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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.
Diseño y validación del cuestionario de prácticas de enseñanza de escritura académica
(2025) Strocchi, María Verónica; Tapia-Ladino, Mónica; Fuentealba-Carrasco, Pablo
La escritura académica constituye una competencia clave en el contexto universitario. No obstante, se cuenta con escasa evidencia sobre su enseñanza, especialmente, en asignaturas disciplinares. A partir de esta necesidad se plantea como objetivo la construcción y validación exploratoria de las propiedades psicométricas de las subescalas que conforman el Cuestionario de prácticas de enseñanza de escritura académica (versión para estudiantes). La investigación adoptó un enfoque instrumental e involucró a 1109 universitarios chilenos. Las subescalas se elaboraron a partir de una fase cualitativa previa y de la revisión de literatura. Para obtener evidencias de la validez de contenido y respuesta, el instrumento fue revisado por 9 especialistas y piloteado con 30 alumnos. Para analizar su estructura interna se llevó a cabo un análisis factorial exploratorio y también se efectuó un análisis de confiabilidad. Los hallazgos demostraron índices adecuados, resultando un instrumento compuesto por 43 ítems distribuidos en siete dimensiones/factores: 1) importancia, 2) contexto, 3) planificación, 4) implementación, 5) evaluación, 6) retroalimentación y 7) autoaprendizaje. Se concluye que el instrumento podría aportar información para el desarrollo de la didáctica en el área
Exploring teacher job satisfaction in five Latin American countries: A Multi-level analysis using TALIS 2018
(2025) Lazcano Castro, Christian; Galilea Izquierdo, Sara; Wenderoth, Stefanie; Rojas, Armando; Ortúzar, María Soledad
This study investigates teacher job satisfaction in Chile, Argentina, Colombia, Mexico, and Brazil, using data from the 2018 Teaching and Learning International Survey. Through multi-level analysis, it examines individual and organizational factors influencing job satisfaction. Findings indicate that teacher cooperation and self-efficacy enhance job satisfaction, while workplace stress detracts from it. Positive teacher-student relationships and stakeholder involvement are identified as essential organizational factors. These results underscore the importance of supportive environments and collaborative practices in improving teacher well-being and retention. Implications for policy and practice are discussed, offering insights to boost job satisfaction and educational quality across diverse educational settings
Traceable and Biocompatible Carbon Dots from Simple Precursors: A Pre-Deployment Safety Baseline
(2025) Silva, Christian; Innocenzi, Plinio; Malfatti, Luca; Fiori, Federico; Blanco, Francisca; Hormazabal, Juan; Gangas, María; Diaz, Oscar; Balic, Iván
Carbon dots (CDs) are promising for agro-environmental applications; however, clear connections between synthesis, photophysical properties, size, and biosafety are often not well established. In this study, we map these relationships for glucose–arginine CDs (GA-CDs). By using microwave and hydrothermal routes at precursor ratios of 1:3, 1:9, and 1:15, we produced sub-10 nm nanoparticles (analyzed by dynamic light scattering and atomic force microscopy) that exhibit tunable absorption and emission properties, as well as surface properties (demonstrated through UV–Vis spectroscopy, 3D photoluminescence, and FTIR analysis). The hydrothermal 1:9 condition yielded the narrowest size distribution and red-shifted photoluminescence. Across biological models spanning plants, insects, plant-growth-promoting bacteria (PGPR), and human cells, GA-CDs were well tolerated, with no adverse changes detected in plant stress markers, aphid feeding behavior or fecundity, or PGPR growth. In A549 cells, viability remained stable up to a concentration of 0.125 mg mL−1, while exposure to 0.5 mg mL−1 reduced viability, establishing a practical operating range. These results provide a clearer picture of how the structure and properties of carbon dots derived from arginine and glucose are correlated to their safety. The GA-CDs are, therefore, useful, and traceable tools for agro-environmental research. The findings support their use as biocompatible nanomaterials for studying interactions among plants, insects, and microbes in agriculture.
Evolución de las tasas de egreso hospitalario por colesteatoma del oído medio en el periodo 2020 a 2023 en Chile
(2026) Vera, Francisca; Cabello, Rodolfo; Hidalgo, Matías; Ávila, Agustín; Flores, Elizabeth
Introducción: El colesteatoma del oído medio es un quiste invasivo, caracterizado por la acumulación de queratina descamada y detritos. En Chile no está clara su epidemiología. Objetivo: Calcular la tasa de egreso hospitalario por colesteatoma del oído medio durante el periodo 2020-2023 en Chile. Metodología: Estudio
observacional, descriptivo, longitudinal y retrospectivo, sobre la tasa de egreso hospitalario por colesteatoma del oído medio en población total en Chile, según las variables sexo, edad y duración de estadía hospitalaria. No se requirió evaluación por un comité ético científico. Resultado: Se estudiaron 1.359 casos, determinando una tasa de egreso hospitalario del periodo de 1,93 casos por 100.000 habitantes, con una tendencia al alza en el periodo estudiado. Destaca un predominio en hombres jóvenes hasta los 19 años, mientras que, a partir de los 45 años, predomina en mujeres. Se establece una media de estadía hospitalaria de 1,82 días. Discusión: El aumento de la tasa puede deberse al impacto de la pandemia por SARS-CoV-2 y la redistribución de recursos. Esto mismo
pudo afectar a la diferencia de tasas entre ambos sexos. El predominio de hombres jóvenes y mujeres mayores se puede deber a la mayor incidencia de colesteatoma congénito y disfunción de la tuba auditiva, respectivamente. Por último, la mayor estadía hospitalaria en personas mayores puede explicarse por la mayor prevalencia de comorbilidades. Conclusión: Se presenta una tendencia similar a otros países y sugieren que factores anatómicos y fisiológicos influyen en la enfermedad. Se requieren más estudios para establecer adecuadas estrategias de manejo.
Introduction: Bronchus middle ear cholesteatoma is an invasive cystic lesion characterized by the accumulation of desquamated keratin and debris. In Chile the epidemiology of this condition remains unclear. Objective: To calculate the hospital discharge rate for middle ear cholesteatoma during the period 2020-2023 in Chile. Methodology: An observational, descriptive, longitudinal and retrospective study was conducted on the hospital discharge rate for middle ear cholesteatoma in the total population, according to sex, age, and length of hospital stay. Scientific ethics committee approval was not required. Result: A total of 1.359 cases were analyzed, determining an hospital discharge rate of 1,93 cases per 100.000 inhabitants during the study period, with an increasing trend over the years studied. A predominance in young males up to 19 years of age was observed, whereas from 45 years onward, females predominated. The mean length of hospital stay was 1,82 days. Discussion: The increase in hospital discharge rate may be attributed to the impact of the SARS-CoV-2 pandemic and the redistribution of healthcare resources. This may also have influenced the differences in rates between sexes. The predominance of young males and older females may be explained by the higher incidence of congenital cholesteatoma and Eustachian tube dysfunction, respectively. Finally, the longer hospital stay in older individuals may be explained by the higher prevalence of comorbidities. Conclusion: A trend similar to that observed in other countries is presented, suggesting that anatomical and physiological factors influence the disease. Further studies are required to establish appropriate management strategies.
Exploring contextual factors for management and prevention of running-related injuries: runners and experts’ perspectives
(2025) Besomi, Manuela; Roa-Alcaino, Sonia; Lombardi, Angela; Vélez-Rivera, Rocío; Leppe Zamora, Jaime; Bolling, Caroline
Running is one of the most accessible and popular physical activities worldwide; however, injuries are the main barrier to sustaining running practice. While quantitative studies have explored prevalence and risk factors, a critical gap exists in understanding subjective experiences, perceptions and contextual influences on injury management and prevention. This qualitative study aimed to explore the perspectives of runners and experts regarding injury perception, management and prevention, as well as the contextual influence of these processes. Using a secondary data analysis approach, this study drew from qualitative semistructured interviews with Chilean runners (n=15) and running experts (n=6). Thematic analysis, guided by an interpretivist approach, uncovered intrinsic factors (identity, motivation, stress and self-learning) and extrinsic factors (environment, information sources, marketing, peer advice, professional guidance, racing, stereotype and clothing) that shaped runners’ behaviours. Less experienced runners associated injury risk with asphalt surfaces, faced challenges in discerning online information reliability and found motivation in peer advice. Experts emphasised the multifactorial nature of running-related injuries, including previous injuries and training-related factors. Both groups acknowledged a global tendency among runners to resist rest when discomfort arose. This research contributed to a nuanced understanding of injury perception, management and prevention, bridging scientific knowledge with individual experiences. Clinicians may use this information to enhance the therapy alliance and set realistic expectations about the runner’s rehabilitation process.
Trends in initiation of regular cigarette smoking in 28 European countries, 1940-2019: retrospective reconstruction from repeated cross-sectional surveys
(2025) Teshima, Ayaka; Bannon, Olivia; Filippidis, Filippos; Feliu, Ariadna; Gallus, Silvano; Peruga, Armando; Martínez, Cristina; Fernández, Esteve
In the European Union (EU), one in five youth currently smoke, with over half establishing regular smoking by age 18. Yet, evidence on the historical trends of smoking initiation remains scarce despite its importance for tobacco control. Using four waves of the Special Eurobarometer survey (2012-20; n = 110 753, aged ≥15), we retrospectively estimated trends in initiation rates (IRs) of regular cigarette smoking in the EU from 1940 to 2019 among individuals aged 10-24 by sex, region, and country for each calendar decade. EU-wide smoking IRs have decreased compared to the peak period, with narrowing disparities by sex and region. For males, the IRs have declined from 5.7% (95% CI = 5.6-5.9) in the 1970s to 3.2% (95% CI = 3.0-3.3) in the 2010s, and for females from 3.9% (95% CI = 3.7-4.0) in the 1990s to 2.4% (95% CI = 2.3-2.5) in the 2010s. The decline was more pronounced among young adults aged 18-24 than minors aged 10-17, with minors' IRs surpassing those of young adults during the 2010s. Marked declines occurred among young adults in all regions, while among minors, a clear decrease was observed only for males in Northern Europe. Concerningly, the IRs among minors have trended upward in Eastern Europe for both sexes. Despite declining youth smoking initiation, an unacceptably high number of European youth still begin smoking regularly before the legal age of 18. Stricter and comprehensive tobacco control policies targeting youth, along with smoke-free generation initiatives, could substantially reduce future tobacco use and smoking-related mortality.
Human Infection by Zoonotic Eye Fluke Philophthalmus lacrymosus, South America
(2025) Weitzel, Thomas; Cordero, Esteban M.; Mujica, Trinidad; Aravena, Carolina; Phillips, Brianne E.; Yabsley, Michael J.; Lewbart, Gregory A.; Páez-Rosas, Diego; Jercic, María Isabel; Capasso, Sofía
We report a case of severe conjunctivitis in a traveler infected with a Philophthalmus lacrymosus eye fluke, probably acquired on the Galápagos Islands in Ecuador. This zoonotic parasite is endemic in Brazil and Venezuela, where it has been reported in birds and capybaras.
Gestational hypothyroxinemia causes an inflammatory environment at maternal-fetal tissues and fetal brain with impaired hippocampal dendritic spine maturation in the offspring
(2025) González, Enrique; Rangel, Andreina; Opazo, María; Espinoza, Sebastián; Elgueta, Daniela; Cancino, Gonzalo; Mery, Elena; Ardiles, Álvaro; Duarte, Luisa; Soto, Jorge; Carreño, Leandro; Simon, Felipe; Bueno, Susan; González, Pablo; Kalergis, Alexis
Gestational hypothyroxinemia (HTX) is associated with cognitive impairments and autism traits in offspring. However, the underlying mechanisms remain unclear. Prenatal inflammation impairs cortical development and induces diverse neurodevelopmental outcomes. Since thyroid dysfunction elicits inflammation, we sought to investigate whether HTX triggers prenatal pro-inflammatory responses. Using a mouse model of gestational HTX, we found elevated levels of IL-6 and IL-17 A in maternal serum, placental tissues, and embryonic brains at embryonic day (E)14 compared to euthyroid (EUT) dams. We also found increased proportions of dendritic cells, NK cells, M1-like macrophages, and monocytes in the placental tissues of HTX dams. Furthermore, gestational HTX exposure led to reduced Tbr2⁺ progenitors, increased Tbr1⁺ neurons, and an expanded Iba1⁺ microglial population in HTX-exposed embryos compared to EUT-exposed embryos. At postnatal day (P)55, the offspring gestated under HTX exhibited reduced hippocampal dendritic spine density and maturity compared to the progeny gestated under EUT. Notably, restoring T4 levels during HTX induction (HTX + T4 dams) prevented these alterations during pregnancy and in the offspring of HTX + T4 dams. These findings show that gestational HTX causes inflammation during pregnancy and has neurodevelopmental effects on the progeny, opening new pathways related to how maternal HTX impairs neurodevelopment in the offspring.