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La taxatividad legal de las causales de implicancia y recusación y el control de la idoneidad moral del juez
(2025) Jenkins Peña y Lillo, Gaspar; Miranda Reyes, Diego
El presente trabajo examina el derecho de las partes de un juicio a presentar una implicancia o recusación contra el juez, como un mecanismo para garantizar el derecho a un juez independiente, imparcial e idóneo, integrante del contenido sustantivo del debido proceso. Este análisis constata la problemática derivada de la taxatividad de las hipótesis legales que permiten invocar una implicancia y recusación, que limita la posibilidad de señalar situaciones distintas que también podrían evidenciar la parcialidad o falta de idoneidad del juez.
Finalmente, se consideran distintas alternativas para lograr proponer posibles soluciones.
El principio de legalidad impositiva, interpretación administrativa y cambio de criterios administrativos: Un análisis jurisprudencial
(2025) Céspedes Proto, Rodrigo; García Escobar, Jaime
Se analiza una sentencia de protección de la Corte de Santiago, acción interpuesta por Watt's S.A. contra el SII, a ráz de una Circular que modificó el criterio sobre la aplicación de un impuesto adicional a ciertos productos. El fallo aborda temas fundamentales del derecho tributario y administrativo. La Corte acogió el recurso por estimar que la nueva interpretación excedía las facultades del SII y vulneraba garantías constitucionales.
Rol de la biopsia de linfonodo centinela en el manejo del carcinoma escamoso cutáneo de cabeza y cuello
(2025) Quezada, Andrés; Molina, Luis; Araya, Cristóbal; Chang, Mauricio; Valdes, Fabio; Tapia, Mario
El cáncer de piel de tipo no melanoma corresponde al cáncer más común a nivel mundial. Dentro de ellos, el carcinoma escamoso cutáneo (CEC) representa aproximadamente el 20% de los casos, con una incidencia en aumento y mayor afectación en áreas fotoexpuestas de la cabeza y el cuello. Aunque la mayoría de los casos se trata con éxito mediante cirugía, existe un grupo de pacientes que enfrenta un mayor riesgo de recurrencia, metástasis y mortalidad. La presencia de metástasis linfática reduce significativamente la supervivencia, lo que ha impulsado el desarrollo de estrategias de evaluación y manejo en pacientes sin evidencia de compromiso linfonodal. Estas incluyen la identificación de grupos de alto riesgo, el estudio imagenológico, la observación clínica y la disección cervical electiva. En los últimos años, se ha investigado la utilidad de la biopsia de linfonodo centinela (BLC) en el manejo del CEC en cabeza y cuello. Sin embargo, actualmente no existe evidencia suficiente que permita establecer su uso generalizado. Este artículo revisa la literatura actual con objeto de ayudar a los equipos de cirugía oncológica de cabeza y cuello en su toma de decisiones.
Non-melanoma skin cancer is the most common cancer worldwide. Among them, cutaneous squamous cell carcinoma (SCC) represents approximately 20% of cases, with an increasing incidence and greater impact on sun-exposed areas of the head and neck. While most cases are successfully treated with surgery, a subset of patients faces higher risks of recurrence, metastasis, and mortality. The presence of nodal metastasis significantly reduces survival, prompting the development of various management strategies for patients without clinical evidence of nodal involvement. These strategies include identifying high-risk groups, imaging evaluation, clinical observation, and elective cervical dissection. In recent years, the utility of sentinel lymph node biopsy (SLNB) has been investigated in managing SCC in the head and neck. However, there is insufficient evidence to establish its widespread use. This article reviews the current literature to assist head and neck surgical oncology teams in decision-making.
La intervención de terceros cotitulares de la acción de interés colectivo y difuso
(2025) Carrasco Poblete, Jaime; Contardo-González, Juan Ignacio
La investigación busca reflexionar sobre la intervención de terceros cotitulares de la acción colectiva o difusa en el ámbito del consumo y establecer según la dogmática procesal cómo deben comparecer en un proceso pendiente. Para ello, se analiza la legitimación activa de los sujetos que pueden ejercer acciones de interés colectivo y difuso en el ámbito del consumo, se objetan las formas tradicionales de intervención de terceros que la jurisprudencia ha aplicado al tercero
cotitular de estas acciones, se postula que la figura correcta es la del tercero adhesivo litisconsorcial y se señalan las principales características de ese tipo de intervención.
Análisis comparativo de la desinformación verificada por plataformas de chequeo durante los plebiscitos constituyentes 2022 y 2023 en Chile
(2025) Labrador, María José; Jaramillo Castro, Oscar; Sibrian, Nairbis
El presente estudio analiza los desórdenes informativos y las metodologías de verificación utilizadas por las plataformas chilenas Mala Espina Check y Fact Check.CL durante los plebiscitos constitucionales de 2022 y 2023. Se empleó un enfoque cuanti-tativo-comparativo y la técnica de análisis de contenido. La muestra consistió en 237 casos de desinformación verificados por ambas plataformas. Los resultados indican que la desinformación en temas electorales circula principalmente en redes sociales y, en menor medida, en medios de comunicación. Estos contenidos se originan en fuentes difusas o son compartidos por personalidades públicas y se presentan en formato de imagen. Se clasifican mayoritariamente como contenido engañoso e impostor, con una intencionalidad media. Las plataformas verificaron estos casos mediante la búsqueda inversa de imágenes y la revisión de documentos oficiales. Las conclu-siones sugieren que los procesos políticos son los principales focos de desinformación intencionada, proveniente de fuentes difusas. El estudio también revela la necesidad de implementar metodologías complementarias para una selección, caracterización y clasificación más rigurosa de la desinformación. Esto permitirá análisis más complejos y detallados en futuros estudios sobre contextos electorales
Unequal expression: Social position modulates APOE genotype risk of dementia
(2025) Aravena, José M.; Chen, Xi; Levy, Becca R.
Background
Although social position plays a pivotal role in cognitive aging, most dementia prevention strategies and risk prediction models continue to emphasize biomedical and genetic factors (particularly APOE status). This disconnect raises critical questions about how social environments may shape the effect of genetic risk on dementia. We examined how APOE alleles interact with social adversity to determine dementia risk.
Methods
We conducted an observational analysis using two large cohort studies—the Health and Retirement Study (HRS) and the English Longitudinal Study of Ageing (ELSA)—including individuals aged 55 years or older without dementia at baseline. A social adversity index was constructed based on the five domains of social determinants of health outlined in the Healthy People 2030 framework: education access, economic stability, healthcare quality, neighborhood environment, and social context. Participants were classified as having low (APOE-ε2), intermediate (APOE-ε3/ε3), or high (APOE-ε4) genetic risk of dementia. Dementia was ascertained via clinical diagnosis, cognitive testing, or validated caregiver report. Cox proportional hazards models were used in each cohort, and estimates were pooled using random-effects adjusting for covariates.
Results
A total of 9,849 participants (HRS = 5,797; ELSA = 4,052) were followed for up to 12 years. Genetic effects were most pronounced among individuals with social advantage (reference: APOE-ε3/ε3 with social advantage; APOE-ε2 HR = 0.67, 95%CI = 0.48–0.93; APOE-ε4 HR = 1.68, 95%CI = 1.37–2.06). In contrast, those experiencing high social adversity had elevated dementia risk regardless of genotype (reference: APOE-ε3/ε3 with social advantage; APOE-ε2 HR = 3.26, 95%CI = 2.06–5.16; APOE-ε3/ε3 HR = 3.12, 95%CI = 2.47–3.95; APOE-ε4 HR = 3.21, 95%CI = 2.34–4.41). Notably, individuals with high genetic risk but social advantage had a lower dementia risk than those with low genetic risk but high social adversity.
Conclusions
The influence of genetic risk on dementia appears shaped by social position. Addressing social adversity may reduce dementia risk across genotypes and enhance equity in dementia prevention strategies.
Incorporación del enfoque de derechos en la gestión local migratoria en Chile
(2025) Colmenares Mejías, Neida Josefina; Sibrian, Nairbis; Gissi Barbieri, Nicolás
In Chile, migrants constitute 10% of the population with 75% residing just 14% of the country’s municipalities. This high territorial concentration of migration is a distinctive feature of the Chilean context; however, research on the subject remains scarce and there is no national policy that effectively guides public migration management at the territorial level. For this reason, the article contributes to determining the characteristics of Chilean local migration management and its possible rights-based approach from the perspective of public officials who worked directly with the migrant and refugee population between 2023 and 2024. An exploratory and descriptive research design with a quantitative approach was employed. Data were collected through a survey in which 465 civil servants from 158 municipalities participated. The results show that Venezuelan, Colombian and Haitian women are the ones who request social assistance the most and that municipalities with larger migrant populations experience greater demand for regularization and protection against gender-based violence. However, municipal service provision remains fragmented and insufficiently coordinated with the central government. A gender approach implementation index was developed and an appraisal of the implementation level of the rights-based approach was conducted, obtaining average levels with territorial asymmetries. Messages from the media and opposition politicians emerge as the main obstacle in local work with the migrant population, and the main challenges are training and strengthening municipal institutions.
Bacterial Analysis of Hamstring Autograft With Vancomycin Presoaking in Primary Anterior Cruciate Ligament Reconstruction Shows High Incidence of Colonization Without Early Clinical Infection
(2025) Scheu, Maximiliano; Bosselin, Raimundo; Araos, Rafael; Ugalde, Juan; Tuca, María Jesús; Espinoza, Gonzalo
Purpose:
To determine the incidence of autograft bacterial colonization (BC) in anterior cruciate ligament reconstruction (ACLR) and to identify any bacteria type at the genus level.
Methods:
This prospective descriptive study
included patients aged 18 years or older undergoing ACLR with hamstring autograft. Thirty-one patients (21 male and 10
female patients), with a mean age of 32.2 years, were included, with a mean follow-up period of 150 days (range, 90-208
days). Three samples were taken from every surgical procedure: a sample from the graft at the time it was obtained, a
sample from the graft after tibial fixation, and a sample from the saline solution receptacle on the instrument table
(control). All grafts underwent vancomycin presoaking. Bacterial composition was determined by next-generation
sequencing of the 16S ribosomal RNA coding gene. Descriptive statistics were used to summarize data. The Fisher
exact test was used to compare group samples (with P<.05 considered significant).
Results:
BC was detected in 11 of 31 patients (35.4%). BC was found in the first sample (sample from the graft at the time it was obtained) in 1 patient and in
the third sample (control) in another. All 11 patients showed BC in the second sample (sample from the graft after tibial
fixation), with statistical significance (P=.003). In these samples with BC, 47 types of gram-negative bacteria (GNB)were identified, averaging 6.8 bacteria per sample, with 3.97% relative abundance per bacterium.
Pseudomonas was present in 5 of 11 samples, with 6.76% relative abundance. Additionally, 33 types of gram-positive bacteria (GPB) were
found, averaging 6 bacteria per sample, with 9.62% relative abundance per bacterium; Streptococcus was present in 8 of 11 samples, with 26.23% relative abundance. All colonized samples exhibited both GPB and GNB.
Conclusions:
Bacterial contamination during ACLR is frequent, with the presence of both GNB and GPB. Although such colonization was common, no early clinical infections were noted in our patient cohort.
Level of Evidence:
Level III, prospective descriptive study.
Abordando los desafíos de la EPOC en Latinoamérica: preguntas y respuestas basadas en metodología GRADE
(2025) Mendoza, Laura; Sánchez, Efraín; Torres, David; Valenzuela, Juan; Cohen, Mark; Pérez, Rogelio
Introducción: La enfermedad pulmonar obstructiva crónica (EPOC) representa un importante desafío para la salud pública en América Latina, contribuyendo sustancialmente a la morbilidad y la mortalidad. Este documento busca brindar recomendaciones
basadas en la evidencia para el diagnóstico y el tratamiento de la EPOC en América Latina, adaptadas a las necesidades y recursos específicos de la región. Su propósito es servir de guía para los profesionales de la salud en sus esfuerzos por mejorar la calidad de vida de las personas con EPOC.
Metodología: Se estableció el comité ejecutivo de las recomendaciones conformado por
cuatro médicos neumólogos miembros del departamento de EPOC de ALAT y dos epidemiólogos clínicos. Representantes de sociedades nacionales de Neumología y representantes de departamentos científicos de ALAT, quienes formularon preguntas clínicas; se seleccionaron 12 preguntas por su relevancia para contexto latinoamericano. Luego, se utilizó el sistema GRADE (Grading of Recommendations Assessment, Development and Evaluation) para evaluar la evidencia disponible y formular las recomendaciones.
Resultados: Se obtuvieron recomendaciones en 12 preguntas PICO divididas en cuatro apartados: prevención secundaria, pronóstico I, pronóstico II y terapéutica.
Conclusiones: El objetivo del presente documento es proporcionar recomendaciones de relevancia para el diagnóstico y tratamiento de la EPOC en Latinoamérica, que sean aplicables para médicos especialistas y de atención primaria con la finalidad de reducir el impacto asistencial y los costos asociados a la enfermedad.
Introduction: Chronic obstructive pulmonary disease (COPD) represents a major public health challenge in Latin America, contributing substantially to morbidity and mortality. This document seeks to provide evidence-based recommendations for the diagnosis and treatment of COPD in Latin America, tailored to the specific needs and resources of the region. Its purpose is to serve as a guide for healthcare professionals in their efforts to improve the quality of life of people with COPD.
Methods: An executive committee for the recommendations was established, consisting of four pulmonologists from the COPD Department of ALAT and two clinical epidemiologists. Representatives of national pulmonology societies and representatives of ALAT scientific departments formulated clinical questions, and twelve questions were selected based on their relevance to the Latin American context. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) system was then used to evaluate the available evidence and formulate recommendations.
Results: Recommendations were obtained in 12 PICO questions divided into four sections: secondary prevention, prognosis I, prognosis II and therapeutics.
Conclusions: The objective of this document is to provide recommendations for the diagnosis and treatment of COPD relevant to Latin America, applicable to specialists and primary care physicians, with the goal of reducing the healthcare impact and costs associated with the disease.
Reconstruction as an Opportunity to Reduce Risk? Physical Changes Post-Wildfire in Chilean Case Studies
(2025) González-Mathiesen, Constanza; Aravena-Solís, Natalia; Rosales, Catalina
Post-wildfire reconstruction processes offer an opportunity to implement structural risk reduction measures and develop wildfire resilience; however, these efforts often lack comprehensiveness. Focusing on Chile, this research addresses the need for increased and nuanced understanding of the implementation and subsequent modifications in wildfire risk reduction actions in the built environment during post-wildfire reconstruction processes. Accordingly, this study aims to identify the physical changes associated with implementing structural wildfire risk reduction measures in Chile’s reconstruction efforts from their establishment to the present, organized based on two secondary objectives: (1) document the physical changes that have occurred following the disaster, and (2) distinguish and categorize the reconstruction interventions. A mixed-methods multiple case study approach was employed, analyzing four post-wildfire reconstruction processes (Valparaiso, 2014; Santa Olga, 2017; Castro, 2021; and Punta Lavapie, 2023) through spatial analysis of physical changes and qualitative content analysis of documents to identify and categorize interventions. The research found that structural wildfire risk reduction measures and wider settlement improvements have been implemented in all case studies with varying emphasis and comprehensiveness. However, the results also suggest that these reconstruction efforts have not improved settlements’ long-term wildfire resilience. This study contributes to the theory and practice of reconstruction and risk reduction by showing that the post-disaster period often fails to lead to lasting systemic change.
Local injection of botulinum toxin for the prevention of hypertrophic scars and keloids: an overview of reviews
(2025) Silva, Iván; Ramos, José; Peña, Javiera; Novillo, Francisco; Rada, Gabriel
Introduction: Hypertrophic scars and keloids arise from an abnormal healing process in the skin, significantly affecting the quality of life. There is a wide array of treatment options available, but they often come with high costs and yield inconsistent results. Botulinum toxin is one such option that is thought to have a preventive effect, although evidence from multiple reviews have not provided a clear answer. Our objective is to compile evidence from systematic reviews of randomized controlled trials concerning the impact of local botulinum toxin injection on preventing hypertrophic scars and keloid formation following surgical skin trauma. Methods: We conducted an overview of reviews following the Preferred Reporting Items for Overviews of Reviews (PRIOR) reporting guidelines. We searched for the Epistemonikos Database up to January 2024. Quality was assessed using the AMSTAR-2 tool. We compared reviews addressing similar questions, calculated the covered area and corrected covered area to assess overlap, and explored reasons for differences between reviews. Results: Fifteen systematic reviews were included. All were classified as having low or critically low confidence according to AMSTAR-2. The covered area was 28.38%, and the corrected covered area was 23.26%, indicating very high overlap. Findings of the included reviews showed a beneficial effect on scar appearance and patient satisfaction, but in adverse events the direction of effect varied. Conclusion: Botulinum toxin could be an alternative for preventing hypertrophic scars and keloids after surgical skin trauma, but given the low confidence of the reviews, these results should be interpreted with caution.
Introducción: Las cicatrices hipertróficas y los queloides resultan de un proceso de cicatrización anómalo que puede afectar significativamente la calidad de vida. Existen diversas alternativas terapéuticas; sin embargo, suelen implicar altos costos y resultados poco predecibles. La toxina botulínica se ha propuesto como tratamiento preventivo, aunque la evidencia disponible no ha permitido establecer conclusiones definitivas. El objetivo de este estudio fue sintetizar la evidencia proveniente de revisiones sistemáticas de ensayos clínicos aleatorizados sobre el efecto de la inyección local de toxina botulínica en la prevención de cicatrices hipertróficas y queloides posteriores a trauma quirúrgico cutáneo. Métodos: Se realizó una revisión panorámica siguiendo las directrices PRIOR (Preferred Reporting Items for Overviews of Reviews). Se buscó en la base de datos Epistemonikos hasta enero de 2024. La calidad de las revisiones se evaluó
mediante la herramienta AMSTAR-2. Se compararon revisiones con preguntas similares, se calcularon el área cubierta y el área cubierta corregida para determinar el grado de superposición, y se exploraron las causas de las diferencias entre las revisiones. Resultados: Se incluyeron quince revisiones, todas con nivel de confianza bajo o críticamente bajo según AMSTAR-2. El área cubierta fue de 28,38% y el área cubierta corregida del 23,26%, lo que indica una superposición elevada. Las revisiones reportaron un efecto beneficioso sobre la apariencia de las cicatrices y la satisfacción del paciente; no obstante, los resultados respecto a eventos adversos fueron variables.
Land Cover and Wildfire Risk: A Multi-Buffer Spatial Analysis of the Relationship Between Housing Destruction and Land Cover in Chile’s Bío-Bío Region in 2023
(2025) Hora, Benedikt; González-Mathiesen, Constanza; Aravena-Solís, Natalia; Tapia, Tomás
Wildfires pose increasing risks to human settlements, particularly in the Wildland–Urban Interface (WUI). This study examines the relationship between land cover (LC) characteristics and housing destruction during the 2023 wildfires in Chile’s Bío-Bío region. Using high-resolution remote sensing data and GIS-based multi-buffer spatial analysis (30 m and 100 m), we assessed LC patterns around affected and unaffected rural houses. Results indicate that the proximity of forest plantations significantly increased housing loss, with a notably higher presence of plantations within 30 m of destroyed houses. In contrast, agricultural and pasture mosaics demonstrated a protective function by reducing fire spread. Shrublands also showed moderate protection, albeit with statistical uncertainty. The findings highlight the critical role of immediate LC in determining wildfire impact, emphasizing the need for integrating LC considerations into wildfire risk management, land-use planning, and policy interventions. Strategies such as creating defensible spaces, enforcing zoning regulations, and promoting fire-resistant landscapes can help mitigate future wildfire damage. This research provides spatially explicit insights that contribute to wildfire risk reduction theory and inform targeted prevention and resilience-building strategies in Chile and other fire-prone regions.
Uso de toxina botulínica en pacientes con distonía laríngea y temblor vocal
(2025) Capdeville Olcese, Florencia; Leung, Jai-sen; Rosenbaum, Andrés; León, Norma; Napolitano, Carla; Lagos, Antonia
Introducción: Los trastornos del movimiento laríngeo, como la distonía laríngea (DL), el temblor vocal esencial (TVE) y distónico (TVD) generan inestabilidad vocal, afectando la funcionalidad y calidad de vida. Aunque no existe un tratamiento curativo, las inyecciones laríngeas de toxina botulínica (TB) son la terapia estándar. Objetivo: Caracterizar la población de pacientes con DL, TVD y TVE, y evaluar los resultados del tratamiento con TB. Material y Métodos: Estudio de cohorte retrospectivo. Se revisaron registros médicos de los pacientes con DL, TVD y TVE evaluados en la Unidad de Voz entre enero de 2013 y julio de 2024. Se recopilaron datos biodemográficos, clínicos y de tratamiento. Los pacientes tratados con TB completaron una encuesta de autoreporte vocal, incluyendo el Índice de Discapacidad Vocal (VHI-10). Se realizó análisis estadístico descriptivo y comparativo. Resultados: Se incluyeron 66 pacientes (edad media: 60 años y 84,9% mujeres). Los diagnósticos fueron DL (56,1%), TVD (12,1%) y TVE (31,8%). El subtipo más común de DL fue aductora (97,8%). A 40 pacientes se les indicó TB y 35 fueron tratados, con 133 inyecciones en total, principalmente por abordaje cricotiroideo. La calidad y esfuerzo vocal y el puntaje de VHI-10 mejoraron significativamente (P < 0,0001). Se reportó voz soplada en 100% y disfagia de sólidos (21,7%) y líquidos (60,1%). Conclusión: La inyección laríngea de TB es segura y efectiva en pacientes con DL, TVD y TVE, mejorando la autopercepción en todos los diagnósticos y mejorando la calidad de la voz y reduciendo el esfuerzo vocal en DL y TVD.
Introduction: Laryngeal movement disorders, such as laryngeal dystonia (LD), essential voice tremor (EVT), and dystonic voice tremor (DVT) cause vocal instability, affecting functionality and quality of life. Although there is no curative treatment, laryngeal botulinumtoxin (BT) injections are the standard therapy. Objective: To characterize the population of patients with LD, DVT and EVT and assess the outcomes of laryngeal BT injections. Material and Methods: A retrospective cohort study was conducted. Medical records of patients with LD, DVT, and EVT evaluated at the Voice Unit between January 2013 and July 2024
were reviewed. Biodemographic, clinical, and treatment data were collected. Patients treated with BT completed a self-reported vocal symptoms survey, including the Voice Handicap Index (VHI-10). Descriptive and comparative statistical analyses were performed. Results: Sixty-six patients were included (mean age: 60 years, 84,9% female). Diagnoses included LD (56.1%), DVT (12.1%), and EVT (31.8%). The most common LD subtype was adductor LD (97.8%). Of the total cohort, 40 patients were prescribed BT treatment, and 35 received it at our center, totaling 133 injections, mostly administered via the cricothyroid
approach. Vocal quality, vocal effort and VHI-10 scores significantly improved after treatment (P < 0.0001). Breathy voice was reported in 100% of cases, and dysphagia with solids and liquids in 21.7% and 60.1%, respectively. Conclusion: Laryngeal BT injection is a safe and effective treatment for patients with LD, DT, and EVT, improving self-perceived across all diagnoses and improving voice quality and reducing vocal effort in LD and DLT.
Oligosymptomatic B cell lymphoma presenting as an ANA-positive polyarthritis with PET/CT full-body infiltration
(2025) Karsulovic, Claudio; Oportus, J.; Hojman, Lia
The radiologist versus commercial medicine and potential ethical conflicts
(2025) Salas Ibarra, Sofía Patricia; Micolich, Constanza
The medical profession has, as its primary interest, the well-being of the patient over economic, prestige, or any other interests, so the latter always correspond to secondary interests. However, we frequently see that the physicians’ financial relationships with the pharmaceutical and medical device industries constitute genuine conflict of interest that may jeopardize the health and well-being of the population, as well as the trust that society has in the medical profession. Given this scenario, in this article we will update the definitions for conflict of interest in clinical practice in general and in the field of radiology and imaging in particular; we will identify those areas where this is most likely to occur, such as requesting unnecessary examinations or carrying out management not based on the best evidence, those related to the way in which professional practice is organized, and also those related to clinical research. We will conclude with some recommendations for eliminating conflict of interest, or at least to managing them in a better way, thus preserving the autonomy and professional integrity of radiology specialists.
La profesión médica tiene como interés primordial el bienestar del paciente por sobre el interés económico, de prestigio o cualquier otro, de modo que estos últimos siempre corresponden a intereses secundarios. No obstante, con cierta frecuencia vemos que las relaciones financieras de los médicos con la industria farmacéutica y de dispositivos médicos constituyen reales conflictos de intereses que pueden poner en riesgo la salud y el bienestar de la población, así como también la confianza que la sociedad tiene en la profesión médica. Dado este escenario, en el presente artículo actualizaremos las definiciones sobre conflicto de intereses en la práctica clínica en general y en particular en el ámbito de la especialidad de radiología e imágenes, e identificaremos aquellas áreas en las que es más posible que esto ocurra, como por ejemplo al solicitar exámenes innecesarios o realizar una gestión no basada en la mejor evidencia, aquellos relacionados con la forma en que se organiza la práctica profesional y también los relacionados con la investigación clínica. Finalizaremos con algunas recomendaciones para eliminar los conflictos de intereses o, al menos, poder manejarlos de mejor manera para así preservar la autonomía y la integridad profesional de los especialistas en radiología
Risk Factors for Failure of Non-operative Management in Isolated Unilateral Non-displaced Facet Fractures of the Subaxial Cervical Spine: Systematic Review and Meta-Analysis
(2025) Cirillo, Ignacio; Ricciardi, Guillermo Alejandro; Cabrera, Juan Pablo; Lopez Muñoz, Felipe; Romero Valverde, Lyanne; Joaquim, Andrei; Carazzo, Charles; Yurac, Ratko
Study Design: systematic review.
Objective: To evaluate risk factors associated with failure of non-operative management of isolated unilateral facet fractures of the subaxial cervical spine in neurologically intact patients.
Methods: A systematic review of the PubMed, Embase, LILACS, and Cochrane Library databases was conducted in order to determine risk factors associated with failure of non-operative management in isolated unilateral facet fractures of the subaxial cervical spine without facet and/or vertebral displacement, in neurologically intact patients. Our research was in line with the PRISMA Statement and registered on PROSPERO (CRD42023405699).
Results: A total of 1639 studies were identified through a database search on May 5, 2023. In total, 7 studies from the databases were included, along with 1 study found through a manual citation search. The evidence showed high clinical heterogeneity, a serious risk of bias according to the ROBINS-I tool, and a predominance of retrospective cohort studies. In comparison to less complex facet fractures, lateral floating mass fractures were found to have 5.41 times higher odds of failure of non-operative management (OR = 5.41; 95% CI = 1.32, 22.19). We calculated the potential association between lower absolute fracture height and non-operative treatment success [Fracture height (percentage) Mean Difference = 17.51 ( 28.22, 6.79 95% CI); Absolute height Mean Difference: 0.46 ( 0.60, 0.31 95% CI)]. Other risk factors were not included in the meta-analysis due to lack of data. The level of certainty was rated as “very low”.
Conclusions: Lateral floating mass cervical facet fractures and larger fracture fragment size (measured either in absolute terms or as a percentage) are significant risk factors for failure of non-operative treatment.
Human inborn errors of immunity: 2024 update on the classification from the International Union of Immunological Societies Expert Committee
(2025) Poli Harlowe, María Cecilia; Aksentijevich, Ivona; Aziz, Ahmed; Cunningham, Charlotte; Hambleton, Sophie; Klein, Christoph; Morio, Tomohiro; Picard, Capucine; Puel, Anne; Rezaei, Nima; Seppänen, Mikko; Somech, Raz; Su, Helen; Sullivan, Kathleen; Torgerson, Troy; Meyts, Isabelle; Tangye, Stuart
This report provides an updated classification of inborn errors of immunity (IEIs) involving 508 different genes and 17 phenocopies. Of these, we report 67 novel monogenic defects and 2 phenocopies due to neutralizing anti-cytokine autoantibodies or somatic mutations, which either have been discovered since the previous update (published June 2022) or were reported earlier but have been recently confirmed and/or expanded. The new additions were made after rigorous review of new genetic descriptions of IEIs by the International Union of Immunological Societies (IUIS) Expert Committee using criteria established to define IEI. Although similar pathogenic variants in one gene, in terms of both classes of mutation (missense, nonsense, etc.) and impact on protein function, can result in a spectrum of phenotypic manifestations, they are herein classified according to the most consistently reported phenotype. In addition, because different variants in a single gene can result in recognizable diseases due to gain or loss of function, such cases are classified according to their clinical manifestations as a distinct entry in the same or a different table depending on the associated phenotype. This report will serve as a valuable resource for clinical immunologists and geneticists involved in the molecular diagnosis of individuals with heritable and acquired immunological disorders. Moreover, we expect this report to also serve as a valuable resource for all disciplines of medicine, since patients with IEIs may be first seen by rheumatologists, hematologists, allergists, dermatologists, neurologists, gastroenterologists, and pulmonologists, depending upon their spectrum of presenting clinical features. Finally, expanding the known monogenic and related causes of human immune diseases requires dissection of underlying cellular and molecular mechanisms, which reveals fundamental requirements for specific genes, pathways, processes, and even cell types. Such knowledge may not only contribute to improved patient diagnosis and management but also pave the way to the development and implementation of therapies that target the cause-rather than the symptoms-of these conditions.
The 2024 update of IUIS phenotypic classification of human inborn errors of immunity
(2025) Aziz, Ahmed; Jeddane, Leïla; Moundir, Abderrahmane; Poli Harlowe, María Cecilia; Aksentijevich, Ivona; Cunningham, Charlotte; Hambleton, Sophie; Klein, Christoph; Morio, Tomohiro; Picard, Capucine; Puel, Anne; Rezaei, Nima; Seppänen, Mikko; Somech, Raz; Su, Helen; Sullivan, Kathleen; Torgerson, Troy; Tangye, Stuart; Meyts, Isabelle
Here, we report the 2024 update of the phenotypic classification by the International Union of Immunological Societies (IUIS) expert committee (EC) on inborn errors of immunity (IEI), which accompanies and complements the 2024 genotypic classification. The aim of this classification is to help diagnosis for clinicians at the bedside and focuses on clinical features and basic laboratory phenotypes of specific IEI. In this update, 559 IEI are described, including 67 novel monogenic defects and 2 new phenocopies. This phenotypic classification is presented in the form of decision trees when possible, with essential clinical or immunological phenotype entries.
A minimal One Health approach? Lessons from the salmon aquaculture crisis in Chile
(2025) Aguilera, Bernardo; Lecaros Urzúa, Juan Alberto; Olivares, Jorge
This paper explores the application of the One Health approach through an analysis of the response to the 2007 crisis in Chile's salmon aquaculture industry. To evaluate the extent to which the case aligns with a "minimal" One Health framework, we draw on four key dimensions of this framework (methodological, epistemic, ontological, and ethical) and contrast the case with the response to the 2009 Q fever outbreak in the Netherlands. We conclude that the Dutch response to Q fever, characterized by limited institutional collaboration, a narrow disciplinary focus, and an anthropocentric ethical stance, fell short of even a minimal One Health approach. In contrast, the response by the Aquaculture Health Management Program (PGSA) to Chile's salmon aquaculture crisis represents a more integrated approach, involving multisectoral collaboration, interdisciplinary dialogue, and concern for animal and environmental health. While the Chilean case does not fully achieve a strong One Health model, it demonstrates the practical benefits of adopting a minimal One Health perspective, including reduced antibiotic use and improved disease control. The paper concludes that One Health should be understood as a flexible, problem-solving framework, and that clarity regarding its core dimensions is essential for strengthening One Health approaches.
Análisis de la carga de entrenamiento e indicadores de variabilidad y estrés fisiológico durante una temporada en fútbol femenino de élite
(2025) González-Vargas, M.; Gallardo-Pérez, J.; González-Escobar, A.
El objetivo del estudio fue analizar la carga e indicadores de variabilidad y estrés fisiológico durante un periodo de 43 semanas a 24 jugadoras (21,1 ± 3,0 años; 61,7 ± 5,1 kg; 159,3 ± 6,0 cm) de primera división del fútbol femenino chileno. El estudio fue cuantitativo de corte longitudinal. La carga e índices de monotonía y Strain fueron evaluados con el método PSE-sesión. Los resultados indicaron que la carga e indicadores de monotonía y strain tuvieron mayor impacto en periodos de preparación. Hubo diferencias significativas al comparar los periodos de preparación, competitivo y transición. (F = 6,657; p = 0,001; TE = 0,41). Se concluye que la periodización semanal es diferente entre los periodos de preparación y competitivo, mostrando una mayor ondulación de las cargas el período competitivo, pero que en periodos de preparación hay menor variabilidad y mayor estrés fisiológico que puede inducir la aparición de lesiones por sobrecarga.