha sido generado por la distribución natural de los distintos agentes etiológicos y por la emergencia y reemergencia de estas enfermedades. Objetivo: Estudiar la distribución del riesgo de mortalidad de las cuatro principales zoonosis en Chile continental, basados en datos nacionales de mortalidad, con el objetivo de visualizar geográficamente donde focalizar los esfuerzos de control de estas enfermedades. Metodología: Se estima el riesgo relativo de las principales zoonosis en Chile, mediante estadística Bayesiana. Resultados: Se obtuvo la distribución de las cuatro principales zoonosis de Chile. Discusión/Conclusión: Se obtuvo la distribución de las cuatro principales zoonosis de Chile. Los mapas de riesgo obtenidos muestran una enfermedad parasitaria transmitida por vectores de alto riesgo en el norte, la enfermedad de Chagas; una enfermedad parasitaria de comunidades biológicas en que el hombre es un hospedero accidental, asociada a zonas ganaderas, prevalente en el sur, la hidatidosis; una enfermedad bacteriana transmitida por vertebrados, especialmente por roedores, donde el agua es un vehículo importante, dominante en el centro, la leptospirosis; y una enfermedad viral transmitida por roedores, muy dominante en el sur, la infección por hantavirus.

Background Reproductive number (R0)-maps estimate risk zones of vector-borne diseases and geographical distribution changes under climate change. Aim To map R0 aiming to estimate the epidemiological risk of Chagas disease in Chile, its distribution and possible changes due to the global climate change. Material and methods We used a relationship between R0 and entomological parameters of vectors as function of environmental variables, to map the risk of Chagas disease in Chile, under current and projected future environmental conditions. Results We obtained a geographical R0 estimation of Chagas disease in Chile. The highest R0averages correspond to the Central-Northern regions of Chile. T. cruzi transmission area could increase in the future due to climate changes. Independent of the future condition, both for optimistic and pessimistic climate change scenarios, the area of potential risk for Chagas disease transmission would increase. The estimated R0 values suggest that, if a control of T. infestans is not maintained, Chagas disease endemic status will persist or increase, independently of the climate change scenarios. Conclusions Mapping R0 values is an effective method to assess the risk of Chagas disease. The eventual increase in the transmission area of the disease is worrisome.

Neurocysticercosis is the most prevalent parasitic disease of the central nervous system in Chile, where sporadic cases are reported, without information about the epidemiology or distribution of the disease.To identify the main risk zones for cysticercosis in Chile.Analysis of hospital discharge databases between 2002 and 2019, available at the website of the Chilean Ministry of Health. Cases with B69 code of the tenth international classification of diseases were identified.In the study period, there were 1752 discharges with the diagnoses of neurocysticercosis, ocular cysticercosis and cysticercosis of other sites. The ages of patients ranged from 0 to 89 years with a clustering between 30 and 59 years. Sixty two percent were males. The zone between the regions of Maule and Araucania concentrated 82% of cases.We identified the zone with the greatest concentration of cysticercosis in Chile, where preventive strategies should eventually be directed.

A novel reservoir stimulation methodology combines oriented extended perforation tunnels of lengths up to 300 ft with specially designed hydraulic fracturing operations. The new stimulation methodology was introduced in the Florence Field in Colorado and primarily targeted the Niobrara Formation. The technology test included two vertical wells completed with two and five pairs, respectively, of extended perforation tunnels, each 300 ft in length, jetted using radial drilling technology. The jetting operation was followed by a fracture stimulation treatment. The orientation of the extended perforation tunnels and the design of the fracturing treatment were based on analysis of the geological data and were defined using geomechanical modeling as well as far-field and near-wellbore flow simulations. The use of radial drilling technology to create extended perforation tunnels for the vertical wells offered a cost-effective way to significantly increase the reservoir contact area ofthe wellbore, making it similar to that of horizontal wells in the area. The engineered fracture treatments were performed at low treating pressures, and low proppant and fluid volumes. The initial production rates of the two vertical wells included in this technology test exceeded expectations and are comparable to the initial production rate of the offset horizontal well that was completed in the same zone with significantly greatervolumes of proppant and fluid. The initial evaluation of the economic efficiency of this novel reservoir stimulation technology showed that its deploymentdelivered improved production rate to cost ratio for the second vertical well, compared to the reference horizontal well. Based on the test results from the two wells, we conclude that the proposed reservoir stimulation methodology leads to substantial improvements in well production performance compared to traditional reservoir stimulation methods. Both the applied cost-effective approach for increasing the reservoir contact and the significantly lower resource intensity required for the hydraulic fracturing treatment further improve the economic benefits of this methodology. This novel reservoir stimulation methodology opens the way for reconsidering well completion practices in the Niobrara Formation and holds significant potential for improving the hydrocarbon production economics in the Florence Field.

Trichinellosis is a foodborne disease caused by several Trichinella species around the world. In Chile, the domestic cycle was fairly well-studied in previous decades, but has been neglected in recent years. The aims of this study were to analyze, geographically, the incidence of trichinellosis in Chile to assess the relative risk, as well as to analyze the temporal fluctuation in the incidence rates in the last decades. Using temporal data spanning 1964–2019, as well as geographical data from 2010–2019, the time series of cases was analyzed with ARIMA models to explore trends and periodicity. The Dickey–Fuller test was used to study trends, and the Portmanteau test was used to study white noise in the model residuals. The Besag–York–Mollie (BYM) model was used to create Bayesian maps of the level of risk relative to that expected by the overall population. The association of the relative risk with the number of farmed swine was assessed with Spearman’s correlation. The number of annual cases varied between 5 and 220 (mean: 65.13); the annual rate of reported cases varied between 0.03 and 1.9 cases per 105 inhabitants (mean: 0.53). The cases of trichinellosis in Chile showed a downward trend that has become more evident since the 1980s. No periodicities were detected via the autocorrelation function. Communes (the smallest geographical administrative subdivision) with high incidence rates and high relative risk were mostly observed in the Araucanía region. The relative risk of the commune was significantly associated with the number of farmed pigs and boar (Sus scrofa Linnaeus, 1758). The results allowed us to state that trichinellosis is not an (re)emerging disease in Chile, but local conditions must be further studied to identify the factors favoring the presence of outbreaks in some communes, particularly in Araucanía.

Background: The anatomy of the trochlea plays a significant role in patella stability. Surgical approaches to alter the anatomy of the trochlea and associated structures to influence patella tracking continue to evolve. Unlike the development of the pediatric hip joint which has been well studies for decades, the developmental anatomy of the trochlea and its relationship to patella stability remains poorly understood. An improved understanding of trochlear growth and development may alter both the timing and type of surgical procedures for patella stability. Purpose: The purpose of this study was to describe the developmental changes of the osseous and cartilage trochlear morphology in skeletally immature specimens. Methods: Fifty-five skeletally immature cadaveric knees between the ages of 2 months and 11 years were evaluated using 0.625mm computed tomography scans. In the axial plane, measurements included medial and lateral osseous condylar height, medial and lateral cartilaginous condylar height, osseous and cartilaginous sulcus angles, osseous and cartilaginous condylar height asymmetry, and trochlear depth. Results: Analysis of trochlear morphology using osseous and cartilaginous measurements of condylar height, condylar height asymmetry, and trochlear depth demonstrated an increase in the size of the medial and lateral trochlea as age increased. The osseous and cartilaginous sulcus angles decreased (became deeper) with age until around age 8 and then plateaued. This corresponded with an increase in trochlear depth that plateaued also around age 8. In contrast, medial and lateral condylar height continued to increase through age 11. Cartilaginous condylar asymmetry rose slightly with age with the lateral condyle consistently larger than the medial condyle. Osseous condylar asymmetry increased with age but flipped from a larger medial condyle to a larger lateral condyle around age 8. Conclusions: This cadaveric analysis demonstrated that there is an increase in the medial and lateral trochlear height as age increased by all measurements analyzed. These changes in height continue to be seen through age 11 suggesting a still developing trochlea past this age. By age 8, a plateau in sulcus angle and sulcus depth suggests more proportionate growth after this point. Access to pediatric cadaveric specimens is exceptionally rare. This study provides a unique evaluate of the developing trochlea in young children, especially those under age 7, who rarely receive advanced imaging. [Figure: see text][Figure: see text]

Introducción: El cambio climático ha sido identificado como uno de los principales desafíos del siglo XXI, aumentando la morbilidad, mortalidad y el gasto en salud. A pesar de que las enfermedades no transmisibles (ENT) son la principal causa de muerte en la mayoría de los países del mundo, su relación con el clima ha sido menos estudiada en comparación con las enfermedades transmisibles. Los efectos en salud producto del cambio climático, van a depender de la capacidad de los países de adaptar sus sistemas de salud y organizaciones para enfrentar este nuevo escenario. Objetivo: Analizar la evidencia científica internacional y nacional publicada relacionada con clima y ENT. Materiales y métodos: Se realizó un análisis bibliométrico de la evidencia publicada sobre clima y ENT, entre los años 1990 y 2019, utilizando Web of Science (WoS) en la búsqueda internacional y PubMed, WoS, Scopus y Lilacs para la búsqueda nacional, definiendo palabras clave, criterios de inclusión y exclusión. Resultados: Se identificó un importante aumento de los artículos publicados a nivel mundial, donde Estados Unidos ocupa el primer lugar. Brasil es el país con más publicaciones de Sudamérica, seguido por Argentina y Chile. En la búsqueda local, 27 artículos cumplieron los criterios de inclusión para ser analizados en profundidad. Sus resultados principalmente muestran el efecto de la contaminación atmosférica sobre ENT como aumento de morbi-mortalidad por enfermedades respiratorias y cardiovasculares, número de consultas de urgencia, hospitalizaciones y muertes. Las variables climáticas (temperatura, precipitaciones, humedad, etc.) fueron utilizadas para controlar el efecto de otras variables, como la contaminación atmosférica. Discusión: Esta revisión busca incentivar la investigación en Chile, especialmente focalizada en el efecto del clima sobre ENT, con el objeto de entregar más y mejor información para la toma de decisiones en salud.

The interruption of vector-borne transmission of Chagas disease was certified in Chile in 1999. Our goal was to determine the effects of the interruption of vector transmission on the age and spatial distributions of the risk of Chagas disease. We analyzed cases of Chagas disease by age and sex between 1989 and 2017, from notified disease reports of the Ministry of Health. Bayesian risk maps were constructed using the Besag-York-Mollie model. The reported cases of Chagas disease had a mean age of 45.9 ± 17.6 years. Small changes in the age distribution were found among different periods (χ

La cobertura universal en salud debe ser trasversal para toda persona y comunidad, sin discriminación. Pese a esto, en la actualidad existen grupos de población que presentan menores niveles de cobertura del sistema y seguros de salud, como es el caso de la población migrante internacional (MI). La georreferenciación puede ser una medida útil para subsanar esta situación permitiendo realizar intervenciones sectorizadas. Así, el objetivo del estudio fue explorar la distribución espacial a escala regional, provincial y comunal de los migrantes internacionales sin previsión de salud, en comparación con la población local. Para ello, en base a la encuesta CASEN 2015, se estimó la distribución por región, provincia y comuna (auto-representada) de la población MI y local sin previsión de salud. Asimismo, por cada unidad espacial se determinó la proporción de población MI sin previsión de salud y locales sin previsión de salud. Todo representado cartográficamente mediante cartografías temáticas utilizando SIG. Los resultados reflejaron una marcada brecha en la proporción de población sin cobertura de salud entre migrantes internacionales y nacidos en Chile, con diferencia de hasta 21 puntos porcentuales a nivel regional en contra de la población MI. No se identifican patrones zonales, sin embargo, tanto a nivel de provincias como de comunas existe heterogeneidad intrarregional. En la zona central, esta variación se encuentra más marcada en población MI qué en local, centrando más de un 60-80% del total de la población MI sin previsión de la región en una o dos provincias. Esto sugiere un posible fenómeno de migración en cadena, futuros estudios podrían indagar en profundidad este posible efecto y complementar los análisis con estimaciones para áreas pequeñas.

La cocaína es una sustancia que produce graves complicaciones para la salud, e incluso puede causar la muerte en personas aparentemente sanas, además, es comercializada de forma adulterada por lo que aumenta su potencial adictivo y tóxico, convirtiéndola en uno de los problemas sanitarios más graves en el mundo occidental en el campo de las toxicomanías. Es por esta razón, la necesidad de contar con datos que permitan observar el comportamiento de la cocaína base durante un extenso período de tiempo, fijándonos en su concentración, adulterantes y diluyentes utilizados, como también una descripción según distribución regional de Chile continental. El objetivo fue evaluar la concentración de cocaína base, la frecuencia de adulteración y su distribución territorial en Chile en un período de 10 años, desde el 2006 hasta el 2016. El universo fue de 131.830 muestras confirmadas con cocaína base. La caracterización y cuantificación de las muestras se realizó con metodologías validadas y recomendadas por las Naciones Unidas mediante GC-FID, GC-MS, HPTLC, TLC y FTIR –ATR. El 52,3% (68.976/131.830) del total de muestras se cuantificó, de éstas, la concentración promedio de cocaína base a través de los años fue de 41,3%. Se observó que las regiones del norte de Chile presentan las más altas concentraciones de cocaína base, en contraposición de las regiones del sur. Por otra parte, de la totalidad de muestras analizadas en el periodo el 40,4% (53.258) presentaba adulteración y/o dilución. Dentro de los diluyentes, destaca la presencia de carbonatos (98,5%), mientras que dentro del grupo de adulterantes se observa que predominan fenacetina (55,2%) y cafeína (36,1%), continuando con el grupo de anestésicos lidocaína (3,7%), benzocaína (2,6%) y procaína (1,4%).

Zoonoses are infections caused by all types of etiological transmissible agents from vertebrate animals to humans. During the last decades, the risk to health caused by different zoonoses has been a consequence of the natural distribution of the different etiological agents and by the emergence and reemergence of these diseases.To study the distribution of the risk of mortality of the four main zoonoses in continental Chile, based on national mortality data, with the objective of visualizing geographically where to focus the control efforts of these diseases.Relative risk was estimated by means of Bayesian Statistics.The distribution in Chile of the main zoonoses was obtained.The risk maps obtained show a parasitic disease transmitted by high-risk vectors in the north, Chagas disease; a parasitic disease of biological communities in which man is an accidental host, associated with livestock areas, more prevalent in the south, hydatidosis; a bacterial disease transmitted by vertebrates, especially by rodents, where water is an important vehicle, dominant in the center, leptospirosis; and a viral disease transmitted by rodents, very dominant in the south, the hantavirus infection.

In Chile, hydatidosis is endemic throughout the country and hyperendemic in some regions. It continues to be a public health problem that has been neglected and little addressed at the national level. In the Region of Libertador Bernardo O'Higgins, reported cases and hospital discharges still show high values, this area being representative of medium risk.To estimate the risk of human hydatidosis in this region, studying the relationship of notifications and hospital discharge rates with social and environmental factors such as population, poverty index, schooling, literacy, average temperature, average rainfall and sheep population size.Poisson regressions were used to study the factors associated with reported cases and hospital discharge rates and the BYM model for relative risk.We found that the factors most related to absolute risk were the schooling index as a protective factor and the average temperatures as an enhancing factor. The sheep population size was also a relevant factor, especially when analyzing the distribution of relative risk. The areas of greatest risk in the region were La Estrella, Marchigue, Litueche, Santa Cruz and Lolol according to discharge rates, adding Pumanque and Peralillo according to notifications. These reveal a distribution of the zones of risk of hydatidosis towards the coastal mountain range in this region.The more relevant factors associated to hydatidosis were schooling index, temperature an sheep population.

El Derecho Administrativo norma las actuaciones de la Administración y a los órganos que realizan la función administrativa, el objeto del Derecho Administrativo es la Administración Pública, conceptualizada como la actividad permanente, concreta y práctica del Estado que tiende a la satisfacción ciudadana. La organización del Estado es necesaria para ejercer esta función administrativa, de esta manera se regula la competencia, las relaciones jerárquicas, la situación jurídica, las formas de actuación y en especial el control. El control como garantía de legitimidad y oportunidad logra la eficiencia y moralidad de las actividades del Estado; por tanto, el control es necesario y aplicable a la gestión de la Administración Pública, a quienes ejercen la función administrativa e incluso a los que tratan con la Administración. La contratación pública forma parte del Derecho Administrativo y como política pública de Estado es el medio utilizado para el cumplimiento de objetivos nacionales, su ejecución pretende la satisfacción de las necesidades ciudadanas y el desarrollo común del país. Debido a su importancia tanto en el ámbito administrativo como económico del Estado, y por los considerables montos del recurso público que utiliza, es indispensable realizar el control de sus actividades para asegurar la competencia entre participantes, las condiciones técnicas del bien o servicio, la selección objetiva, la transparencia, los fines de la contratación y en especial el esmero y pulcritud en el uso de los fondos del erario. Con el fin de escoger al mejor proveedor del Estado para la adquisición de bienes, prestación de servicios o ejecución de obras, cada entidad contratante requiere pasar por un procedimiento administrativo complejo que comprende la fase precontractual. En esta fase donde se forma la voluntad de la Administración pública se involucran actores públicos y privados, actos públicos, órganos de control, administrados y la ciudadanía. La regulación normativa para la consecución del procedimiento de adquisición es indispensable, sin embargo, las funciones de los entes de control en el ejercicio de la contratación pública se han visto interferidas en nuestra opinión por la profusa e inconsulta emisión de normas desde numerosas entidades públicas con competencia reguladora y controladora.

Reproductive number (R0)-maps estimate risk zones of vector-borne diseases and geographical distribution changes under climate change.To map R0 aiming to estimate the epidemiological risk of Chagas disease in Chile, its distribution and possible changes due to the global climate change.We used a relationship between R0 and entomological parameters of vectors as function of environmental variables, to map the risk of Chagas disease in Chile, under current and projected future environmental conditions.We obtained a geographical R0 estimation of Chagas disease in Chile. The highest R0averages correspond to the Central-Northern regions of Chile. T. cruzi transmission area could increase in the future due to climate changes. Independent of the future condition, both for optimistic and pessimistic climate change scenarios, the area of potential risk for Chagas disease transmission would increase. The estimated R0 values suggest that, if a control of T. infestans is not maintained, Chagas disease endemic status will persist or increase, independently of the climate change scenarios.Mapping R0 values is an effective method to assess the risk of Chagas disease. The eventual increase in the transmission area of the disease is worrisome.

Infection with human T-lymphotropic virus type 1/2 (HTLV-1/2) is a major health problem. HTLV-1/2 infection is endemic in Chile but representative donor prevalence data are lacking. Data on all blood donors in a large network of Chilean blood centers were examined during 2011-2013. Screening of HTLV-1/2 antibodies were measured by enzyme immunoassay (EIA) at all blood banks. Blood samples with anticoagulants from initially reactive blood donors were analyzed by serological confirmation tests (immunofluorescence or recombinant immunoblot) at the HTLV National Reference Laboratory of the Public Health Institute of Chile. Additionally, detection of HTLV-1 and HTLV-2 provirus in peripheral blood mononuclear cells (PBMCs) was performed in all blood donors as confirmatory test. Prevalence rates were calculated. Among 694,016 donors, 706 were seropositive for HTLV-1 (prevalence, 1.02 cases per 1,000; 95% confidence interval [CI], 0.94-1.09), and 97 were seropositive for HTLV-2 (prevalence, 0.14 cases per 1,000; 95%CI, 0.11-0.17). Prevalence of HTLV-1 differed considerably by region, from 0.51 to 1.69 per 1,000. Prevalence of HTLV-2 was similar across the country (0.12-0.16). HTLV-1 prevalence was associated with female sex, older age, and residence in the north of Chile. HTVL-2 prevalence was associated with older age. The HTLV-1 prevalence among Chilean blood donors was relatively high and could be reduced by improving donor recruitment and selection in high prevalence areas. Blood center data may contribute to surveillance for HTLV-1 and HTLV-2 infections.

SUMMARY The frequency of anti-Toxocara spp. antibodies in individuals attended by the Centro de Salud Familiar in the coastal Niebla town, Chile, was related to the host and to environmental factors. IgG anti- Toxocara antibodies were detected with a commercial ELISA kit (SCIMEDX Corporation, USA). Samples with undetermined absorbance values were subjected to an additional ELISA standardized by the Instituto de Salud Pública, Chilean Health Ministry, a commercial ELISA (NOVATEC, Germany), and a commercial Western blot kit (LDBio Diagnostics, France). Hematological exams were performed using an automated blood counter and blood smears. Dog feces were collected from the ground along the main road in Niebla, including rural and urban locations. Ninety (25.4%) of the 355 examined individuals were positive by the ELISA test. The frequency of anti-Toxocara antibodies and the infection risk were significantly higher (p < 0.05) among those individuals ≥ 40 years old with respect to the 20-39 years old group, in individuals from rural locations, those who did not have a safe drinking water supply in the house or who presented blood eosinophilia. The proportion of positive samples of dog feces and the mean number of Toxocara canis eggs/g of feces in urban and rural areas were similar (p > 0.05).

La introducción de nuevas formas de producción y desarrollo en este territorio, así como la visión de manejo (conservacionista) con la que se ha administrado al archipiélago, presenta un ejemplo de la influencia que ejercen los organismos internacionales y países considerados como desarrollados para lograr el acople de países como el nuestro dentro del mundo globalizado y el sistema socioeconómico predominante. Es por estos motivos que dentro del contexto mencionado, la presente investigación cobra importancia, en cuanto un conocimiento detallado de la configuración del sistema alimentario de Galápagos, nos permite comprender la situación socio-ambiental existente, y con ello la visibilización de las condiciones en que se encuentra la población respecto a la producción, suministro y consumo de alimentos.