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Colorectal cancer (CRC) represents the second deadliest malignancy worldwide. Around 75% of CRC patients exhibit high levels of chromosome instability that result in the accumulation of somatic copy number alterations. These alterations are associated with the amplification of oncogenes and deletion of tumor-ppressor genes and contribute to the tumoral phenotype in different malignancies. Even though this relationship is well known, much remains to be investigated regarding the effect of said alterations in long non-coding RNAs (lncRNAs) and, in turn, the impact these alterations have on the tumor phenotype. The present study aimed to evaluate the role of differentially expressed lncRNAs coded in regions with copy number alterations in colorectal cancer patient samples. We downloaded RNA-seq files of the Colorectal Adenocarcinoma Project from the The Cancer Genome Atlas (TCGA) repository (285 sequenced tumor tissues and 41 non-tumor tissues), evaluated differential expression, and mapped them over genome sequencing data with regions presenting copy number alterations. We obtained 78 differentially expressed (LFC > 1|< -1, padj < 0.05) lncRNAs, 410 miRNAs, and 5028 mRNAs and constructed a competing endogenous RNA (ceRNA) network, predicting significant lncRNA-miRNA-mRNA interactions. Said network consisted of 30 lncRNAs, 19 miRNAs, and 77 mRNAs. To understand the role that our ceRNA network played, we performed KEGG and GO analysis and found several oncogenic and anti-oncogenic processes enriched by the molecular players in our network. Finally, to evaluate the clinical relevance of the lncRNA expression, we performed survival analysis and found that C5orf64, HOTAIR, and RRN3P3 correlated with overall patient survival. Our results showed that lncRNAs coded in regions affected by SCNAs form a complex gene regulatory network in CCR.

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Introduction: Vitamin D (VD) deficiency is common in children with chronic kidney disease (CKD) because of multiple factors. During the coronavirus disease 2019 (COVID-19) pandemic, it increased because of medicine shortage and no enough medical service for patients with non-COVID-19 diseases. Objective: To analyze the effects of the COVID-19 pandemic-related lockdown on the serum levels and status of 25-hydroxyvitamin D3 (25-[OH]D) in children with CKD. Materials and methods: This retrospective study included patients (6-18 years old) who were diagnosed with CKD stage 2-5 and routinely measured for serum VD levels between May 2019 and December 2022. Serum 25-(OH)D levels were measured before, during, and after the pandemic (2019, 2020-2021, and 2022, respectively). The daily dose of cholecalciferol supplementation and the readjustment (if required) were recorded. Results: This study included 171 patients (median age: 12 years). Before the pandemic, the median serum VD level was 25.0 ng/mL (19.3% VD deficiency). Then, VD supplementation was adjusted to 400-1,200 UI daily in 98.8% (n = 169) of patients. During the pandemic, the median VD level decreased to 22.5 ng/mL (43.3% VD deficiency). Hence, the supplementation was readjusted, and after the pandemic, the level was 28.7 ng/mL (18.7% VD deficiency), indicating a statistically significant increase in serum VD levels from the prepandemic period (p = 0.007). Conclusion: Decreased serum VD levels and increased VD deficiency frequency were observed in patients with CKD during the COVID-19 but improved after readjustment of supplementation.

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Introduction: Cervical cancer is a worldwide health problem due to the number of deaths caused by this neoplasm. In particular, in 2020, 30,000 deaths of this type of tumor were reported in Latin America. Treatments used to manage patients diagnosed in the early stages have excellent results as measured by different clinical outcomes. Existing first-line treatments are not enough to avoid cancer recurrence, progression, or metastasis in locally advanced and advanced stages. Therefore, there is a need to continue with the proposal of new therapies. Drug repositioning is a strategy to explore known medicines as treatments for other diseases. In this scenario, drugs used in other pathologies that have antitumor activity, such as metformin and sodium oxamate, are analyzed. Methods: In this research, we combined the drugs metformin and sodium oxamate with doxorubicin (named triple therapy or TT) based on their mechanism of action and previous investigation of our group against three CC cell lines. Results: Through flow cytometry, Western blot, and protein microarray experiments, we found TT-induced apoptosis on HeLa, CaSki, and SiHa through the caspase 3 intrinsic pathway, including the critical proapoptotic proteins BAD, BAX, cytochrome-C, and p21. In addition, mTOR and S6K phosphorylated proteins were inhibited in the three cell lines. Also, we show an anti-migratory activity of the TT, suggesting other targets of the drug combination in the late CC stages. Discussion: These results, together with our former studies, conclude that TT inhibits the mTOR pathway leading to cell death by apoptosis. Our work provides new evidence of TT against cervical cancer as a promising antineoplastic therapy.

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In 2013, recognizing that Colorectal Cancer (CRC) is the second leading cause of death by cancer worldwide and that it was a neglected disease increasing rapidly in Mexico, the community of researchers at the Biomedicine Research Unit of the Facultad de Estudios Superiores Iztacala from the Universidad Nacional Autónoma de México (UNAM) established an intramural consortium that involves a multidisciplinary group of researchers, technicians, and postgraduate students to contribute to the understanding of this pathology in Mexico. This article is about the work developed by the Mexican Colorectal Cancer Research Consortium (MEX-CCRC): how the Consortium was created, its members, and its short- and long-term goals. Moreover, it is a narrative of the accomplishments of this project. Finally, we reflect on possible strategies against CRC in Mexico and contrast all the data presented with another international strategy to prevent and treat CRC. We believe that the Consortium's characteristics must be maintained to initiate a national strategy, and the reported data could be useful to establish future collaborations with other countries in Latin America and the world.

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PURPOSE: To analyze antibiotic resistance and genetic profile of conjunctival bacteria flora before and after cataract surgery with the focus on coagulase-negative staphylococci (CNS) during cataract surgery and discuss the implications of this colonization as a potential risk of acquiring endophthalmitis. METHODS: After approval of the institutional review board and informed consent from patients had been obtained, conjunctival swabs for culture from 59 patients undergoing cataract surgery were taken of the fellow eye at baseline (C0) and from the eye to be operated before (T0) and after (T1) irrigation with povine-iodine 5%, and at the end of surgery (T2). Genes responsible for virulence (mecA, ica and atlE) and antibiotic profile were determined; strain clonality of persistent colonizing Staphylococcus epidermidis strains was established by the Multi-locus sequence typing (MLST). RESULTS: The frequency of CNS was significantly reduced in T1 (13.6%) from 81.4% in T0 and 86.4% in C0. The frequency of mecA, ica and atlE genes was 34.4%, 37.5% and 61.4%, respectively; and methicillin phenotypic resistance was 35.4%. S. epidermidis was the most frequent species isolated in every time point. MLST revealed in 7 patients 100% coincidence of the seven alleles of the S. epidermidis isolated previous to povine-iodine 5% disinfection and at the end of the surgery. CNS isolates from T1 or T2 corresponded to the same species, antibiotic and virulence profile as those isolates from C0 or T0. CONCLUSION: Povidone-iodine 5% prophylaxis before surgery significantly reduced conjunctival contamination; in those that persisted, the source of contamination was mostly the patient's microbiota confirmed by the MLST system.

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Introducción. Las disfunciones sexuales femeninas son altamente prevalentes a lo largo de la vida, sin embargo, no son de fácil abordaje para los profesionales de salud. Los aspectos físicos de las disfunciones sexuales y su tratamiento, frecuentemente son subvalorados, porque la evidencia sobre la terapia física en estas disfunciones es limitada. Lo que genera que sean parcialmente tratadas y su sintomatología se pueda mantener y/o aumentar en el tiempo, impactando en la función sexual y en la calidad de vida. Objetivo. Revisar la literatura disponible sobre la terapia física en disfunciones sexuales femeninas y establecer su efectividad. Metodología. Se realizaron búsquedas bibliográficas, entre los años 2012 y 2022 en inglés y portugués, disponibles en diferentes bases de datos como; Pubmed, Scielo, Cochrane, Pedro y en Google Scholar. Se incluyeron los registros que hicieran referencia a la terapia física en las disfunciones sexuales femeninas y que cumplieran con nuestros criterios de inclusión y exclusión. Resultados. Se incluyeron 8 registros en la síntesis cualitativa. Se identificaron 3 modalidades: herramientas de terapia física, valoración de la función sexual y del dolor. Conclusión. La terapia física demuestra ser efectiva para el tratamiento de las disfunciones sexuales femeninas. La evidencia disponible que demuestre su uso y efectividad aún es escasa, lo que limita su difusión para ser considerada en el abordaje multidisciplinario habitual. Se requiere aumentar la investigación en esta área, enfocada en el rol de la terapia física y sus modalidades terapéuticas, en el tratamiento de las disfunciones sexuales femeninas.

Background. Female sexual dysfunction is highly prevail throughout our life, nevertheless, they are not easily addressed by health professionals. The physical aspects of sexual dysfunctions and their treatment are frequently undervalued because the evidence about physical therapy in these dysfunctions is limited. What causes them to be partly treated and their symptoms can be maintained and/or increased over time and having an impact on sexual function and quality of life. Objetive. To review through literature about physical therapy in female sexual dysfunction and to establish its effectiveness. Methods. Through 2012 and 2012 it was carried out bibliographic searches in English and Portuguese, available in different databases, such as Pubmed, Scielo, Cochrane, Pedro and Google Scholar. Records referring to physical therapy in female sexual dysfunction and that fulfill our requirements of inclusion and exclusion criteria were included. Results. Eight records were included in the qualitative synthesis. Three modalities were identified: physical therapy tools, assessment of sexual function and pain. Conclusion. Physical therapy proves to be effective for the treatment of female sexual dysfunctions. The available evidence that demonstrates its use and effectiveness is still scarce, which limits its diffusion to be considered in the regular multidisciplinary approach. More researches are demand in this area, focused on the role of physical therapy and its therapeutic modalities, in the treatment of female sexual dysfunctions.

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Pregnancy makes women more susceptible to infectious agents; however, available data on the effect of SARS-CoV-2 on pregnant women are limited. To date, inflammatory responses and changes in serum metal concentration have been reported in COVID-19 patients, but few associations between metal ions and cytokines have been described. The aim of this study was to evaluate correlations between inflammatory markers and serum metal ions in third-trimester pregnant women with varying COVID-19 disease severity. Patients with severe symptoms had increased concentrations of serum magnesium, copper, and calcium ions and decreased concentrations of iron, zinc, and sodium ions. Potassium ions were unaffected. Pro-inflammatory cytokines IL-6, TNF-α, IL-8, IL-1α, anti-inflammatory cytokine IL-4, and the IP-10 chemokine were induced in the severe presentation of COVID-19 during pregnancy. Robust negative correlations between iron/magnesium and zinc/IL-6, and a positive correlation between copper/IP-10 were observed in pregnant women with the severe form of the disease. Thus, coordinated alterations of serum metal ions and inflammatory markers - suggestive of underlying pathophysiological interactions-occur during SARS-CoV-2 infection in pregnancy.

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INTRODUCTION: Little is known about how people with haemophilia (PWH) perceive and assess the usefulness, safety and effectiveness of telerehabilitation. OBJECTIVE: To describe usefulness, safety, effectiveness and limitations of a telerehabilitation program applied in people with severe haemophilia implemented during the COVID-19 pandemic in Chile. DESIGN AND METHODS: A qualitative study was conducted based on a focus group. Four analytical categories were predefined, three of which involved elements of Donabedian's model for quality assessment in health care (structure, process and results). RESULTS: One of the most important aspects according to all of the participants is the sense of safety they experienced while being taken care of by a physiotherapist specializing in PWH rehabilitation. This facilitated trust in the professional and adherence to treatment. All participants reported improvements in their physical condition and sense of well-being. The lack of adequate equipment at home, the limited length of the sessions, the perception that the physiotherapist may not be able to perform an appropriate physical examination and the lack of direct supervision were described as disadvantages. CONCLUSIONS: The findings underscored that telerehabilitation had high satisfaction among PWH. Telerehabilitation was perceived by PWH as a safe and effective intervention to improve physical condition. Telerehabilitation could be further supported and improved, and coverage could be enhanced, including rural and remote areas, which suffer from chronic inequalities in access to rehabilitation. The lack of face-to-face supervision and physical examination were perceived as the principal disadvantages. These results may help to improve telerehabilitation programs in PWH elsewhere.

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BACKGROUND: Women's pain is still poorly understood. Moreover, maladaptive pain beliefs contribute to the disability associated with low back pain and play a key role in the transition from acute to chronic symptoms. OBJECTIVES: To explore the beliefs of women with non-specific chronic low back pain in terms of nature of symptoms, fears associated with pain, expectations for recovery, family, social and work-related limitations, and perceived self-efficacy. DESIGN AND METHODS: A qualitative study with an interpretative approach was undertaken. Face-to-face, semi-structured individual interviews were performed. Study participants were 10 women with non-specific chronic low back pain living in the Metropolitan Region of Chile. Thematic analysis was used to analyze the data. A deductive process was used to code the text and categorize the data. RESULTS: Participants described maladaptive beliefs about pain, leading to fearful attitudes and low expectations for recovery. These beliefs seemed to perpetuate pain and limit engagement in daily tasks and meaningful activities. Some of these beliefs were associated with information provided by healthcare professions. Despite having maladaptive beliefs, women perceived themselves as self-effective. CONCLUSION: Women with chronic low back pain described a range of different pain beliefs across a complex categorial structure. The contents of such structure may interfere with their decisions about therapeutic options. Their beliefs were often ungrounded in scientific principles, even if the information may have been provided by healthcare providers. Physical therapists would benefit from these findings to improve communication with their patients and assess the role of beliefs in decision-making.

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Las metodologías cualitativas de investigación están siendo cada vez más utilizadas en el ámbito de la salud. Estas metodologías son útiles cuando se quiere estudiar fenómenos sociales complejos que difícilmente pueden ser estudiados mediante técnicas estadísticas o cuantitativas. Para llevar a cabo estudios cualitativos de buena calidad es necesario que los investigadores/as tengan sólidos conocimientos de la metodología y de los enfoques teóricos-metodológicos que la sustentan. Estos enfoques reflejan un posicionamiento teórico-filosófico acerca de la construcción de los fenómenos sociales y posee un cuerpo de conocimientos y procedimientos propios. Los enfoques teórico-metodológicos más utilizados en las investigaciones cualitativas en salud son la etnografía, la fenomenología y la teoría fundamentada. La recomendación es fortalecer la formación metodológica de los investigadores/as cualitativos, aumentar el rigor de los procesos investigativos y procurar la coherencia epistemológica de los estudios a través de la elección adecuada del enfoque teórico-metodológico.

Qualitative research methodologies are being increasingly used in the field of health. These methodologies are useful when you want to study complex social phenomena that can hardly be studied using statistical or quantitative techniques. To carry out qualitative studies of good quality, it is necessary for the researchers to have solid knowledge of the methodology and of the theoretical-methodological approaches that support it. These approaches reflect a theoretical-philosophical position on the construction of social phenomena and have a body of knowledge and procedures of their own. The most widely used theoretical-methodological approaches in qualitative health research are ethnography, phenomenology, and grounded theory. The recommendation is to strengthen the methodological training of qualitative researchers, increase the rigor of the investigative processes and ensure the epistemological coherence of the studies through the appropriate choice of the theoretical-methodological approach.

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BACKGROUND: Deaths in the intensive care unit (ICU) represent an experience of suffering for patients, their families, and professionals. End-of-life (EOL) care has been added to the responsibilities of the ICU team, but the evidence supporting EOL care is scarce, and there are many barriers to implementing the clinical recommendations that do exist. OBJECTIVES: To explore the experiences and perspectives of the various members of an ICU care team in Chile regarding the EOL care of their patients. METHODS: A qualitative study was performed in the ICU of a high-complexity academic urban hospital. The study used purposive sampling with focus groups as a data collection method. A narrative analysis based on grounded theory was done. RESULTS: Four discipline-specific focus groups were conducted; participants included 8 nurses, 6 nursing assistants, 8 junior physicians, and 6 senior physicians. The main themes that emerged in the analysis were emotional impact and barriers to carrying out EOL care. The main barriers identified were cultural difficulties related to decision-making, lack of interprofessional clinical practice, and lack of effective communication. Communication difficulties within the team were described along with lack of self-efficacy for family-centered communication. CONCLUSION: These qualitative findings expose gaps in care that must be filled to achieve high-quality EOL care in the ICU. Significant emotional impact, barriers related to EOL decision-making, limited interprofessional clinical practice, and communication difficulties were the main findings cross-referenced.

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BACKGROUND: Adenosine is a natural nucleoside present in a variety of organs and tissues, where it acts as a modulator of diverse physiological and pathophysiological processes. These actions are mediated by at least four G protein-coupled receptors, which are widely and differentially expressed in tissues. Interestingly, high concentrations of adenosine have been reported in a variety of tumors. In this context, the final output of adenosine in tumorigenesis will likely depend on the constellation of adenosine receptors expressed by tumor and stromal cells. Notably, activation of the A3 receptor can reduce the proliferative capacity of various cancer cells. OBJECTIVE: This study aimed to describe the anti-proliferative effects of two previously synthesized adenosine derivatives with A3 agonist action (compounds 2b and 2f) through in vitro assays. METHODS: We used gastric and breast cancer cell lines expressing the A3 receptor as in vitro models and theoretical experiments for molecular dynamics and determination of ADME properties. RESULTS: The antiproliferative effects of adenosine derivatives (after determining IC50 values) were comparable or even higher than those described for IB-MECA, a commercially available A3 agonist. Among possible mechanisms involved, apoptosis was found to be induced in MCF-7 cells but not in AGS or MDA-MB-231 cells. Surprisingly, we were unable to observe cellular senescence induction upon treatment with compounds 2b and 2f in any of the cell lines studied, although we cannot rule out other forms of cell cycles exit at this point. CONCLUSION: Both adenosine derivatives showed antiproliferative effects on gastric and breast cancer cell lines, and were able to induce apoptosis, at least in the MCF-7 cell line. Further studies will be necessary to unveil receptor specificity and mechanisms accounting for the antiproliferative properties of these novel semi-synthetic compounds.

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In the automatic diagnosis of ocular toxoplasmosis (OT), Deep Learning (DL) has arisen as a powerful and promising approach for diagnosis. However, despite the good performance of the models, decision rules should be interpretable to elicit trust from the medical community. Therefore, the development of an evaluation methodology to assess DL models based on interpretability methods is a challenging task that is necessary to extend the use of AI among clinicians. In this work, we propose a novel methodology to quantify the similarity between the decision rules used by a DL model and an ophthalmologist, based on the assumption that doctors are more likely to trust a prediction that was based on decision rules they can understand. Given an eye fundus image with OT, the proposed methodology compares the segmentation mask of OT lesions labeled by an ophthalmologist with the attribution matrix produced by interpretability methods. Furthermore, an open dataset that includes the eye fundus images and the segmentation masks is shared with the community. The proposal was tested on three different DL architectures. The results suggest that complex models tend to perform worse in terms of likelihood to be trusted while achieving better results in sensitivity and specificity.

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INTRODUCTION AND OBJECTIVE: The weight gained during pregnancy could determine the immediate and future health of the mother-child dyad. Excessive gestational weight gain (EGWG) due to abnormal adipose tissue (AT) accumulation is strongly associated with adverse perinatal outcomes as gestational diabetes, macrosomia, obesity, and hypertension further in life. Dysregulation of adipokine, AT dysfunction, and an imbalance in the prooxidant-antioxidant systems are critical features in altered AT accumulation. This study was aimed to investigate the association between adipokines and oxidative stress markers in pregnant women and the influence of the GWG on this association. METHODS: Maternal blood samples were obtained in the third trimester of pregnancy (n = 74) and serum adipokines (adiponectin, leptin, and resistin), oxidative damage markers: 8-oxo-2'-deoxyguanosine (8-oxodG), lipohydroperoxides (LOOH), malondialdehyde (MDA), and carbonylated proteins (CP), and glucose a metabolic marker were measured. RESULTS: Women with EGWG had low adiponectin levels than women with adequate weight gain (AWG) or insufficient weight gain (IWG). Multiple linear regression models revealed a positive association between adiponectin and 8-oxodG in women with AWG (B = 1.09, 95% CI: 164-222, p = 0.027) and IWG (B = 0.860, 95% CI: 0.199-1.52, p = 0.013) but not in women with EGWG. In women with EGWG, leptin was positively associated with LOOH (p = 0.018), MDA (p = 0.005), and CP (p = 0.010) oxidative markers. CONCLUSION: Our findings suggest that concurrent mechanisms regulate adipokine production and oxidative stress in pregnant women and that this regulation is influenced by GWG, probably due to an excessive AT accumulation.

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Ocular toxoplasmosis (OT) is commonly diagnosed through the analysis of fundus images of the eye by a specialist. Despite Deep Learning being widely used to process and recognize pathologies in medical images, the diagnosis of ocular toxoplasmosis(OT) has not yet received much attention. A predictive computational model is a valuable time-saving option if used as a support tool for the diagnosis of OT. It could also help diagnose atypical cases, being particularly useful for ophthalmologists who have less experience. In this work, we propose the use of a deep learning model to perform automatic diagnosis of ocular toxoplasmosis from images of the eye fundus. A pretrained residual neural network is fine-tuned on a dataset of samples collected at the medical center of Hospital de Clínicas in Asunción, Paraguay. With sensitivity and specificity rates equal to 94% and 93%,respectively, the results show that the proposed model is highly promising. In order to replicate the results and advance further in this area of research, an open data set of images of the eye fundus labeled by ophthalmologists is made available.

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Colorectal cancer (CRC) is among the top three most deadly cancers worldwide. The survival rate for this disease has not been reduced despite the treatments, the reason why the search for therapeutic alternatives continues to be a priority issue in oncology. In this research work, we tested our successful pharmacological combination of three drugs, metformin, doxorubicin, and sodium oxamate (triple therapy, or TT), as an autophagy inducer. Firstly, we employed western blot (WB) assays, where we observed that after 8 h of stimulation with TT, the proteins Unc-51 like autophagy activating kinase 1(ULK1), becline-1, autophagy related 1 protein (Atg4), and LC3 increased in the CRC cell lines HCT116 and SW480 in contrast to monotherapy with doxorubicin. The overexpression of these proteins indicated the beginning of autophagy flow through the activation of ULK1 and the hyperlipidation of LC3 at the beginning of this process. Moreover, we confirm that ULK1 is a bona fide target of hsa-miR-106a-5p (referred to from here on as miR-106a) in HCT116. We also observed through the GFP-LC3 fusion protein that in the presence of miR-106a, the accumulation of autophagy vesicles in cells stimulated with TT is inhibited. These results show that the TT triggered autophagy to modulate miR-106a/ULK1 expression, probably affecting different cellular pathways involved in cellular proliferation, survivance, metabolic maintenance, and cell death. Therefore, considering the importance of autophagy in cancer biology, the study of miRNAs that regulate autophagy in cancer will allow a better understanding of malignant tumors and lead to the development of new disease markers and therapeutic strategies.

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INTRODUCCIÓN: La rehabilitación basada en la comunidad (RBC) busca mejorar el acceso a la rehabilitación y la inclusión social de las personas con discapacidad. Los escasos estudios realizados muestran experiencias heterogéneas en su implementación. El objetivo de este estudio fue describir las experiencias y percepciones sobre RBC de profesionales sanitarios, personas con discapacidad y familiares participantes en centros de atención primaria de la Región Metropolitana de Chile. MÉTODOS: Se realizó un estudio cualitativo exploratorio-descriptivo. A través de un muestreo de caso típico se seleccionaron profesionales sanitarios, hombres y mujeres con discapacidad física y familiares. Se desarrollaron 16 entrevistas grupales semiestructuradas, 4 por cada grupo. Se realizó análisis de contenido semántico mediante codificación inductiva y deductiva. RESULTADOS: La RBC es valorada positivamente por las personas con discapacidad y familiares. Sin embargo, los profesionales consideran que es insuficiente para lograr la inclusión social. DISCUSIÓN: Existen barreras y facilitadores para la implementación de la RBC. Su ubicación en la Atención Primaria permite flexibilidad en la atención. No obstante, se centra en intervenciones de rehabilitación física, relegando la salud integral y el trabajo intersectorial a un segundo plano. Se requiere capacitar a los equipos sanitarios para proveer una rehabilitación integral, que contribuya a la inclusión social de las personas con discapacidad

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Resumen Este estudio busca describir experiencias y percepciones sobre discapacidad y participación social de personas con discapacidad y profesionales sanitarios de centros de rehabilitación comunitaria de la Región Metropolitana de Chile. Se realizó un estudio cualitativo con muestreo teórico de actores claves en cuatro centros. Se realizaron 16 grupos focales y análisis de contenido semántico. Las experiencias de personas con discapacidad son diversas, existen elementos comunes como la homologación de la dependencia con la discapacidad y el reconocimiento de barreras sociales. Las percepciones sobre discapacidad representan los modelos individual y social, esto último se evidencia en las injusticias y discriminaciones. La participación social es intensa y afectiva en el centro de salud, sin embargo, otros espacios de participación son escasos. Las concepciones sobre discapacidad y niveles de participación señalan la necesidad de más lineamientos, capacitación y recursos para la efectiva implementación de la rehabilitación comunitaria.

Abstract This study seeks to describe experiences and perceptions about disability and social participation of people with disabilities and professionals who are part of community rehabilitation centers in the Metropolitan Region of Chile. A qualitative study was carried out with a theoretical sampling of key actors from 4 community rehabilitation centers. 16 focus groups were conducted and a semantic content analysis was applied. The experiences of people with disabilities are diverse, there are common elements such as dependency made equivalent to disability and recognition of social barriers. Perceptions of disability represent individual and social models. The latter appears when injustices and discrimination are experienced. Social participation linked to the center is intense and affective. However, other participation spaces are scarce. The concepts of disability and levels of social participation show the need for more guidelines, training and resources for an effective implementation of community rehabilitation.

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