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In Chile, depressive symptoms are highly prevalent among Chilean older adults, and research that examines the factors associated with them is scarce. This study aimed to determine if subjective assessments of quality of life are associated with positive screen for depressive symptoms among older adults enrolled in primary care in Chile. The participants of the study were people aged 70 years or more enrolled in primary care centers in three Chilean cities. The 15-item Geriatric Depression Scale was used to determine depressive symptoms. Multivariate logistic models were used to determine the associations. Overall, 17.28% men, and 26.47% women (p = 0.003) screened positive for depression. Subjective assessments of quality of life, including self-perceived health, memory, quality of life, and pain, were associated with a positive screen for depression. Only 17.65% of men and 43.55% of women who screened positive for depressive symptoms reported a diagnosis of depression. Assessments of quality of life in health checks of older adults in primary care could contribute to narrow the diagnosis and treatment gap by improving the ability to identify those who are more likely to experience depressive symptoms. ispartof: JOURNAL OF PERSONALIZED MEDICINE vol:12 issue:7 ispartof: location:Switzerland status: published

Objetivo: caracterizar las intervenciones psicoemocionales de investigaciones que aborden el manejo de personas y familias contagiadas por el virus SARS-CoV-2. Métodos: se realizó una revisión sistemática exploratoria de trabajos publicados entre los años 2019 y 2021, en español e inglés, en PubMed, Web of Science, Biblioteca Virtual en Salud y Embase. Se seleccionó aquellos trabajos que abordaron el manejo psicoemocional de pacientes con COVID-19 y sus familias. Se utilizó la Herramienta de Evaluación para Métodos Mixtos para la evaluación de la calidad metodológica de los estudios, aplicado por dos evaluadoras independientes. Resultados: se incluyeron 13 artículos, la mayoría de ellos ensayos controlados randomizados. Se encontró que realizar intervenciones psicológicas en pacientes COVID19 es efectivo. Se observaron intervenciones de 2 a 3 semanas, reportando beneficios en pacientes desde la primera semana de aplicación. Por otra parte, los canales de comunicación digital como intervenciones telefónicas, chat, videograbaciones, videollamadas en línea, entre otras, son tan beneficiosas como las atenciones presenciales. Conclusión: realizadas precoz y oportunamente, a través de distintas modalidades, las intervenciones para preservar o mejorar la salud mental, deben ser parte esencial de la atención clínica en pacientes con COVID-19. Se requiere de más investigaciones en este ámbito, que integren un número de pacientes representativo para asegurar la efectividad de las medidas, así como aquellas que demuestren el potencial de las intervenciones ambulatorias.

Indexación: Scopus; Scielo. Las infecciones de sitio operatorio (ISO), son las infecciones asociadas a la atención de salud (IAAS) más frecuentes en los países en desarrollo, representando una carga epidemiológica sustancial en los países de ingresos altos. La prevención de esta infección es compleja y requiere la integración de una serie de medidas preventivas. Mediante esta publicación, la Organización Mundial de la salud (OMS) propone directrices mundiales, que entregan recomendaciones basadas en la evidencia, para la prevención y control de ISO, para los períodos intraoperatorio y post-operatorio https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0716-10182017000500523&lng=en&nrm=iso&tlng=en

Objective: The aim is to describe the prevalence of chronic diseases and conditions that may affect the oral health and oral health self-care of independent living Chilean older adults. Method: In all, 4,766 residents aged 60 years and older took part in the study. Participants were interviewed using an 11-module instrument, including demographic data, quality of life, nutritional status, systemic diseases, and lists of medications. Results: Participants with cognitive impediments ( n = 553) were eliminated from further analysis. Of the remaining 4,213, 61.2% were female. The mean age was 71.1 ( SD = 7.8) years. A total of 19.6% reported no medical conditions, 53.1% reported one or two conditions, and 27.3% reported between three and nine conditions. The most commonly reported conditions were high blood pressure (78.0%), diabetes (26.5%), depression (23.4%), and cardiovascular disease (18.7%). Seventy-six percent reported taking medication, with an average of 3.4 drugs per person. Among those taking medication, 70.2% were taking at least one that may cause salivary hypofunction. Discussion: With the aging of Chile and the reciprocal links between oral disease and chronic diseases, policies and innovative initiatives need to be implemented so that programs become affordable and accessible for this population.

Ageing in place is related to the ability of seniors to perform daily activities autonomously in interaction with their physical and social environment. This case study presents the validation of the Neighborhood Environment Walkability Scale Abbreviated (NEWS-A) in a sample of 291 seniors from a neighborhood of Valparaiso, Chile, estimated with 95% of confidence and a 5% margin error, to determine the perception that they have about the urban surroundings where they live, using the survey technique. The dimensions that are part of the scale were evaluated with a confirmatory factorial analysis. In this case the results indicate that the social aspects of the neighborhood, such as the fear of crime, are more important than the physical aspects, in terms of contribution to the neighborhoods walkability. The basis of the survey is that the ageing of Chilean population is related to social and economic transformations and changes in the epidemiological profile, which is an important challenge to public policy, due to the sustained increasing of this age group.

Background The rapid increase in life expectancy in Chile, with obesity as the main nutritional problem in all age groups, makes it necessary to ask whether the years gained are healthy. Aim To study the trajectories of disability associated with obesity in Chilean elderly groups from different socio-economic and demographic backgrounds. Material and methods Longitudinal study of 3 cohorts of older adults from Santiago: the SABE cohort including 1235 people born before 1940; the Alexandros cohort including 950 people born between 1940 and 1948 from Primary Health Care centers and the ISAPRES cohort of 266 people from private health insurance registries (ISAPRES) born before 1947. An interview yielded socio demographic data and history of diseases. Anthropometric measurements and hand dynamometry were performed. Cognitive status was assessed by the Mini Mental State Examination, depressive symptoms through the geriatric depression score-5 and functional limitations through self-reporting of basic (ADL), instrumental (IADL) and advanced daily living (AADL) activities. Results We report here baseline results from ISAPRES and SABE cohorts. Important social and gender differentials were observed. After adjustment by age and gender, a significant lower frequency of limitations in ADL (odds ratio (OR) = 0.17; 95% confidence intervals (CI): 0.079-0.343), IADL (OR = 0.27; 95%CI: 0.159-0.452), and AADL (OR = 0.42; 95%CI: 0.298-0.599) persisted in the ISAPRE cohort, compared to the SABE cohort. Obesity was associated with functional limitations only in AADL (OR = 1.65; 95%CI: 1.18-2.31) and hand dynamometry was associated with lower functional limitation in ADL, IADL and AADL. Conclusions This study demonstrates profound socio-economic and gender inequalities in older people, thus showing that the years of healthy life gained are not the same for the whole society.

This study aims to examine the self-assessed oral health status and quality of life (QoL) of independent living Chilean older adults, and their distribution by selected socio-demographic characteristics. The study conducted a secondary analysis of data collected as part of a larger study of dependency which involved 4766 independent living older adults, 60 years of age and older, residents of all Chilean Regions. Participants were interviewed using an 11-module instrument. The majority (61.2%) were female. Mean age was 72.3 (s.d. 8.5) years. 47.5% lived with their spouses/partners. The majority had primary education (63.4%), were under the National Health Fund (87.9%), and lived in urban locations (68.3%). The majority (56%) perceived their QoL to be 'Excellent/Very good'; another 37.5% self-assessed their QoL as 'Average'; and 6.6% self-assessed his/her QoL as being 'Bad/Very bad'. 21.7% of participants reported no natural teeth; 43.1% had 'the majority' of teeth missing; 29.9% had 'A few' teeth missing; and 5.3% reported no missing teeth. The probability of being edentulous was explored using LRA. Age; health conditions; education; gender and region of residence remained statistically significant [χ(2)(13)=379.05; p0.001]. Those who self-reported their QoL as 'Average/Bad' were more likely to be edentulous than those who self-reported their QoL as Good/Excellent (OR=1.5; 95% CI 1.10-2.00). Despite general improvements in oral health among Chilean older adults, this study found poor oral health among older adults is compounded by poor QoL, and substantial inequalities in oral health outcomes by location, levels of education and income.

To describe and compare socioeconomic inequalities in the onset and progression of disability in a cohort of Chilean community-dwelling older people that provides unprecedented information about this process in Chile.The data were drawn from a 10-year longitudinal study (2000-2010) that followed a probabilistic and representative sample of the SABE (Health, Welfare and Aging) cohort. The present study was based on 78% (1019) of the baseline sample of adults aged 60 years or more living in Santiago, Chile. Functional limitation was defined on the basis of a combination of six basic activities of daily living, seven instrumental activities, and seven mobility activities (limited, no limited). Socioeconomic position (high, medium and low) was assessed by combining measures of household equipment, wealth, and education.The initial prevalence of functional limitation was 47.3% (95%CI: 44.2-50.4) with a clear socioeconomic gradient (60.1% low, 47.5% medium, and 28.7% high; p0.001). At the end of the follow-up, older adults with low socioeconomic status remained functionally limited while those with high socioeconomic status remained non-limited. The incidence density of functional limitation also followed a socioeconomic gradient (5.33, 6.59 and 7.73 per 100 years-person for low, medium and high socioeconomic status). Social inequalities were also observed for mortality.This study corroborates the social stratification of functional status and mortality, suggesting that aging is not a leveler of inequalities. In Latin-American countries, policies should aim to reduce inequalities by attempting to limit exposure to risk factors and to compensate for deficiencies (especially among the poorest older people) in order to prevent the progression of functional impairment to disability.

The rapid increase in life expectancy in Chile, with obesity as the main nutritional problem in all age groups, makes it necessary to ask whether the years gained are healthy.To study the trajectories of disability associated with obesity in Chilean elderly groups from different socio-economic and demographic backgrounds.Longitudinal study of 3 cohorts of older adults from Santiago: the SABE cohort including 1235 people born before 1940; the Alexandros cohort including 950 people born between 1940 and 1948 from Primary Health Care centers and the ISAPRES cohort of 266 people from private health insurance registries (ISAPRES) born before 1947. An interview yielded socio demographic data and history of diseases. Anthropometric measurements and hand dynamometry were performed. Cognitive status was assessed by the Mini Mental State Examination, depressive symptoms through the geriatric depression score-5 and functional limitations through self-reporting of basic (ADL), instrumental (IADL) and advanced daily living (AADL) activities.We report here baseline results from ISAPRES and SABE cohorts. Important social and gender differentials were observed. After adjustment by age and gender, a significant lower frequency of limitations in ADL (odds ratio (OR) = 0.17; 95% confidence intervals (CI): 0.079-0.343), IADL (OR = 0.27; 95%CI: 0.159-0.452), and AADL (OR = 0.42; 95%CI: 0.298-0.599) persisted in the ISAPRE cohort, compared to the SABE cohort. Obesity was associated with functional limitations only in AADL (OR = 1.65; 95%CI: 1.18-2.31) and hand dynamometry was associated with lower functional limitation in ADL, IADL and AADL.This study demonstrates profound socio-economic and gender inequalities in older people, thus showing that the years of healthy life gained are not the same for the whole society.

El síndrome de embolia grasa (SEG) sigue siendo un reto diagnóstico para los médicos. Se asocia fundamentalmente en fracturas de los huesos largos y es una importante fuente de morbilidad y mortalidad en pacientes politraumatizados. La mortalidad general se encuentra entre el 5 a 15% en todos los estudios. Esto nos motiva a presentar el caso de una mujer joven que 72 horas después de fracturas sufridas durante el terremoto ocurrido en Chile el 27 de febrero del 2010, presentó un SEG. Es importante conocer este síndrome, ya que se puede confundir con otras patologías graves que requieren un manejo distinto y al tener una alta sospecha en el contexto adecuado, se permite un diagnóstico oportuno, tratamiento precoz y mejorar el pronóstico.

The Pulmonary Langerhans cell histiocytosis (PLCH) is an uncommon pulmonary diffuse cystic disease. This review presents one case of PLCH diagnosed in a non-smoker female adolescent, who consulted for rapidly progressive dyspnea associated to left pleuritic pain that corresponded to a bilateral pneumothorax. The diagnosis was confirmed by surgical biopsy of the lung. Treatment with corticoids (prednisone) was indicated during the first year. After 18 years from diagnosis she presented an important clinical improvement, with a favourable but not complete radiological and spirometric improvement. The cases that make their debut with recurrent spontaneous pneumothorax are infrequent. The natural evolution of this disease is variable and the treatment is still controversial, been the immunosuppressive therapy, as corticoesteroids and cytotoxic agents of limited value, since are few studies that confirm their effectiveness

Los agentes atípicos, especialmente Mycoplasma pneumoniae, Chlamydia pneumoniae y Legionella sp eventualmente pueden causar neumonías adquiridas en la comunidad (NAC) graves. En Chile, en el diagnóstico diferencial se debe incluir además el síndrome cardiopulmonar causado por hantavirus (SCPH). Describimos el cuadro clínico de tres pacientes con fiebre alta, disnea, insuficiencia respiratoria aguda e infiltrados intersticiales difusos en la radiografía de tórax, que requirieron de cuidados intensivos. En los tres casos, el diagnóstico diferencial incluyó NAC graves y SCPH. Los antecedentes epidemiológicos y la clínica son de gran utilidad en el diagnóstico diferencial entre NAC graves y SCPH. El hemograma es el examen de laboratorio de mayor utilidad en el diagnóstico precoz del SCPH, considerando que ~87% de los pacientes tiene hemoconcentración, leucocitosis y plaquetopenia. Estos hallazgos son extremadamente infrecuentes en pacientes con neumonía adquirida en la comunidad. El diagnóstico definitivo de NAC causada por agentes atípicos debe ser confirmada por exámenes serológicos. Dos de nuestros pacientes tuvieron títulos altos de anticuerpos-anti Mycoplasma pneumoniae al ingreso, y uno de ellos títulos altos de anticuerpos anti-Chlamydia pneumoniae

ResumenObjetivoDescribir y comparar las desigualdades socioeconómicas en el proceso de discapacidad de adultos mayores chilenos residentes en la comunidad, aportando información inédita sobre esta dinámica en Chile.MétodosDiseño longitudinal de 10 años de seguimiento (2000-2010) de una muestra representativa y probabilística de la cohorte SABE (Salud, Bienestar y Envejecimiento). Este artículo está basado en un 78% (1019) de la muestra inicial de sujetos de 60 y más años de edad que viven en Santiago, capital de Chile. La limitación funcional se definió combinando seis actividades básicas de la vida diaria, siete instrumentales y siete de movilidad (limitado, no limitado). El nivel socioeconómico (alto, medio y bajo) sintetiza variables de calidad de vivienda, equipamiento del hogar, ingresos y educación.ResultadosLa prevalencia inicial de limitación funcional fue del 47,3% (intervalo de confianza del 95%: 44,2-50,4), con un marcado gradiente socioeconómico (bajo 60,1%, medio 47,5%, alto 28,7%; p