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The increase in the frequency and severity of global wildfires has been largely influenced by climate change and land use changes. From February 2 to 6, 2024, central Chile experienced its most devastating wildland-urban interface wildfire in history, severely impacting the Valparaíso region. This catastrophic event, which led to extensive forest destruction, the loss of thousands of homes, and over a hundred human fatalities, directly impacted the area surrounding the campus of Federico Santa María Technical University. In that period, an air quality monitoring campaign was set up on the campus to measure black carbon (BC) and particulate matter (PM) during the wildfire season. The monitoring station was located directly within the smoke plume, allowing for the collection of unprecedented air quality data. Extremely high concentrations of BC at 880 nm were reported during the wildfires, with a daily mean (±σ) of 14.83 ± 19.52 µg m-3. Peak concentrations measured at 880 nm and 375 nm reached 812.89 µg m-3 and 1561.24 µg m-3, respectively. The maximum daily mean BC concentrations at these wavelengths were 55 and 99 times higher, respectively, compared to the pre-event period. The mean Ångström absorbing coefficient during the event was 1.66, indicating biomass burning as the primary BC source, while the maximum BC/PM2.5 ratio (at 375 nm) reached 57 %. From February 2 to 5, 2024, PM concentrations exceeded the Chilean air quality standard by 82 % and 198 % for coarse and fine particles, respectively. These levels are 4.7 and 6.0 times higher than the World Health Organization's recommendations. These elevated concentrations persisted for up to three days after the fire was extinguished. This study provides unique evidence of the rapid deterioration of regional air quality during a wildfire event using in situ measurements, serving as a stark reminder of the far-reaching consequences of a warming climate.

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The Latin American Brain Health Institute (BrainLat) has released a unique multimodal neuroimaging dataset of 780 participants from Latin American. The dataset includes 530 patients with neurodegenerative diseases such as Alzheimer's disease (AD), behavioral variant frontotemporal dementia (bvFTD), multiple sclerosis (MS), Parkinson's disease (PD), and 250 healthy controls (HCs). This dataset (62.7 ± 9.5 years, age range 21-89 years) was collected through a multicentric effort across five Latin American countries to address the need for affordable, scalable, and available biomarkers in regions with larger inequities. The BrainLat is the first regional collection of clinical and cognitive assessments, anatomical magnetic resonance imaging (MRI), resting-state functional MRI (fMRI), diffusion-weighted MRI (DWI), and high density resting-state electroencephalography (EEG) in dementia patients. In addition, it includes demographic information about harmonized recruitment and assessment protocols. The dataset is publicly available to encourage further research and development of tools and health applications for neurodegeneration based on multimodal neuroimaging, promoting the assessment of regional variability and inclusion of underrepresented participants in research.

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Introdução: O uso de cigarros eletrônicos (CE) tem aumentado, mas sem um estudo aprofundado sobre seus efeitos na saúde cardiovascular e pulmonar. Uma pergunta norteadora foi elaborada: Os cigarros eletrônicos causam acometimentos cardiovasculares e pulmonares? Esta revisão de escopo pontua a existência dos acometimentos cardiovasculares e pulmonares causados pelo uso de cigarros eletrônicos. Metodologia: Bancos de dados: MEDLINE-Pubmed, LILACS e Web of Science. Descritores: "Electronic Nicotine Delivery System", "E-Cigarette Vapor", "COPD", "Lung Neoplasms", "Myocardial Infarction" e "Pneumonia". Primeira busca: 28 artigos. Critérios de Exclusão: artigos que não se encaixam na classificação de estudos primários e estudos duplicados. Busca final: 6 artigos, descritos na íntegra. Resultados: Dos artigos encontrados: 83,3% (EUA); 16,7% (Coreia do Sul); 16,7% estudo transversal; 16,7% estudo longitudinal; 33,3% ensaio clínico randomizado com pessoas; 33,3% estudos de coorte. Discussão: Os artigos demonstraram que o CE pode estar associado a acometimentos cardiovasculares, como infarto e acidente vascular, apesar de não ser tão influente quando comparado ao cigarro tradicional. Quanto aos acometimentos pulmonares, não houve consenso entre os dados dos artigos pesquisados. Conclusão: Faz-se necessária a realização de mais pesquisas sobre o tema, devido a divergência entre os dados presentes na literatura.

Introduction: The use of electronic cigarettes (EC) has increased, but without an in-depth study on their effects on cardiovascular and pulmonary health. A guiding question was formulated: Do electronic cigarettes cause cardiovascular and pulmonary disorders? This scoping review points out the existence of cardiovascular and pulmonary disorders caused by the use of electronic cigarettes. Methodology: Databases: MEDLINE-Pubmed, LILACS and Web of Science. Descriptors: "Electronic Nicotine Delivery System", "E-Cigarette Vapor", "COPD", "Lung Neoplasms", "Myocardial Infarction" and "Pneumonia". First search: 28 articles. Exclusion Criteria: articles that do not fit into the classification of primary studies and duplicated studies. Final search: 6 articles, described in full. Results: Of the articles found: 83.3% (USA); 16.7% (South Korea); 16.7% cross-sectional study; 16.7% longitudinal study; 33.3% randomized clinical trial with people; 33.3% cohort studies. Discussion: The articles showed that the EC may be associated with cardiovascular disorders, such as infarction and stroke, although it is not as influential when compared to traditional cigarettes. As for pulmonary disorders, there was no consensus among the data from the researched articles. Conclusion: More research on the topic is necessary, due to the divergence between the presented data in the literature.

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Glaciers in Chilean Central Andes have significatively retreated, at least, in the last 60 years. From 2004 to 2014, the largest retreat in the area (-0.15 km2 yr-1) was observed at Olivares Alpha Glacier (OAG). Previous glacier fluctuation studies proposed that two open-pit mines distant 7 km from the glacier could be the cause of its enhanced retreat. However, this had not been yet tested due to the lack of measured data. Here, we investigated the impact that major air pollutants emitted by local mining activities could have on the differences observed in OAG glacial retreat compared with a glacier of similar size and altitude with no nearby anthropogenic sources: Bello Glacier (BG), which has a reported lower retreat (-0.02 km2 yr-1). Results revealed a link between anthropogenic air pollutants and glacial retreat rates, meaning that glacial retreat is decoupled from climatic and glaciological factors. Considering that both glaciers are located in the same climatic setting, the anthropogenic air pollutants deposited onto the OAG surface appear to be forcing positive feedback in which the pollutants deposition best explain the differences in the glacier retreat. With the results of this study, it has been calculated that the impact of mining in OAG could be responsible for 82% of its total retreat since between 2004 and 2014, and only the remaining 18% would correspond to the impact of climate change.

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As with many other trophic interactions, the interchange of microorganisms between plants and their herbivorous insects is unavoidable. To test the hypothesis that the composition and diversity of the insect bacteriome are driven by the bacteriome of the plant, the bacteriomes of both the plant Datura inoxia and its specialist insect Lema daturaphila were characterised using 16S sRNA gene amplicon sequencing. Specifically, the bacteriomes associated with seeds, leaves, eggs, guts, and frass were described and compared. Then, the functions of the most abundant bacterial lineages found in the samples were inferred. Finally, the patterns of co-abundance among both bacteriomes were determined following a multilayer network approach. In accordance with our hypothesis, most genera were shared between plants and insects, but their abundances differed significantly within the samples collected. In the insect tissues, the most abundant genera were Pseudomonas (24.64%) in the eggs, Serratia (88.46%) in the gut, and Pseudomonas (36.27%) in the frass. In contrast, the most abundant ones in the plant were Serratia (40%) in seeds, Serratia (67%) in foliar endophytes, and Hymenobacter (12.85%) in foliar epiphytes. Indeed, PERMANOVA analysis showed that the composition of the bacteriomes was clustered by sample type (F = 9.36, p < 0.001). Functional inferences relevant to the interaction showed that in the plant samples, the category of Biosynthesis of secondary metabolites was significantly abundant (1.4%). In turn, the category of Xenobiotics degradation and metabolism was significantly present (2.5%) in the insect samples. Finally, the phyla Proteobacteria and Actinobacteriota showed a pattern of co-abundance in the insect but not in the plant, suggesting that the co-abundance and not the presence−absence patterns might be more important when studying ecological interactions.

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BC can be transported through the atmosphere from low and mid-latitudes to Antarctica, or it can be emitted in the Antarctica in situ. To establish a possible relationship between BC and the human activities in Antarctica, shallow snow samples were taken in four sites from Antarctic peninsula during summer periods (2014-2019): Chilean Base O'Higgins (BO), La Paloma Glacier (LP) (6 km away from BO); Chilean Base Yelcho (BY) and P4 (5 km away from BY). BC concentration in snow samples was determined by using a novel methodology recently developed, published and patented by the authors. The methodology consisted in a filter-based optical transmission method at a wavelength of 880 nm. Results showed that snow from BO presented the highest BC concentration (3395.7 µg kg-1), followed by BY (1309.2 µg kg-1), LP 2016 (745.9 µg kg-1), LP 2015 (233.6 µg kg-1) and finally P4 (179.4 µg kg-1). BC values observed in Antarctic snow were higher than others previously reported in the literature and showed the influence of anthropic activities in the study area, considering that the two highest values of BC concentration in snow were found at sites near the bases. To evaluate the impact of the BC concentrations found in the snow of the study area, snow albedo modeling was performed, using the on-line version of the "Snow, Ice, and Aerosol Radiative" (SNICAR) Model. Modeling outputs exposed that the measured variations in BC content caused large differences in the modeled albedo in the visible range of the spectra, which showed to be more sensitive at lower BC concentrations. These data could help to understand the role of BC in the actual scenario of climate change, in which Antarctica is presented as a very fragile environment that needs to be protected, starting with the management of the activities developed in-situ.

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Cone Beam Computed Tomography (CBCT) has modified the perspective of dentistry images, providing manipulable threedimensional images with a 1:1 patient:image ratio. Treatments and diagnosis are modified or corroborated by CBCT; however, its accuracy in thin structures such as cortical bone has been subjected to critical review. The aim of this study is to correlate the measurement of vestibular alveolar bone height using direct measurements and measurements performed with cone-beam tomographic images with standard (SD) voxel resolution. Thirty incisor and premolar teeth of patients undergoing open curettage were measured with a high-precision caliper and with Cone Beam Computed Tomography (CBCT) at an SD resolution of 0.16 mm voxels in a 3D Orthophos XG Sirona scanner. Intra-observer evaluation was performed using the intraclass correlation coefficient (ICC). Direct measurements and CBCT measurements were correlated using Pearson correlation (PCC). The mean difference between indirect and direct measurements was 3.15 mm. Paired t test and Pearson Correlation coefficient determined that all measurements differed statistically from each other with p<0.05. With the CT scanner and protocol used in this study, CBCT images do not enable accurate evaluation of vestibular alveolar bone height.

La tomografía de haz cónico (CBCT) ha modificado la perspectiva de la imagenología en odontología que brinda una imagen tridimensional manipulable con una relación 1:1, paciente: imagen. Los tratamientos y diagnósticos se ven modificados o corroborados por el CBCT; sin embargo, la exactitud que presenta en estructuras delgadas como las corticales óseas ha sido sometida a críticas. El objetivo fue correlacionar la medición de la altura del hueso alveolar vestibular mediante mediciones directas y las realizadas con imágenes tomográficas de haz cónico con resolución de vóxel estándar (SD). Treinta dientes incisivos y premolares de pacientes sometidos a un curetaje abierto se midieron con un calibrador de alta precisión y una tomografía computarizada de haz cónico (CBCT) a una resolución SD de 0,16 mm de vóxeles en un escáner 3D Orthophos XG Sirona. La evaluación intraobservador se realizó utilizando el coeficiente de correlación intraclase (ICC), y las mediciones directas y las mediciones CBCT se correlacionaron utilizando la correlación de Pearson (PCC). La diferencia media entre las mediciones indirectas y directas fue de 3,15 mm. La prueba t pareada y el Coeficiente de Correlación de Pearson determinaron que todas las mediciones fueron estadísticamente diferentes entre sí con una p <0.05. Con el escáner de TC y el protocolo utilizado en este estudio, las imágenes CBCT no permiten una evaluación precisa de la altura del hueso alveolar vestibular.

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ABSTRACT Cone Beam Computed Tomography (CBCT) has modified the perspective of dentistry images, providing manipulable threedimensional images with a 1:1 patient:image ratio. Treatments and diagnosis are modified or corroborated by CBCT; however, its accuracy in thin structures such as cortical bone has been subjected to critical review. The aim of this study is to correlate the measurement of vestibular alveolar bone height using direct measurements and measurements performed with conebeam tomographic images with standard (SD) voxel resolution. Thirty incisor and premolar teeth of patients undergoing open curettage were measured with a highprecision caliper and with Cone Beam Computed Tomography (CBCT) at an SD resolution of 0.16 mm voxels in a 3D Orthophos XG Sirona scanner. Intraobserver evaluation was performed using the intraclass correlation coefficient (ICC). Direct measurements and CBCT measurements were correlated using Pearson correlation (PCC). The mean difference between indirect and direct measurements was 3.15 mm. Paired t test and Pearson Correlation coefficient determined that all measurements differed statistically from each other with p<0.05. With the CT scanner and protocol used in this study, CBCT images do not enable accurate evaluation of vestibular alveolar bone height.

RESUMEN La tomografía de haz cónico (CBCT) ha modificado la perspectiva de la imagenología en odontología que brinda una imagen tridimensional manipulable con una relación 1:1, paciente: imagen. Los tratamientos y diagnósticos se ven modificados o corroborados por el CBCT; sin embargo, la exactitud que presenta en estructuras delgadas como las corticales óseas ha sido sometida a críticas. El objetivo fue correlacionar la medición de la altura del hueso alveolar vestibular mediante mediciones directas y las realizadas con imágenes tomográficas de haz cónico con resolución de vóxel estándar (SD). Treinta dientes incisivos y premolares de pacientes sometidos a un curetaje abierto se midieron con un calibrador de alta precisión y una tomografía computarizada de haz cónico (CBCT) a una resolución SD de 0,16 mm de vóxeles en un escáner 3D Orthophos XG Sirona. La evaluación intraobservador se realizó utilizando el coeficiente de correlación intraclase (ICC), y las mediciones directas y las mediciones CBCT se correlacionaron utilizando la correlación de Pearson (PCC). La diferencia media entre las mediciones indirectas y directas fue de 3,15 mm. La prueba t pareada y el Coeficiente de Correlación de Pearson determinaron que todas las mediciones fueron estadísticamente diferentes entre sí con una p <0.05. Con el escáner de TC y el protocolo utilizado en este estudio, las imágenes CBCT no permiten una evaluación precisa de la altura del hueso alveolar vestibular.

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Polycyclic aromatic hydrocarbons, PM2.5 and micrometer-sized particles are mainly emitted by residential wood combustion, affecting air pollution in the cities of Chile. Eucalyptus globulus (EG) at 0% and 25% wood moisture was burning using a new controlled combustion chamber for emissions (3CE) to determine the emission factors of PM2.5, micrometer-sized particle numbers (0.265µm to 34.00µm) and 16 EPA-PAHs plus retene adsorbed on PM2.5 quartz filters. A method using accelerated solvent extraction, concentration, clean-up and GC-MS is proposed for determining emission factors for 16 EPA-PAHs for the concentration from biomass combustion. Chromatographic conditions and analytical steps were optimized in terms of linearity, selectivity, limits of detection and quantification, precision and accuracy. The recovery obtained from urban dust SRM 1649A (NIST reference material) analyses was between 63% (benzo[b]fluoranthene) and 102% (benzo[k]fluoranthene). In this investigation, it was shown that increasing the wood moisture in combustion tests decreased combustion efficiency (93% to 49%) and increased the emission factors of total PAHs (5215.47ngg-1 to 7644.48ngg-1), the gravimetric PM2.5 (2.01g kg-1 to 22.90gkg-1) and the total number of measured micrometer-sized particles (3.15×1012 particles kg-1 to 1.33×1013 particles kg-1) due to incomplete combustion. The PM2.5 emission rates (ERs) were estimated using EG at 0% WM (2.39g-1 to 3.15gh-1) and 25% WM (27.32gh-1 to 35.77gh-1) for three regions of Chile. In almost all regions, the Chilean emission regulations were exceeded for PM2.5 from wood combustion in the heater (stove with thermal power ≤8kW and emission limit of 2.5gh-1). Finally, when using wet wood for residential combustion, the amount of PAHs on the PM2.5 increased, presenting a potential hazard to population health. Therefore, improvements are necessary in the current regulation of PM emissions.

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In November/December 2013 a pilot experiment on aerosol/fog interaction was conducted on a coastal hill in the suburbs of Valparaíso, Chile. Passages of garúa fog were monitored with continuous recordings of a soot photometer and an optical aerosol spectrometer. An optical fog sensor and an automatic weather station provided meteorological data with which the aerosol could be classified. High-resolution back trajectories added meteorological information. From filter samples, optical and chemical aerosol information was derived. Scavenging coefficients of black carbon (BC) and measured particulate mass below 1 µm diameter (PM1) were estimated with three approaches. Averaging over all fog periods of the campaign yielded a scavenging coefficient of only 6% for BC and 40% for PM1. Dividing the data into four 90°-wind sectors gave scavenging factors for BC ranging from 13% over the Valparaíso, Viña del Mar conurbation to 50% in the marine sector (180°-270°). The third, and independent approach was achieved with two pairs of chemical aerosol samples taken inside and outside fogs, which yielded a scavenging coefficient of 25% for BC and 70% for nonseasalt sulfate. Whereas fogs occurred rather infrequently in the beginning of the campaign highly regular daily fog cycles appeared towards the end of the experiment, which allowed the calculation of typical diurnal cycles of the aerosol in relation to a fog passage.

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Relata-se neste artigo o caso de um paciente de ascendência negra com quadro agudo e progressivo de paralisia flácida ascendente, sem comprometimento de musculatura respiratória ou facial, em vigência de hipertireoidismo em tratamento e hipocalemia desencadeados por quadro infeccioso. Foi realizado o diagnóstico de paralisia periódica hipocalêmica tireotóxica e controle inicial dos sintomas por adequação sérica do potássio e posterior resolução do quadro após tratamento com iodoterapia.

It is reported in this paper the case of a black ancestry patient with acute and progressive framework ascending flaccid paralysis without impairment of respiratory and facial muscles, in effect in treatment of hyperthyroidism and hypokalemia triggered by infection. The diagnosis of thyrotoxic hypokalemic periodic paralysis was accomplished and initial symptoms were controlled for adequacy of serum potassium and subsequent resolution after treatment with radioiodine.

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This study addresses human health concerns in the city of Temuco that are attributed to wood smoke and related pollutants associated with wood burning activities that are prevalent in Temuco. Polycyclic Aromatic Hydrocarbons (PAHs) were measured in air across urban and rural sites over three seasons in Temuco using polyurethane foam (PUF) disk passive air samplers (PUF-PAS). Concentrations of ΣPAHs (15 congeners) in air ranged from BDL to ∼70 ng m(-3) and were highest during the winter season, which is attributed to emissions from residential heating by wood combustion. The results for all three seasons showed that the PAH plume was widespread across all sites including rural sites on the outskirts of Temuco. Some interesting variations were observed between seasons in the composition of PAHs, which were attributed to differences in seasonal point sources. A comparison of the PAH composition in the passive samples with active samples (gas+particle phase) from the same site revealed similar congener profiles. Overall, the study demonstrated that the PUF disk passive air sampler provides a simple approach for measuring PAHs in air and for tracking effectiveness of pollution control measures in urban areas in order to improve public health.

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Metal contents in soil samples are commonly used to evaluate contamination levels. However, the distribution of metals is dependent on particle size. We investigated the distribution of metals in various particle size fractions of the soil from four sites of the Puchuncaví Valley (Central Chile). The soil samples were segregated into size fractions ranging from 0.3 to 20µm and analyzed using inductively coupled plasma atomic emission spectrometry (ICP-AES) and inductively coupled plasma mass spectrometry (ICP-MS). The results of the statistical analysis of the total metal concentrations indicated that the soil samples from Greda and Maitenes, the sites nearest the industrial sources, are the most contaminated. For these sites, the size-fractionated samples containing higher concentrations of Cu, Zn, As, and Pb were found in the finer fractions, suggesting anthropogenic depositions from smelter facilities. In addition, a high Ca concentration was observed in the finer fractions, which could be attributed to the technological approaches used to reduce the SO2 emissions from the roasting process of copper sulfide. The mineral composition of fine particles permitted the identification of Tenorite and Calcium oxide, which are most likely associated with smelting activities, confirming emission of enriched particulate matter from the copper smelter.

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It is known that residential wood combustion (RWC) is an important source of fine particle emissions. The purpose of this work was to characterize the chemical composition of the particulate matter present in the Temuco urban atmosphere during winter, specifically the polycyclic aromatic hydrocarbon (PAH) profile, because PAHs are considered to be among the key compounds in particulate matter toxicity. During the 2008 winter monitoring campaign, samples of particulate matter with aerodynamic diameters of < or = 10 (PM10) and < or = 2.5 (PM2.5) microm were taken on days with contamination episodes. Sixteen U.S. Environmental Protection Agency (EPA) PAH compounds were extracted with toluene and determined by gas chromatography-mass spectrometry (GC-MS). The results show that phenantrene was the predominant compound associated with particulate matter at a concentration range between 300 and 600 ng m(-3), 18 times higher than the second most abundant PAH compound. High-molecular-mass compounds such as dibenz[a,h]anthracene, benzo[g,h,i]perylene, and indeno[1,2,3,c,d]pyrene were also found, but they were minorities in the set. It was recognized from the PAH concentration ratios of the Temuco atmospheric aerosol that the main contamination source was in fact residential wood combustion; although not all the concentration ratios evaluated match the reported reference values, probably due to the kind of biomass used, the characteristics of Chilean heating appliances and climate.

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Introducción: Neurocisticercosis es la infección parasitaria más frecuente del sistema nervioso central, causada por ingesta de alimentos contaminados con huevos del céstodo Taenia solium. La forma más común de presentación son crisis covulsivas. Objetivo: Realizar perfil epidemiológico y clínico de pacientes con diagnóstico de neurocisticercosis en el Hospital de Temuco, entre los años 2000-2006. Pacientes y Método: Revisión retrospectiva del 100 por ciento (n = 26) de historias clínicas de pacientes ingresados con diagnóstico de neurocisticercosis, según código de la Clasificación Internacional de Enfermedades (CIE – 10 B69.0), entre 1 de enero de 2000 y 31 de diciembre de 2006. Resultados: Media de edad al diagnóstico de 33,6 años; 65,3 por ciento de sexo masculino; 73,1 por ciento no registró apellidos de origen mapuche; 73,0 por ciento fueron procedentes de áreas urbanas. Crisis convulsivas fue el motivo de consulta más frecuente. Mediana de evolución de 30 días al momento de la consulta; 30,7 por ciento descritos como “larga data”, sin estimación exacta del tiempo evolución. El 100 por ciento fue estudiado con neuroimágenes. La mayoría presentó 2 o más lesiones y 80 por ciento de localización parenquimatosa; 30,7 por ciento requirió cirugía, indicada por hidrocefalia secundaria. No hubo pacientes fallecidos en esta serie. Conclusiones: Afecta a población activa, con predominio de sexo masculino, la mayoría sin apellidos mapuches y de procedencia urbana. Uno de cada tres pacientes consultó por crisis convulsivas. Todos nuestros pacientes fueron estudiados con neuroimágenes, que mostraron dos lesiones y de ubicación parenquimatosa en la mayoría de los casos. Un tercio requirió manejo quirúrgico, por hidrocefalia secundaria como complicación.

Introduction: Neurocysticercosis is the most common parasitic infection of the central nervous system caused from the ingestion of food that contains the Taenia solium eggs. Seizures are the most common clinical features. Aim: To establish an epidemiological-clinical profile of patients diagnosed with Neurocysticercosis in the Hospital of Temuco between the years 2000-2006. Methods and patients: Retrospective review of the 100 percent (n = 26) of clinical histories of patients diagnosed with Neurocysticercosis according to the International Classification of Diseases (CIE – 10 B69.0), between the 1st of January, 2000 and the 31th of December, 2006. Results: Average of age at diagnosis of 33,6 years old; 65,3 percent are male; 73,1 percent with no Mapudungun last names; 73,0 percent from urban areas. The principal reason of consult was seizures. Average 30-day evolution at the time of consultation; 30,7 percent were described as “long data”, without an exact estimation of the time of evolution. Within the 100 percent that was studied with neuroimaging, most of them presented two lesions and 80 percent was in the parenchyma; 30,7 percent needed surgery, in most of the cases because of hydrocephalus. Any of the patients died in this group. Conclusions: This pathology affects active population. Just a few were male, and most of them did not have Mapudungun last names or come from urban areas. One of three patients consulted because of seizures. All of the patients were studied with neuroimaging and in most cases they had two lesions and parenchymal localization. One of three patients required surgical management because of hydrocephalus.

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La neumonía grave adquirida en la comunidad (NAC) representa 10 por ciento-30 por ciento del total de esta patología. La morbilidad y la mortalidad son elevadas. Objetivo: Dilucidar factores predictores de mortalidad en NAC. A través de sus historias clínicas, se obtuvieron antecedentes de 121 pacientes (100 por ciento) que ingresaron con este diagnóstico, durante 2005-2010. Resultados: Media de edad de 59,2 +/- 19,1 años, 61,1 por ciento sexo masculino y 79,3 por ciento con comorbilidad; 74,3 por ciento con CURB-65 entre 3 y 5 y 64,4 por ciento con al menos 2 criterios mayores ATS modificados. Media de puntaje de APACHE II de ingreso de 20,3 +/- 7,7 puntos y media de puntaje SOFA de8,5 +/- 3,9 puntos. Mortalidad global del grupo de 31,1 por ciento. Pacientes no fallecidos versus fallecidos con puntaje CURB-65 mayor a 3 en 66,6 por ciento versus 89,4 por ciento, respectivamente (p=0,08), puntaje APACHE II de 18,1 +/- 6,7 versus 25 +/- 7,8 puntos, respectivamente (p<0,0001) y puntaje SOFA de 7,7+/- 4 versus 10 +/- 3,1 puntos, respectivamente (p= 0,003). Mortalidad en relación al ingreso precoz a UCI (antes de 24 horas de evolución) 24,6 por ciento versus 42,2 por ciento cuando fue tardío (p= 0,035). Se observó tendencia a menor mortalidad (26,9 por ciento) en quienes tuvieron cobertura para gérmenes atípicos versus 35,5 por ciento sin cobertura (p= 0,09). El score SOFA y APACHE II en general tienen una buena correlación en relación a mortalidad, sin embargo, la mayor influencia en este punto lo tienen el ingreso precoz a una Unidad de Cuidados Intensivos, los protocolos de reanimación precoz y la cobertura para gérmenes atípicos.

Severe community acquired pneumonia represents 10 –30 percent of this disease. High morbidity and mortality. In this review, we pretend found some predictor factors of mortality in this type of pneumonia. We realize a retrospective study of 121 adult patients admitted at ICU with diagnosis of severe community acquired pneumonia, between 2005-2010. Results: The patients was an average of age of 59,2 +/- 19,1 years, 61,1 percent were male and 79,3 percent with comorbidity; 74,3 percent with CURB – 65 score between 3 – 5 and 64,4 percent with at least 2 major criteria ATS modified. At admission: average of APACHE II score of 20,3 +/- 7,7 points and average of SOFA socre of 8,5 +/- 3,9 points. Global mortality of 31,1 percent. Survivor patients versus patients who died because of the disease, with CURB-65 score up to 3 points in 66,6 percent versus 89,4 percent, respectively (p=0,08), APACHEII score of 18,1 +/- 6,7 versus 25 +/- 7,8 points, respectively (p<0,0001) and SOFA score of 7,7 +/- 4 versus 10 +/- 3,1 points, respectively (p=0,003); 24,6 percent versus 42,2 percent of mortality in early admission to ICU (before 24 hours of evolution) and delayed admission, respectively (p=0,035). Tendence to minor mortality in patients who recived atypical bacteria treatment (26,9 percent versus 35,5 percent, p=0,09). The SOFA and APACHE II score with good correlation with mortality, however, the most important point is the early admission to ICU, early reanimation protocols and atypical bacteria treatment.

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Síndrome de Guillain-Barré (SGB) corresponde a la parálisis fláccida más frecuente de causa autoinmune. Pacientes y método: Revisión retrospectiva de historias clínicas del 100% (n = 57) de pacientes mayores de 15 años, egresados con diagnóstico de SGB, entre 2000 - 2006. Resultados: La edad promedio al diagnóstico fue de 43,1 años; 52,6% de sexo masculino; 70,1% sin apellidos mapuches; 73,8% de áreas urbanas. Motivo de consulta más frecuente fue tetraparesia. La mediana de tiempo de evolución fue de 5 días al momento de la consulta; 33,3% con antecedente de infección cuatro semanas previas al inicio. El 100% con paresia de extremidades inferiores y con hipo o arreflexia global al ingreso. El 49,1% requirió manejo en Unidad de Cuidados Intensivos (UCI). De ellos, 67,8% tuvieron compromiso ventilatorio y necesidad de ventilación mecánica (VM). La mediana de tiempo de apoyo ventilatorio y de hospitalización en UCI fue de 21 y 18 días respectivamente. El 42,2% recibió tratamiento inmunoglobulina endovenosa versus 10,3% en que se utilizó plasmaféresis. Sólo un paciente de nuestra serie falleció. Conclusiones: Leve predominio del sexo masculino en su presentación. La mayoría presentó manifestaciones clínicas clásicas. El perfil está en relación a un paciente varón que consulta por tetraparesia, que tiene un 50% de posibilidad de requerir manejo intensivo y necesidad de VM en 2/3 de los casos.

Guillain-Barré syndrome is the most common acute flaccid paralysis due to an autoimmune disorder. Aim: Clinical - epidemiological profile of patients who leaves Temuco’s Hospital with diagnosis of Guillain-Barré Syndrome (GBS), between 2000 and 2006. Methods: Retrospective review of 100 percent of clinical histories of adult patients with diagnosis of GBS in that time. Results: They are young patients, men most of them. The average of age was 43,1 years. Most frequent cause of consult was bilateral ascending weakness. 33,3% with some type of infection at least four weeks before the onset of neurological symptoms; 100% with bilateral ascending weakness and with a decrease or disappearance of deep tendon reflexes; 49,1% required intensive management, 67,8% of them have ventilatory compromise and need of mechanical ventilation. Mean of time of ventilatory support of 21 days. Mean of time at Intensive Care Unit of 18 days; 42,2% treated with endovenous immunoglobulin versus 10,3% who were treated with plasma exchange. Only one patient died during this period. Conclusion: Epidemiological and clinical profile of these patients was a man who consults for a bilateral ascending weakness, with a 50% of possibility of intensive management and with need of mechanical ventilation in two of three patients.

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RESUMO

Desde que se inicia la cirugía de aneurismas intracerebrales en el Hospital Dr. Hernán Henríquez Aravena de Temuco (año 1989) a la fecha, se han intervenido 8 por aneurismas paraclinoideos de la arteria carótida interna. Seis pacientes de sexo femenino y dos de sexo masculino, con un promedio de edad de 46.7 años al momento del ingreso. Siete debutaron con cuadro de hemorragia subaracnoídea, en 6 casos determinada por el aneurisma paraclinoideo y uno de otra localización. El restante paciente es diagnosticado a través de una tomografía parte del estudio de patología neoplásica del tracto digestivo. De la técnica utilizada destaca: Control de la arteria carótida cervical disecada previa al tiempo craneal, uso de drenaje espinal, abordaje pterional intradural, fresado de clinoides, disección del anillo distal y uso de clip quirúrgico según anatomía de la lesión. Los pacientes fueron intervenidos en un promedio de 10.12 días desde el inicio de la sintomatología o desde el hallazgo de la lesión en forma incidental. Buenos resultados quirúrgicos 87.5 por ciento y sobrevida promedio de 8 años a la fecha.

Since the beginning of surgery of intracraneal aneurysms in Temuco's Hospital, (1989) to our days, eightr patients has been operated because of an aneurysm situated at the paraclinoid segment of the internal carotid artery. Six of them were female and two were male, with a mean age of 46,7 years at the event. Seven patients consulted for a history of subarachnoid bleeding, six of them had a carotid - ophthalmic aneurysm. The diagnosis of the other patient was done by a tomographic control of malignant digestive tract pathology. All patients were approached by fronto-pterional side of the skull, previously doing a cervical incision at the same side of the aneurysm, to expose the primitive and internal carotid artery, intradural access and spinal drainage. Anterior clinoid process was extirpated and distal ring was dissected before clipping the aneurysm. The use of surgical clips was according to the anatomy of the lesion. The patient was operated in an average of 10 days since the beginning of the symptoms or since the casual discovery of the aneurysm. Good surgical prognosis in 87.5 percent and survival mean 8 days.

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RESUMO

Objetivo: Realizar un perfil clínico - epidemiológico de los pacientes ingresados a la Unidad de Cuidados Intensivos (UCI) de Adultos del Hospital Dr. Hernán Henríquez Aravena de Temuco entre los años 2002 y 2005 con diagnóstico de traumatismo encefalocraneano (TEC) grave, a quienes se les realizó monitorización de presión intracraneana. Material y método: Revisión retrospectiva del 100 por ciento de las historias clínicas de los pacientes con diagnóstico de TEC grave ingresados a UCI Adultos, de los cuales 44 fueron monitorizados. Resultados: Se trata de pacientes jóvenes, predominantemente varones, con una media de edad de 36,5 años (1 DS = 14,98), en quienes las caídas de altura y a nivel fueron la principal causa de TEC. El 61,3% de los pacientes resultaron con un traumatismo cerrado. Se realizó una TAC de encéfalo sin contraste, al ingreso, la que reveló en el 38,6% de los casos un hematoma subdural (HSD) agudo como patología principal. A su ingreso a la Unidad de Emergencia el 43,1% de los pacientes tuvo evidencia clínica de consumo de alcohol, en una gama que incluye desde aliento etílico hasta ebriedad manifiesta. El 81,8 por ciento fue monitorizado con captor subdural. La media de estadía en UCI de 10,86 días (1 DS = 10,39). El 52,2% de los pacientes falleció durante su estadía hospitalaria, atribuyéndose como causa de muerte al TEC o a sus consecuencias en el 69,5% de los casos. Conclusiones: El TEC grave sigue siendo una causa importante de morbilidad y mortalidad en población joven, esto a pesar del adecuado manejo neurointensivo en nuestro centro. Perfil del paciente similar al documentado en literatura nacional, con algunas diferencias con respecto a las publicaciones internacionales.

Aim: Clinical-epidemiological profile of patients admitted in Temuco's Hospital Adult Intensive Care Unit with diagnosis of severe traumatic brain injury (TBI) and intracranial pressure monitoring, between 2002 and 2005. Methods: Retrospective review of 100 percent of clinical histories of patients with diagnosis of severe TBI admitted in ICU, 44 of them were monitorized during the hospitalization in ICU. Results: They are young patients, men most of them. The average of age was 36,5 years (1 SD = 14,98). Falls were the principal cause of severe TBI; 61,3% of patients resulted with a closed traumatism. The CT shown in 36,8% of the cases an acute subdural haematoma like principal patology. At the Emergency Unit, 43,1% had clinical evidence of consume of alcohol; 81,8% of patients where monitorized with a subdural cateter. The patients stayed in ICU an average of 10,86 days (1 SD = 10,39). 52,2% of patients died during their hospitalization; 69,5% of them due to the TBI or its consequencies. Conclusions: Severe TBI continues being an important cause of morbidity and mortality in young population, despite the adequate neurointensive management in our center. Patient's profile is similar from other national studies with some differences with international literature.

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