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Reducing global inequities in medical oxygen access: the Lancet Global Health Commission on medical oxygen security
(2025) Graham, Hamish; King, Carina; Ehsanur , Ahmed; Kitutu, Freddy; Greenslade, Leith; Aqeel, Masooma; Baker, Tim; De Magalhães, Lucio; Campbell , Harry; Czischke, Karen; English, Mike; Falade, Adegoke; Garcia, Patricia; Gil, Mireia; Graham, Stephen; Gray, Amy; Howie, Stephen; Kissoon, Niranjan; Laxminarayan, Ramanan; Li Lin, Inês; Lipnick, Michael; Lowe, Dianne; Lowrance, David; McCollum, Eric; Mvalo, Tisungane; Oliwa, Jacquie; Swartling, Stefan; Shimeles, Rediet; Za, Heather; El Arifeen, Shams; Ssengooba, Freddie
Core practices of people management for active learning in higher education
(2026) Cea González, Pablo; Villacura-Avalos, Paula; Romero-Vidal, Alexandra; Sannino-Berríos, Daniela; Blaser, Michelle
This article identified key core practices for people management to support active learning in university education. Interviews were conducted with 16 professionals using a narrative approach. The analysis combined semantic coding techniques from grounded theory. The sample consisted of organizational psychologists with at least two years’ experience in people management in Chilean organizations. The functions were dichotomized into traditional and strategic using a function identification matrix based on Dave Ulrich’s people management role model. Semantic content analysis was applied for category grouping using open coding, with the support of Atlas.ti software. The analysis revealed that paradox management is a distinctive component of the studied role, activating two sets of practices: sustaining strategy and managing resources. The first focuses on strategic positioning, flexibility, and energy for action.
The second focuses on the effective management of resources, particularly those aimed at achieving objectives and fostering interpersonal relationships. These core practices bridge the gap between the educational and disciplinary functions and serve as the basis for active learning. Although core practices have been established in teaching and technology professions, their identification for people management functions is remains in its early stages.
Revisión sistemática para la construcción de un perfil de Competencias Docentes en el primer año de Educación Superior
(Universidad del Desarrollo. Facultad de Psicología, 2025) Acevedo, Carlos; González Montenegro, Pablo; Reyes Reyes, Fernando
En Chile y el resto de Latinoamérica, el aumento progresivo de la matrícula en Educación Superior no ha ido acompañado de mayores tasas de titulación, sino de una disminución en la retención y persistencia en el primer año. Esto resalta la importancia de las estrategias institucionales desplegadas para adecuar las prácticas docentes en función de las relaciones establecidas con los estudiantes, para lo que resulta fundamental identificar las competencias docentes que fomentan la adherencia de los estudiantes en su primer año formativo. Este estudio tuvo como objetivo revisar los estudios en torno al perfil de competencias docentes en educación superior a nivel internacional. Se realizó una revisión sistemática PRISMA que incluyó 21 artículos de WOS, utilizando los términos Teaching skills y Teaching abilities en Educación Superior. Se encontraron estudios que analizan el impacto de las competencias docentes en el proceso formativo, así como perfiles específicos para las áreas de salud y ciencias sociales. Además, algunos estudios evaluaron la percepción sobre los programas de capacitación docente y su efectividad. Los hallazgos sugieren la necesidad de profundizar en las características compartidas por los docentes universitarios desde una identidad pedagógica, distinguiendo los roles que desempeñan según el nivel formativo en la educación superior
Myocardial perfusion imaging in advanced coronary artery disease
(2025) Hoek, Roel; Van Diemen, Pepijn; Somsen, Yvemarie; De Winter, Ruben W.; Jukema, Ruurt; Dahdal, Jorge; Raijmakers, Pieter; Driessen, Roel; Danad, Ibrahim; Knaapen, Paul
Myocardial perfusion imaging (MPI) is widely adapted as a noninvasive technique to assess the presence and extent of ischemia in patients with symptoms suggestive of obstructive coronary artery disease (CAD). However, as CAD advances, several factors can complicate the interpretation of MPI, subsequently impacting clinical decision-making. This review focuses on the utility of MPI by means of cardiac magnetic resonance (CMR) imaging, single-photon emission computed tomography (SPECT) and positron emission tomography (PET) in patients with advanced CAD-the latter characterized by documented CAD (i.e. prior myocardial infarction [MI] and/or percutaneous coronary intervention [PCI]), prior coronary artery bypass grafting (CABG) or the presence of a chronic total occlusion (CTO). It will discuss factors impacting the interpretation of MPI, the diagnostic performance for detecting obstructive CAD and coronary microvascular dysfunction (CMD), as well as the role of MPI in guiding revascularization.
The Presence of Associated Injuries in Pediatric Radial Neck Fractures: A Systematic Review of the Literature and Meta-Analysis of Pooled Individual Patient Data
(2025) Langenberg, Lisette; Benner, Joyce; Bernal, Nazira; Van Bergen, Christiaan; Colaris, Joost
Background: Pediatric radial neck fractures (pRNFs) can occur in isolation or in association with concomitant injuries. It is unknown whether the presence of associated injuries should influence the choice of treatment. The aim of this study is to assess the incidence of associated injuries in pRNF and their correlation with fracture angulation (Judet grade) or the patient's age (under or over ten years of age). Methods: A systematic literature review was performed following PRISMA-IPD guidelines, including case series on pRNF with a minimum of five cases of children until 16 years of age. The quality assessment included a risk of bias analysis and evaluation using the MINORS criteria. Individual patient data on age, Judet classification and associated injuries were extracted from the included studies and pooled for the meta-analysis. The correlation between the presence of associated injury and the patient's age or Judet classification was depicted in two forest plots. Results: A total of 20 articles published sufficient individual patient data (n = 371) on associated injuries. All but one were retrospective case series. Fifteen articles had MINORS scores of 8 or higher. The incidence of associated injuries was 33% (123 of 371 cases). Almost half of the associated injuries included an olecranon fracture (61/123). There was no correlation between Judet classification (p = 0.243) and incidence nor between patient age and the incidence of associated injuries (p = 0.694). Conclusions: Surgeons should be aware of potential associated injuries in over a third of pRNF cases, regardless of the patient's age or fracture angulation. Deduction of the trauma mechanism may be a more useful tool for assessing the potential presence of associated injuries than the most frequently used fracture classification or the patient's age. More research is needed regarding the requirements for enhanced diagnostic imaging, specific treatment or follow-up adaptations in children with pRNFs and associated injuries.
Test de Aprendizaje y Desarrollo Infantil (TADI): Evidencia adicional de su validez a nivel poblacional
(2025) Edwards, Marta; Armijo, Iván; Schonhaut, Luisa; Godoy, María Inés; Valdés, Antonia
El “Test de Aprendizaje y Desarrollo Infantil” (TADI) es una escala de tamizaje del desarrollo para niños/as de 6 a 72 meses construida en Chile. Objetivo: Determinar la validez de la primera edición de TADI muestra nivel poblacional. Metodología: Análisis psicométrico secundario de una muestra de 11.283 niños/as chilenos que participaron de la Encuesta Longitudinal de Primera Infancia (ELPI) 2012. Se evaluó validez convergente mediante el Análisis Factorial Confirmatorio (AFC), verificado mediante Análisis Factorial Exploratorio (AFE). Se consideraron variables sociales para la validez de constructo. Para la validez concurrente, sensibilidad, especificidad y correlación se tomaron como referencias las pruebas Battelle Developmental Inventory Segunda Edición (BDI-2) y el Test de Vo-cabulario en Imágenes Peabody (TVIP). Resultados: De los niños evaluados, 12,6% se categorizó en Retraso o Riesgo de Retraso, y 17,3% en categoría Alerta. El AFC arrojó buenos niveles de ajuste del modelo propuesto para los datos de la escala, en particular a edades mayores. El AFE reveló patrones diferentes para distintos rangos etarios. El TADI se correlacionó significativamente con los factores socioeconómicos, como la presencia de materiales de aprendizaje en el hogar, el nivel educativo del cuidador principal, el ingreso económico y la respuesta emocional de la madre. Se encontró corre-lación moderadamente positiva del TADI con el BDI-2 y el TVIP, con sensibilidad y especificidad cercanos a 0,70 al incluir la categoría Alerta. Conclusiones: Los adecuados valores psicométricos del TADI en una muestra poblacional ratifican su validez como instrumento de tamizaje del desarrollo de niños/as pequeños en Chile.
Development of an artificial intelligence powered software for automated analysis of skeletal muscle ultrasonography
(2025) Calulo, Zoe; González Seguel, Felipe; Horikawa, Arimitsu; Granger, Catherine; Sarwal, Aarti; Dha, Sanjay; Ntoumenopoulos, George; Chen, Jin; Bumgardner, V K; Parry, Selina; Mayer, Kirby; Wen, Yuan
Muscle ultrasound has high utility in clinical practice and research; however, the main challenges are the training and time required for manual analysis to achieve objective quantification of muscle size and quality. We aimed to develop and validate a software tool powered by artificial intelligence (AI) by measuring its consistency and comparability of expert manual analysis quantifying lower limb muscle ultrasound images. Quadriceps complex (QC) and tibialis anterior (TA) muscle images of healthy, intensive care unit, and/or lung cancer participants were captured with portable devices. Manual analyses of muscle size and quality were performed by experienced physiotherapists taking approximately 24 h to analyze all 180 images, while automated analyses were performed using a custom-built deep-learning model (MyoVision-US), taking 247 s (saving time = 99.8%). Consistency between the manual and automated analyses was good to excellent for all QC (ICC = 0.85-0.99) and TA (ICC = 0.93-0.99) measurements, even for critically ill (ICC = 0.91-0.98) and lung cancer (ICC = 0.85-0.99) images. The comparability of MyoVision-US was moderate to strong for QC (adj. R2 = 0.56-0.94) and TA parameters (adj. R2 = 0.81-0.97). The application of AI automating lower limb muscle ultrasound analyses showed excellent consistency and strong comparability compared with human analysis across healthy, acute, and chronic population.
Planes de desarrollo profesional docente en la educación secundaria técnico-profesional en Chile. ¿Instrumento administrativo o estrategia de aprendizaje profesional situada?
(2025) Maureira Cabrera, Oscar; Muñoz-Reyes, Máximo; Rojas Jara, Armando
El Desarrollo Profesional Docente (DPD), situado en necesidades institucionales, para mejorar prácticas pedagógicas se torna relevante como prioridad en el quehacer del liderazgo directivo y medio. El siguiente estudio tiene como propósito analizar las características de los Planes Locales de DPD en una muestra de nueve centros de educación secundaria técnico-profesional en Chile, considerando sus dimensiones estructurales,
prioridades directivas y coherencia interna. Se adopta un enfoque cualitativo, empleando técnicas de análisis documental, rúbrica sobre la calidad de los planes y análisis de discurso. Los resultados muestran que los planes hacen referencia a la normativa (Ley 20.903) y conectan con Proyectos Educativos Institucionales, estos no incluyen datos sobre necesidades docentes ni evidencias del impacto en el aprendizaje de los estudiantes. El trabajo colaborativo y reflexión pedagógica son implementadas inconsistentemente. Se concluye que, si bien los Planes de DPD cumplen con requisitos administrativos, no necesariamente aportan al fortalecimiento de las prácticas pedagógicas.
Return-to-sport tests: Do they reduce risk of re-rupture after anterior cruciate ligament reconstruction?
(2025) Figueroa, David; Gonzalez, Waldo; Landea, Daniela; Tapia, Camila; Erskine, Daniela
Introduction: Anterior cruciate ligament (ACL) rupture is one of the most common knee injuries. Despite the effectiveness of reconstruction, re-rupture rates of up to 15 % have been reported. Static and dynamic test of strength and movement control have been used to determine when return to sports (RTS) is appropriate.
Objective: To determine whether successfully passing return to sport (RTS) tests reduces the re-rupture rate.
Methods: Retrospective cohort study. Patients who underwent ACL reconstruction (ACLR) from June 2018 to May 2023, and who performed RTS tests after rehabilitation, were analyzed. Patients who, in addition to ACLR, underwent extra-articular tenodesis, osteotomy, or multiligament injuries were excluded. RTS tests included the following: repeat sprint ability, dynamic valgus, proagility, unilateral counter movement jump (CMJ), isokinetic, triple hop test, and functional movement screen (FMS). All statistical analyses were performed with STATA version 18.0.
Results: Ninety five patients underwent RTS tests after ACLR, with a follow-up time of 27.8 months. 71.6 % of patients were men with a mean age of 25.15 ± 10.7 years. The overall re-rupture rate was 13.68 % (13 patients). When comparing patients who passed and did not pass the RTS tests, there were no differences by sex (p = 0.06) or age (p = 0.11). The only statistically significant difference between the groups was the mean risk score (passed: 11.5 ± 0.7 vs. not passed: 15.5 ± 2.1; p < 0.001). Patients with re-rupture were more likely to be from the non-passed group (passed: 0 % v/s not passed: 18.1 %; p = 0.03), with a statistical power of 0.70.
Conclusion: Our records show that passing RTS test after an ACLR could guarantee the absence of re-rupture in the medium term.
Latin American association for the study of the liver (ALEH) guidance on postoperative care after liver transplantation
(2025) Codes, Liana; Zapata, Rodrigo; Mendizabal, Manuel; De Medeiros, Alfeu; De Lucca, Leonardo; Sá, Luiz; Andraus, Wellington; Gadano, Adrian; Padilla, Martin; Villamil, Alejandra; Silveira, Raquel; Castro, Graciela; Pages, Josefina; Terrabuio, Debora; Urzúa, Alvaro; Guimarães, Mário; Mainardi, Victoria; Pedro, Rodolpho; Imventarza, Oscar; Gerona, Solange; Wolff, Rodrigo; Abdala, Edson; Tenorio, Laura; Cerda, Eira; Cairo, Fernando; Uribe, Mario; Lisboa, Paulo; Members of ALEH Special Interest Group on Liver Transplantation
Liver transplantation (LT) is a well-established therapy for patients with decompensated cirrhosis and early-stage hepatocellular carcinoma. Liver transplantation activity varies sharply across Latin American (LATAM) countries due to differences in resources, expertise, and funding and local attitudes toward organ donation and transplantation. This current guidance of postoperative care after LT is the first position paper of the Latin American Association for the Study of the Liver (ALEH) Special Interest Group (SIG), drawing evidence-based recommendations regarding immediate and long-term postoperative care of LT recipients, taking into consideration their applicability in Latin America.
Evidencias epidemiológicas de los egresos hospitalarios por displasia del cuello uterino entre 2021-2024 en Chile
(2026) Marín, María; Caballero, Ignacio; Belén, María; Cisternas, Karen; Cisneros, Fernanda; Ceballos, Mikaela
Introducción: La displasia del cuello uterino es una lesión precursora del cáncer del cuello uterino, neoplasia maligna que constituye un desafío de salud pública a nivel mundial. En el país, pese a la existencia de programas de prevención y tamizaje, sigue siendo una patología prevalente y su estudios epidemiológicos actualizados son limitados. Objetivo: Describir el comportamiento de la tasa de egreso hospitalario por displasia del cuello uterino entre 2021 y 2024 en Chile, calcular la tasa según grupo etario y determinar el promedio de estadía hospitalaria total y por grupo etario. Metodología: Estudio observacional, descriptivo y de corte transversal, basado en el análisis censal de los registros del Departamento de Estadística e Información en Salud y del Instituto Nacional
de Estadísticas de Chile. Las variables analizadas fueron año, grupo etario y estadía hospitalaria. Resultado: Entre 2021 y 2024 se registraron 11.181 egresos hospitalarios por displasia del cuello uterino en Chile. Las mujeres de 20 a 44 años concentraron la mayor tasa hospitalaria (55,05 por cada 100.000 habitantes), mientras que las mujeres de 80 años o más presentaron las estadías hospitalarias más prolongadas (2,37 días promedio). Discusión: Las tasas más elevadas en grupos jóvenes podrían asociarse a factores de riesgo modificables. La estadía hospitalaria aumenta con la edad, lo que podría explicarse por distintos factores. Conclusión: Los hallazgos sugieren la necesidad de fortalecer y focalizar las estrategias de tamizaje, lo que podría reducir la carga hospitalaria en los grupos actualmente más susceptibles a estadías prolongadas por displasia del cuello uterino.
Introduction: Cervical dysplasia is a precursor lesion of cervical cancer, a malignant neoplasm that constitutes a global public health challenge. In Chile, despite the existence of prevention and screening programs, it is still a prevalent pathology and updated epidemiological studies are limited. Objective: To describe the behavior of hospital discharge rate due to cervical dysplasia between 2021 and 2024 in Chile, to calculate the rate according to age group, and to determine the average total hospital stay and by age group. Methodology: Observational, descriptive, and cross-sectional study, based on census analysis of the Department of Health Statistics and Information and the National Institute of Statistics of Chile registries. The variables analyzed were year, age group, and hospital stay. Result: Between 2021 and 2024, 11.181 hospital discharges due to cervical dysplasia were registered in Chile. Women aged 20 to 44 years had the highest hospital rate (55,05 per 100.000 inhabitants), while women aged 80 years or older had the longest hospital stays (2,37 days on average). Discussion: Higher rates in young groups could be associated with modifiable risk factors. Hospital stay increases with age, which could be explained by different factors. Conclusion: The findings suggest the need to strengthen and focus screening strategies, which could reduce the hospital burden in the groups currently most susceptible to prolonged
stays due to cervical dysplasia.
Clima Sexista y Vulneración de Derechos Laborales en Académicos: Un Estudio Mixto en dos Regiones de Chile
(2025) Palma-Contreras, Andrea María; Farías-Fritz, Bárbara; San Martín-Cofré, Marilyn; Larraín-Valenzuela, Josefina; Roco-Videla, Angel
Este estudio mixto examina la relación entre el clima sexista y la vulneración de derechos laborales en universidades de las regiones del Biobío y Ñuble en Chile. A partir de una muestra no probabilística de 334 académicos/as, se identificó que un 25,7% percibe un clima sexista, siendo significativamente mayor en mujeres (40,3%) que en hombres (14,1%). Asimismo, un 23,7% reportó haber sufrido vulneraciones de derechos laborales, prevaleciendo también entre las mujeres. El análisis bivariado reveló una asociación estadísticamente significativa entre la percepción de clima sexista y la experiencia de vulneración de derechos (46,5% vs. 15,7%). La fase cualitativa identificó diversas formas de vulneración, tales como incumplimiento de condiciones laborales, acoso, violencia de estudiantes y discriminación por embarazo. Estos hallazgos evidencian un entorno laboral desigual y precarizado, que afecta especialmente a mujeres y disidencias de género, perpetuando barreras estructurales en el ámbito académico.
Se concluye que es urgente implementar políticas institucionales orientadas a erradicar el sexismo y garantizar condiciones laborales equitativas, promoviendo una academia más inclusiva, justa y sostenible.
Lung recruitment maneuver improves right and left ventricular function in patients with acute respiratory distress syndrome
(2025) Lambour, Alexis; Zerbib, Yoann; Mercado, Pablo; Kontar, Loay; De Cagny, Bertrand; Maizel, Julien; Slama, Michel; Brault, Clément
BACKGROUND: Lung recruitment maneuvers (LRM) and high positive end-expiratory pressure (PEEP) may benefit some patients by reopening non- or poorly aerated alveoli. However, the effects of opening the lung with LRM on hemodynamics remain uncertain. This study aimed to evaluate the direct impact of LRM on cardiac function in patients with moderate-to-severe acute respiratory distress syndrome (ARDS). METHODS: This post-hoc analysis included 34 patients with moderate-to-severe ARDS from two prospective cohort studies. The LRM consisted in a gradual increase in PEEP, starting from 25 cmH2O (PEEPpre, before the recruitment maneuver at PEEP 25 cmH2O) until reaching 40 cmH2O. After LRM, PEEP was decreased to 25 cmH2O (PEEPpost, after the recruitment maneuver, also at PEEP 25 cmH2O) followed by a decremental PEEP titration. We compared the size and function of the right ventricle (RV) and left ventricle (LV) between PEEPpre and PEEPpost. RESULTS: The respiratory system compliance significantly increased from 21 ± 7 ml/cmH2O at PEEPpre to 24 ± 7 ml/cmH2O at PEEPpost (p < 0.001), indicating effective lung recruitment. The RV end-diastolic diameter and the RV/LV ratio decreased after LRM (51 ± 11 vs. 41 ± 9 mm; p < 0.001, and 1.05 ± 0.21 vs. 0.90 ± 0.18; p < 0.001, respectively), suggesting reduced pulmonary vascular resistance. The RV free wall strain improved from -22 ± 10 to -25 ± 8% (p = 0.040). The cardiac index significantly increased from 2.1 ± 0.6 to 2.4 ± 0.7 L/min/m2 (p < 0.001) due to improved LV function, as demonstrated by a lower LV global longitudinal strain at PEEPpost (-16 ± 4% vs. -19 ± 3%, p = 0.002). CONCLUSIONS: LRM may benefit both the lungs and the heart. The increase in transpulmonary pressure leads to an expansion in aerated lung volume, potentially reducing lung overdistension and collapse, thereby lowering RV afterload and improving RV systolic function.
Liderazgo y desarrollo profesional docente en la Educación Técnico-Profesional: El caso de Chile y México
(2025) Rojas Jara, Armando; Maureira Cabrera, Oscar; Navarro Corona, Claudia; Díaz, Miguel Angel
Este estudio analiza el liderazgo y desarrollo profesional docente en liceos técnicoprofesionales de Chile y bachilleratos tecnológicos en México. Se centra en tres dimensiones: calidad de la enseñanza, cultura de aprendizaje y trabajo en equipo y relación con la comunidad. Con un enfoque mixto, se recopilaron datos cualitativos mediante entrevistas y grupos focales a equipos directivos, y cuantitativos, a través de un cuestionario aplicado a docentes de cuatro instituciones. Los resultados indican consenso entre personal directivo y docente sobre la necesidad de fortalecer la calidad de la enseñanza; en cultura de aprendizaje, el cuerpo directivo reconoce temas pendientes, mientras que el docente valora su implementación; y en la relación con la comunidad, el equipo directivo considera estas prácticas consolidadas, pero el profesorado identifica áreas de mejora. Se concluye la importancia de seguir consolidando la calidad de la enseñanza.
Autistic and neurotypical variance in the appraisal of emotional and interoceptive words
(2025) Hausen, Felipe von; Larraín-Valenzuela, María Josefina; Carcamo, Benjamin; Salgado-Obregon, Natalia
Introduction: This study investigates how neurotype influences the emotional appraisal of words.
Methods: A total of 131 Spanish-speaking adults in Chile (63 autistic and 68 neurotypical) rated on a 7-point Likert scale 238 Spanish nouns across six
affective dimensions: (a) valence, (b) arousal, (c) subjective frequency, (d) association with depression, (e) association with anxiety, and (f) association with
anger. Descriptive statistics and Principal Component Analysis were used to identify differences in lexical-affective ratings.
Results: The results revealed consistent group differences in the emotional interpretation of words. Autistic participants tended to assign higher ratings to
emotionally intense, concrete, and interoceptively salient terms, particularly those linked to bodily sensations, anxiety, or arousal. Words such as inquietud
(uneasiness), ducha (shower), and ansia (craving) were rated as systematically more emotionally charged by autistic participants. In contrast, neurotypical
participants favored abstract, socially embedded terms like admiración (admiration), soledad (loneliness), and decepción (disappointment), which
rely more heavily on symbolic inference and social scripts. These differences were especially marked in the anxiety and arousal dimensions. Modeling results
further confirmed that neurotype predicted systematic variation in ratings across all dimensions, suggesting distinct cognitive-emotional frameworks.
Discussion: The findings support the hypothesis that autistic and neurotypical individuals construct emotional meaning through different experiential systems:
one grounded in interoception and perceptual salience, and the other guided by social abstraction. These insights offer implications for inclusive pedagogy,
clinical communication, and the design of affective tools in education and therapy. Recognizing neurotype-specific emotional semantics may help reduce
miscommunication and foster more adaptive and respectful forms of interaction across neurodivergent and neurotypical populations.
New standardized five-zone lobectomy with structured assessment in robotic surgery: the French lobectomy
(2025) Mordojovich, Gerardo; Hugen, Niek; Bottet, Benjamin; Montagne, François; Bouabdallah, Ilies; Pagès, Pierre-Benoît; Sarsam, Mathieu; Thomas, Pascal; Baste, Jean-Marc
The use of the robotic approach is rapidly increasing in thoracic surgery worldwide. Mastering this new technique is challenging and teaching robotic surgery is difficult. Nevertheless, to date, no academic certified training program including a standardized approach is available for robotic lobectomy and no objective assessment scale has been proposed. Here we describe new objective criteria for robotic lobectomy including a standardised surgical technique and an objective structured assessment scale to improve educational support for thoracic surgeons. The technique, referred to as the French lobectomy, is a standardized technique, and is based on five exposure and dissection zones. Each zone contains a number of dissection steps, which all together form a complete lobectomy. The technique can be applied to all lobectomies (and segmentectomies) for both the left and right side. In parallel, an objective structured assessment scale is designed to evaluate the performance of trainee surgeons who use the technique. This scale is based on five items with a minimum score of 5 points and a maximum score of 25 points. A conduct to follow based on the score obtained is proposed. This systematic and standardized robotic approach to lobectomies and its assessment scale, may allow surgeons and trainees to improve their technical skills and efficiency.
How I Do It: Evaluating Cardiac Implantable Devices and Noncardiac Mimics on Chest Radiographs
(2025) Silva, Claudio; Christensen, Jared
Cardiac implantable electronic devices (CIEDs), including pacemakers and defibrillators, are increasingly used to manage various cardiac conditions. This article reviews the radiographic appearance, typical components, and placement of CIEDs, including newer technologies like leadless pacemakers and MRI-conditional devices. The article also highlights the imaging findings of common complications such as lead dislodgement, fracture, and perforation, emphasizing the role of imaging in early detection and intervention. Additionally, the radiographic identification of other cardiac and noncardiac devices with similar-appearing imaging features is addressed. Other cardiac devices covered in this article include those for cardiac monitoring, ventricular assistance, and cardiac repair. Noncardiac mimics include deep brain, vagal nerve, and phrenic nerve stimulators as well as breast implant radiofrequency markers. Accurately identifying these devices and their positioning on chest radiographs facilitates the early detection of complications and directs appropriate patient care.
Defunciones por hidrocefalia en chile entre 1997 y 2022 y caracterización de variables epidemiológicas
(2026) Ávalos, Nicolás; Betancourt, Lucas; Bello, Winston; Pierotic, Antonia; Gallegos, Juan
Introducción: La hidrocefalia es una enfermedad compleja con prevalencia bimodal que afecta a recién nacidos y adultos mayores y que, a pesar de los avances en tratamiento y prevención, sigue siendo una causa importante de mortalidad en el mundo. En Chile, la información sobre la hidrocefalia sigue siendo escasa desde el punto de vista epidemiológico, generando un vacío de información que puede llevar a errores en la planificación de la salud pública del país. Objetivo: Caracterizar el comportamiento de las defunciones por hidrocefalia en Chile entre 1997 y 2022 para identificar grupos etarios más afectados y proponer medidas de prevención. Metodología: Estudio observacional, descriptivo, ecológico, de serie temporal a partir de datos anónimos obtenidos del Departamento de Estadística e Información en Salud de defunciones por hidrocefalia en Chile entre 1997 y 2022, separándolas en variables por año, rango etario, sexo y región expresadas en tasas de mortalidad. Resultado: Se registraron 707 defunciones, siendo el año 2022 el de tasa máxima (2,5 defunciones por cada millón de
habitantes). Fue más frecuente en hombres (55,9%), el grupo etario más afectado fue el de ≥80 años y la región con mayor tasa de mortalidad fue Biobío. Conclusión: La hidrocefalia sigue siendo un problema de salud pública, que afecta principalmente a hombres mayores de 60 años y cuya causa más frecuente de muerte es por hidrocefalia “No especificada”, lo que evidencia la necesidad de desarrollar un registro epidemiológico más completo y la formulación de estrategias para la prevención de la enfermedad en grupos de riesgo.
Introduction: Hydrocephalus is a complex disease that presents a bimodal prevalence affecting newborns and older adults; which, despite improvements regarding its treatment and prevention, continues to be an important cause of mortality around the world. In Chile, information on hydrocephalus remains scarce from an epidemiological point of view, generating an information gap that can lead to errors in public health planning in the country. Objective: To characterize the behavior of deaths due to hydrocephalus in Chile between 1997 and 2022 to identify the most affected age groups and propose prevention measures. Methodology: An observational, descriptive, ecological, time series study based on anonymous data obtained from Department of Health Statistics and Information of deaths due to hydrocephalus in Chile between 1997 and 2022, separating them into variables by year, age range, sex and region expressed as mortality rates. Result: A total of 707 deaths were recorded, with the year 2022 being the one with the highest rate (2,5 deaths per one million inhabitants). It was more frequent in the male sex (55,9%), the most affected age group was ≥80 years, and the region with the highest mortality rate was Biobío. Conclusion: Hydrocephalus continues to be a public health problem, which mainly affects men over 60 years of age and whose most frequent cause of death is due to “Unspecified” hydrocephalus, which shows the need to develop a more complete epidemiological registry and the formulation of strategies for the prevention of the disease in risk groups.
Magnetic resonance imaging of paraurethral and paravaginal lesion: relevant diagnoses, key findings and surgical correlation
(https://doi.org/10.21037/tau-2024-726, 2025) Labra, Andrés; Cocio, Rolando; Saavedra, Álvaro; Schiappacasse, Giancarlo; Blaskovic, Fernanda
Paraurethral and paravaginal lesions are uncommon entities that often present diagnostic challenges due to their anatomical complexity, varied etiologies, and overlapping clinical presentations. Accurate identification and characterization of these lesions are essential for appropriate management and surgical planning. A structured diagnostic approach, based on clinical history, lesion location, and imaging features, is critical to avoid misdiagnosis and unnecessary interventions. Magnetic resonance imaging (MRI) has emerged as the modality of choice due to its excellent soft-tissue contrast, multiplanar capabilities, and non-invasive nature, offering superior delineation of lesion extent and relationship with adjacent pelvic structures. This pictorial review seeks to support radiologists and clinicians by offering a comprehensive yet practical guide to the imaging evaluation of paraurethral and paravaginal lesions. Through high-resolution MRI images and original anatomical illustrations, we aim to reduce the gap between imaging interpretation and clinical decision-making. We summarize the primary MRI indications for evaluating female urethral pathology, provide an overview of common and rare differential diagnoses, and highlight relevant MRI protocol considerations. Additionally, we include correlations with surgical findings when available, to enhance clinical applicability. Rather than providing an exhaustive catalog of entities, our focus is to promote standardized imaging assessment and highlight key anatomical and diagnostic considerations that may facilitate a more confident and informed multidisciplinary approach to these often-overlooked pelvic pathologies.
CCTA-Guided Selective Invasive Coronary Catheterization: A Strategy to Reduce Contrast Volume and Improve Efficiency
(2025) Dahdal, Jorge; Jukema, Ruurt; Somsen, Aernout; Kooijman, Eline; Wahedi, Ellaha; Lemkes, Jorrit; Raijmakers, Pieter; Heestermans, Ton; Van Royen, Niels; Knaapen, Paul; Danad, Ibrahim
Background: Symptomatic patients with unilateral obstructive coronary artery disease (CAD) identified by coronary computed tomography angiography (CCTA), involving either the right or left coronary artery, typically undergo per-protocol bilateral coronary visualization during invasive coronary angiography (ICA). However, a selective visualization approach may be sufficient. Objectives: The objectives of this study were to assess the accuracy of CCTA in excluding hemodynamically significant coronary stenosis in patients with unilateral CAD and to evaluate whether a CCTA-guided selective ICA strategy can reduce procedure time and contrast agent use. Methods: In this cross-sectional cohort study, 454 patients with clinically suspected stable CAD who underwent CCTA prior to ICA were included. The study population consisted of 190 patients with unilateral obstructive CAD, defined as ≥50% diameter stenosis on CCTA, and an absence of obstructive CAD on the contralateral side. ICA with invasive functional assessment was used as the reference standard. Results: CCTA demonstrated a high accuracy, 97.4% (95% CI: 94-99%), in excluding hemodynamically significant disease in the contralateral arteries without obstructive CAD. Compared to the conventional ICA approach, a CCTA-guided selective visualization strategy resulted in significant reductions in procedure time and contrast agent usage: procedure time and contrast agent usage were reduced by 27% (95% CI: 12.1-47.5%) and 46.8% (95% CI: 27.5-67.0%), respectively. Conclusions: In patients with unilateral obstructive CAD identified by CCTA, a CCTA-guided selective ICA visualization strategy is highly accurate in ruling out hemodynamically significant CAD on the contralateral side. Additionally, this unilateral ICA approach has the potential to reduce both contrast agent usage and procedure time compared to the conventional bilateral visualization strategy.