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The analysis of multiple population structures (biodemographic, genetic and socio-cultural) and their inter-relations contribute to a deeper understanding of population structure and population dynamics. Genetically, the population structure corresponds to the deviation of random mating conditioned by a limited number of ancestors, by restricted migration in the social or geographic space, or by preference for certain consanguineous unions. Through the isonymic method, surname frequency and distribution across the population can supply quantitative information on the structure of a human population, as they constitute universal socio-cultural variables. Using documentary sources to undertake the Doctrine of Belén's (Altos de Arica, Chile) historical demography reconstruction between 1763 and 1820, this study identified an indigenous population with stable patronymics. The availability of complete marriage, baptism and death records, low rates of migration and the significant percentage of individuals registered and constantly present in this population favoured the application of the isonymic method. The aim of this work was to use given names and surnames recorded in these documentary sources to reconstruct the population structure and migration pattern of the Doctrine of Belén between 1750 and 1813 through the isonymic method. The results of the study were consistent with the ethno-historical data of this ethnic space, where social cohesion was, in multiple ways, related to the regulation of daily life in colonial Andean societies.

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Introducción: Se presenta la experiencia en tratamiento quirúrgico de endocarditis infecciosa (EI) y analizan factores asociados a mortalidad. Método: Estudio retrospectivo de pacientes operados por EI en el Hospital Regional de Concepción entre 1985 y 2005 (N=126). Se estudian características clínicas, cirugía efectuada, y morbimortalidad. Se comparó la mortalidad según periodo (1985–1994, 1995–2005), sexo, edad, válvula afectada, duración del tratamiento médico, indicación de cirugía y procedimiento efectuado. Las diferencias se estudiaron con test de probabilidad exacta de Fisher y test de independencia de variables según la distribución Chi–cuadrado. Resultados: Se operaron 52 pacientes entre 1985 y 1994. Edad promedio 43.5 años. 98 pacientes (77.8%) de sexo masculino. Las válvulas afectadas fueron aórtica (66.7%), mitral (10.3%), mitral y aórtica (21.4%). El tratamiento médico fue < 14 días en 47 (37%), entre 15 y 30 días en 50 (40%) y > 31 días en 29 (23%). Las principales indicaciones quirúrgicas fueron la insuficiencia cardiaca (54.7%) y vegetaciones >1cm (31%). Se realizaron 96 reemplazos univalvulares y 21 reemplazos bivalvulares. Presentaron complicaciones 63 pacientes y fallecieron 19 (15.1%). Se observó una mayor mortalidad en cirugía antes de 1995, sexo femenino, edad mayor de 50 años, compromiso bivalvular, periodo de tratamiento médico inferior a 30 días, indicación quirúrgica por insuficienciacardiaca y reemplazo bivalvular. Las diferencias no tuvieron significación estadística.Conclusiones: En nuestra serie, la mayor mortalidad quirúrgica se observó en los pacientes de mayor edad, sexo femenino y con compromiso bivalvular. Las diferencias observadas no tuvieron significación estadística.

Aim: to review the results of cardiac surgery in patients with Infective Endocarditis (IE) and to determine risk factors associated to surgical mortality. Method: A retrospective study of patients with cardiac surgery for IE at the Hospital Regional de Concepcion between 1985 and 2005 (n=126). We tabulated the clinical characteristics, type of surgery, morbidity and mortality. Mortality was compared for the period 1985-1994 vs. the period 1995-2005, according to sex, age, valve involved, duration of medical treatment, indication for surgery and procedure performed at operation. Differences were evaluated by the Fisher exact test or Chi square, as required Results: The mean age was 34.5 years; 98 patients (77.8%) were males. The aortic valve was affected in 66.7%,mitral valve in 10.3%, and both valves in 21.4%. Medical treatment lasted less than 14 days in 37%, 15-30 Days in 40% and >31 days in 23% of patients. Main surgical indications were congestive heart failure (54.7%) and vegetations greater than 1cm (31%). A single valve was replaced in 96 patients and 2 valves in 21. Complications occurred in 63 patients; the mortality rate was 15.1%. Compared to the later period, patients operated on before 1995 had greater mortality rate, proportion of women, age >50 years, bivalvular disease, frequency of medical treatment under 30 days, CHF as an indication for surgery and bivalvular replacements. However, the differences were not statistically significant.Conclusion: Older age, female sex and bivalvular disease were associated, although not significantly, with surgical mortality for IE.

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Introducción: El EuroSCORE es una escala de riesgo diseñada para predecir mortalidad en cirugía cardiaca. Objetivo: Evaluar el EuroSCORE como predictor de mortalidad, complicaciones y duración de la estadía hospitalaria. Método: Aplicación prospectiva del EuroSCORE a todos los pacientes sometidos a cirugía cardíaca en el Hospital Regional de Concepción entre enero de 2002 y diciembre de 2005 (N=698). Edad promedio 56.7 años. Correspondieron a 452 hombres, 19 pacientes con EPOC, 29 con enfermedad vascular periférica, 52 reoperaciones, 21 con endocarditis activa y 70 considerados como estado preoperatorio crítico. Presentaron angina inestable 155 pacientes, 82 disfunción moderada y 10 disfunción severa del ventrículo izquierdo. 128 pacientes tenían antecedente de infarto menor a 90 días. Se consideraron de urgencia 59 cirugías. Se efectuaron 251 cirugías distintas de bypass coronario aislado. Los pacientes se dividieron en 3 grupos (grupo I: 0-2 puntos; grupo II: 3-5 puntos; grupo III: 6 y más). Se correlacionó cada grupo con mortalidad, complicaciones y duración de la estadía post operatoria con prueba de Chi cuadrado de independencia de variables y análisis de varianza de una vía. Resultados: Grupo I: 224 pacientes, grupo II: 279 pacientes y grupo III: 195 pacientes. La mortalidad observada fue de 1.3%, 4.6% y 7.2% respectivamente (p = 0.012). Se presentaron complicaciones en un 15.2%, 26.5% y 30.2%, respectivamente (p = 0.002). Los días de estada postoperatoria promedio fueron 7.4, 7.4 y 9.2 (p = 0.01). Conclusiones: El EuroScore se correlacionó adecuadamente con la mortalidad, complicaciones y duración de la estadía post - operatoria.

Background: The EuroSCORE is a risk scale designed to predict mortality in cardiac surgery. Aim: to evaluate the EuroSCORE as a predictor of mortality, complications and length of hospital stay in patients undergoing cardiac surgery. Methods: the EuroSCORE was determined in all patients undergoing cardiac surgery at the Hospital Regional de Concepcion between January 2002 and December 2005 (n=698). Mean age was 56.7 years, 452 patients were males. Obstructive pulmonary disease was present in 19, peripheral vascular disease in 29, and active infective endocarditis in 21. Seventy patients were critically ill before surgery and 52 were reoperations. Unstable angina waspresent in 155; the left ventricular ejection fraction was severely depressed in 10 and moderately depressed in 82. Prior myocardial infarction within 90 days was present in 128. Surgery was classified as urgent in 59. According to the EuroSCORE, three groups were identified: G1 (0-2 points, n=224), G2 (3-5 points, n=279) and G3 (³ 6 points, n=195). Operative mortality, complications and length of hospital stay were compared across groups using one way ANOVA. Results: Operative mortality was 1.3%, 4.5% and 7.2% in G1, G2 and G3, respectively (p=0.012). Complications developed in 15.2%, 26.5% and 30.2%, respectively (p=0.002). Mean hospital stay was 7.4, 7.4 and 9.2 days, respectively (p=0.01). Conclusion: The EuroSCORE was a useful predictor of mortality, complications and length of hospital stay in patients undergoing cardiac surgery.

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Introducción: La prótesis Ultracor® es una válvula mecánica monodisco. Se utilizó para reemplazo valvular aórtico(RVA) en nuestro servicio entre 1995 y 2003. Objetivo: Evaluar los resultados del uso de prótesis Ultracor en posición aórtica. Método: Revisión retrospectiva de fichas clínicas de pacientes sometidos a RVA exclusivo con prótesis Ultracor entre 1995 y 2003 en el Hospital Regional de Concepción (N=117). Se tabularon los datos demográficos, patología valvular, capacidad funcional (CF) y fracción de eyección pre operatorios; y la morbi - mortalidad operatoria. En el seguimiento se evaluaron los episodios de hemorragia, tromboembolismo, endocarditis, necesidad de reoperación y defunciones tardías. Resultados: 77 pacientes (65.8 por ciento) de sexo masculino. Edad promedio 54.4 años. 62 pacientes (53 por ciento) estaban en CF I ó II. La indicación quirúrgica fue por estenosis en 59 (50.4 por ciento) e insuficiencia en 42 (53.9 por ciento). Se presentaron complicaciones en 34 pacientes (29 por ciento) y fallecieron 6 (5.1 por ciento). Seguimiento en 105 pacientes (94.6 por ciento) con un total de 402 años/paciente (promedio 3.9 años). Las tasas de complicaciones ( por ciento / año) fueron: 1.2 para tromboembolismo y 2.5 para hemorragia, 1 para endocarditis y 1 para reoperación. Fallecen 18 pacientes en el seguimiento (2.2 por ciento /año). Se realizó ecocardiograma a 75 pacientes. No hubo disfunción estructural y se presentaron 4 leak perivalvulares. Conclusiones: En esta serie observamos tasas de complicaciones similares a las publicadas para otras prótesis. La mayoría de ellas (tromboembolismo, hemorragia, endocarditis y reoperación por endocarditis) no son atribuibles directamente a la prótesis y consideramos que los resultados obtenidos con ella son satisfactorios.

Background: The Ultracor® monodisk prosthesis was used to correct aortic valve disease in our institution in the 1995-2003 period. Aim: To evaluate late results of aortic valve replacement using the Ultracor® prosthetic valve Methods: The clinical records of patients receiving an Ultracor® prosthesis as isolated valve replacement for aortic valve disease at the Hospital de Concepción from 1995 to 2003 were reviewed. A total of 117 patients were evaluated preoperatively to determine the type of aortic valve disease, functional class and LV ejection fraction. Operative mortality and morbidity were recorded. Late results were evaluated in terms of thrombo-embolic and hemorrhagic complications, infective endocarditis, need for reoperation and late death. Results: There were 77 males (66 percent) and the mean age was 54.4 years. Sixty two patients were functional class 1 or 2 (53 percent). Aortic stenosis in 50.4 percent and aortic insufficiency in 53.9 percent were the indications for surgery. Operative mortality was 5.1 percent and significant complications developed in 29 percent. Follow up was obtained in 105 patients (94.6 percent) for a total of 402 patient-years (mean 3.9). Complication rates ( percent per year) were: thrombo-embolism 1.2, bleeding 2.5, endocarditis 1 and reoperation 1. Eighteen patients died during follow up (2.2 percent per year). An echocardiogram performed in 75 patients showed a paravalvular leak in 4; there were no instances of structural damage of the prosthesis. Conclusion: Overall clinical results of aortic valve replacement with the Ultracor® prosthesis were quite satisfactory and complications occurred with rates similar to those reported for other aortic prosthesis. They were not related to the valve.

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