Artículos Medicina y Ciencias de la Salud

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Personas mayores y cuidadores: experiencias con tecnologías digitales en salud en tres regiones de Chile
(2025) Hirmas Adauy, Macarena; Olea, Andrea; Sgombich, Ximena; Castillo-Laborde, Carla; Matute, María Isabel; Abusleme, Teresa; Jofré, Daniel; Slachevsky Chonchol, Andrea; Massad, Cristián
Este artículo da cuenta de las experiencias y expectativas de personas mayores, cuidadores y familiares con respecto al uso de tecnologías digitales para el cuidado de la salud en Chile, asumiendo como perspectiva de análisis la Teoría de Usos y Gratificaciones. Para la realización del estudio se utilizó un enfoque cualitativo con 9 grupos focales y 16 entrevistas individuales. Llevado a cabo entre marzo y noviembre de 2022, la investigación abordó aspectos como competencia digital, accesibilidad y usos. Los resultados indican que las personas mayores tienen una relación tardía con la tecnología, con barreras como miedo a la obsolescencia y falta de habilidades digitales. La tecnología es percibida como útil para las tareas cotidianas y la asistenciasanitaria, aunque existen preocupaciones acerca del fraude y el mal uso de información personal, lo que amplía la brecha digital. La alfabetización digital en personas mayores es sobre todo adquirida a través del apoyo familiar y de procesos de formación informales. La salud digital es vista como multifacética, beneficiando la gestión administrativa y el acceso a la información médica, aunque se requieren estrategias más efectivas de inclusión digital para mejorar la autonomía y lab integración de las personas mayores en el entorno digital.
Advances in Label-Free Detection of Non-Muscle Invasive Bladder Cancer: A Critical Review
(2025) Vera, Gabriela; Cerda, Javier; Fernández Arancibia, Mario; Sánchez, Miguel; Rojas, Pablo
Non-muscle invasive bladder cancer (NMIBC) accounts for about 75% of new bladder cancer diagnoses. Early detection improves survival, yet routine white-light cystoscopy is invasive, costly, and can miss up to 45% of flat or small lesions. These shortcomings have prompted development of label-free diagnostic tools that read the intrinsic optical, electrical, or mechanical signatures of urinary biomarkers without added labels. This review examines recent engineering advances in such platforms for NMIBC detection, focusing on analytical performance, readiness for clinical translation, and remaining barriers to adoption. We compare each technology with conventional cytology using key metrics such as limit of detection, diagnostic accuracy, analysis time, cohort size, and stage of clinical development. Surface-enhanced Raman spectroscopy and interferometric flow cytometry offer femtomolar sensitivity and more than 98% accuracy within minutes, while compact electrochemical sensors targeting NMP22, Galectin-1, and microRNAs reach sub-picogram levels on disposable chips. Standardized sample handling, multicenter validation, and robust cost-effectiveness data are now essential for these tools to advance point-of-care NMIBC surveillance.
Transolecranon fracture dislocation and transolecranon basal coronoid fracture dislocation; results of standardized treatment in a retrospective cohort
(2025) De la Paz, Joaquín; Lecaros, Juan José; Calvo, Andrés; Ariztia, Antonio; Aravena, Cristian; Reinares, Felipe
Background: Our understanding of transolecranon fracture dislocation (TOFD) has evolved to include associate ligament, coronoid, and radial head lesions impacting stability, rather than solely bone stability. Similarly, the understanding of coronoid fracture patterns has progressed. O’Driscoll et al state that basal subtype 2 coronoid fractures correspond to a TOFD, with a fracture passing through the base of the coronoid. In the literature, there is no clear differentiation between basal coronoid TOFD (BC-TOFD) and pure-TOFD outcomes. The main objective of this study is to evaluate the functional results and complications of TOFD using a standardized surgical technique. The secondary objectives are to describe the associated injuries and to compare the results between pure-TOFD and BC-TOFD. Methods: This retrospective study included all patients with a TOFD treated with a standardized surgical procedure and rehabilitation protocol between 2013 and 2018 in a single trauma level 1 center. The surgical procedure mainly consisted of fixing the olecranon with a plate, using the same screws for coronoid fixation and coronoid plate if necessary. Radial head management involved either arthroplasty or screw fixation, with ligament repair performed as needed. Demographic data and the associated bone and ligament injuries were reviewed. The clinical outcomes (range of motion, Mayo Elbow Performance Score (MEPS), and Broberg and Morrey (B&M) scores) were evaluated at the final follow-up, after a minimum of 2 years. Complications and reoperations were assessed. Results: 24 patients were included, and 75.0% were men. The average follow-up was 57.9 ± 22.0 months. The mean age was 42.0 ± 15.1 years. 18 (75.0%) were BC-TOFD and 6 (25.0%) were pure-TOFD. Ligament injuries requiring repair and radial head fracture were present in 8 (33.3%) and 11 (45.8%), respectively. The average range of motion were flexion 119.0 ± 17.6, extension deficit 20.4 ± 12.6 , pronation 68.9 ± 20.4 , and supination 63.1 ± 27.4 . MEPS and B&M mean scores were 82.3 ± 16.5 and 82.0 ± 16.1, respectively. The reoperation rate was 33.3%. No significant differences were found between pure-TOFD and BC-TOFD. A significant distribution difference was found in MEPS (P ¼ .001), B&M (P ¼ .002), range of flexion (P ¼ .011), and extension deficit (P ¼ .005) between patients who had reintervention and those who did not. Conclusion: A standardized protocol for TOFD allows good to excellent functional results. There are no significant differences between pure-TOFD and BC-TOFD. One-third underwent reintervention. Patients with reintervention presented worse outcomes.
Stroke and cervical artery dissection and/or aneurysm: 2019-2021 Chilean hospital-based national registry
(2025) Allende, Maria; Munoz Venturelli, Paula; Mazzon, Enrico; Brunser, Alejandro; Delgado, Iris; Rebolledo Jaramillo, Boris
Background: Cervical artery dissection is one of the main causes of stroke in young adults, yet the characteristics of patients have been mainly described in Caucasian populations. We aimed to identify patients' characteristics associated with stroke among cervical artery dissection patients in Chile. Methods: We conducted a retrospective analysis of a national hospital-based database in Chile between 2019 and 2021. Patients with cervical artery dissection or aneurysm (CeDA) were identified using ICD-10 codes I72.0 (carotid artery) and I72.6 (vertebral artery); stroke events were classified using codes I60-I64. We performed multivariable logistic regression to evaluate the association between patients' characteristics and stroke occurrence. We further performed Poisson regression to assess the impact of the coronavirus pandemic on CeDA admissions. Results: Of 2,647,398 hospital discharges, we identified 597 CeDA patients (mean [SD] age 57 [15] years; female 384, 64 %). Stroke occurred in 233 (37 %) patients, with ischaemic stroke accounting for 71 % of these events. In the multivariable analysis, stroke occurrence was associated with vertebral artery involvement (OR 2.89; 95 %CI 1.76-4.77), atrial fibrillation (2.25; 1.03-4.90), hypertension (1.85; 1.25-2.74), male sex (1.80; 1.24-2.62) and current smoking (1.78; 1.13-2.80). Hospital admissions for CeDA declined in 2020 (rate ratio [RR] 0.69; 95 %CI 0.57-0.85) and 2021 (0.76; 0.63-0.92), compared with 2019. Conclusions: In this Chilean hospital-based database, stroke occurrence among CeDA patients was linked to male sex, vertebral artery involvement, hypertension, current smoking, and atrial fibrillation. Further research is needed to understand the underlying mechanisms and its association with patient prognosis.
Estado nutricional y uso de plataformas de compra y venta de alimentos en línea en estudiantes universitarios
(2025) Araneda, Jacqueline; Concha, Lisett; Muñoz, Jennifer; Quintiliano, Daiana; Navarro, Esteban; Pinheiro, Anna Christina
Introducción: La compra y venta de alimentos en línea ha experimentado un aumento significativo en todo el mundo, propiciado por un mayor acceso a las tecnologías y dispositivos electrónicos. Objetivo: evaluar la asociación entre la exposición a servicios de compra y venta de alimentos en línea y el estado nutricional de los universitarios. Material y métodos: Participaron 587 estudiantes de Universidad del Bío- Bío, Chile. Se aplicó un cuestionario online que incluía preguntas sobre el uso de aplicaciones de delivery y las influencias del entorno en la compra de alimentos. Se realizó un estudio de clúster y se desarrollaron modelos de regresión logística. Resultados: Se obtuvieron 3 clústers de exposición a plataformas de entrega de comida a domicilio, mediante un análisis de conglomerados (MCA K-means): expuestos a estímulos tradicionales (n=198), poco expuestos (n=196) y altamente expuestos (n=193). Quienes están altamente expuestos a plataformas digitales de comida a domicilio, tienen mayor probabilidad de tener malnutri- ción por exceso (OR=1,53; p = 0,048). Comprar comida vegetariana, vegana o sin gluten es un factor protector de la malnutrición por exceso (OR= 0,65; p = 0,049). Conclusión: Existe relación significativa entre la utilización de servicios de compra y venta de alimentos en línea y el estado nutricional de estudiantes universitarios. Los resultados sugieren que el acceso y uso de estas plataformas podría influir en los patrones alimentarios y, en conse- cuencia, en el estado nutricional de esta población.
Evaluating employees’ perceptions of non-monetary incentives in workplace-based weight loss programs
(2025) Oliveira-Barbosa, Adriana Aparecida de; Pinheiro-Fernandes, Anna Christina; Quintiliano Scarpelli, Daiana; Marques de Oliveira, María Rita; Belmar Prieto, Julieta; Masferrer Riquelme, Dominique
This study investigated Chilean employees expectations, perceptions of acceptability, and beliefs about the potential effectiveness of non-monetary incentives in workplace weight loss programs. Eighty-six employees with overweight and sedentary occupations from six Chilean companies partici- pated in 16 focus groups as part of a descriptive qualitative study. The content analysis, grounded in Self-Determination Theory, revealed eight catego- ries grouped into three overarching themes: 1) Beliefs and challenges regarding healthy habits and body weight. 2) Workplace structure, environment, and culture. 3) The use of non-monetary incentives to promote healthy behaviors at work. While participants appreciated the non-monetary incentives, these were not enough to overcome the psychological, emotional, and structural barriers to adopting healthier lifestyles. Non-monetary incentives that provided additional spare time, particularly for family, were the most appreciated by participants; nevertheless, organizational constraints restrict the use of these incentives in workplace weight loss initiatives. In conclusion, although non-monetary incentives were identified as a strategy to promote healthier lifestyles, their success is dependent on implementing structural and cultural modifications in the work environment. A comprehensive strat- egy that considers both individual and organizational factors is needed to promote sustainable healthy habits.
Systemic illness with eosinophilia and urticaria-like rash caused by prolonge d b e dbug exposure
(2025) Weitzel, Ian; Palma, Valeria; Silva, Macarena; Castro, Alex; Weitzel, Thomas
Bedbugs are blood-feeding nocturnal ectoparasites, which are well-adapted to human habitats. In recent decades, bedbug infestation has been an emerging health problem worldwide, affecting all socio-economic population strata. The clinical presentations of bedbug exposure are variable, ranging from simple pruriginous bite lesions to severe cutaneous and systemic manifestations. Diagnosis is challenging and depends on awareness, clinical experience, and a thorough medical history. In our case, cutaneous lesions were accompanied by severe systemic symptoms and hypereosinophilia, leading to prolonged illness and hospitalization. The differential diagnosis of such presentations should include bedbug exposure, to avoid long-lasting disease, unnecessary diagnostic procedures, and the associated psychological burden for the patient.
Uso de la información del envase de alimentos en Chile: análisis nacional con enfoque en responsables de niñas y niños menores de 5 años
(2025) Orellana, Romina; Soto, Carla; Quintiliano-Scarpelli, Daiana; Pemjean, Isabel; Corvalan, Camila; Zancheta, Camila
Objetivos: Describir el uso de información del envase para selección de alimentos por personas adultas en Chile y verificar su asociación con varia- bles sociodemográficas y con ser responsable de niños/as. Métodos: Estudio transversal basado en datos secundarios de la Encuesta Nacional de Salud (ENS) 2016-2017. Fueron incluidas las personas mayores de 18 años e identificadas las responsables de niños/as de entre 7 meses y 5 años. Se analizó el uso de ingredientes, información nutricional, sellos de advertencia, mensajes saludables, marca y precio en la decisión de compra de alimentos (SÍ: siempre, casi siempre, algunas veces; NO: rara vez, nunca). Las asociaciones fueron verificadas con modelos de regresión logística, ajustados por variables sociodemográficas. Resultados: Las informaciones más utilizadas fueron el precio (71,3%) y la marca (62,2%), seguidas de los sellos de advertencia (55,4%). La tabla nutricional fue la menos utilizada (43,3%). El uso frecuente de las informaciones del envase se relacionó con el sexo femenino, mayor educación y renta y con residencia en zona urbana. El 11,2% de los/as participantes eran responsables de niños/as, mayo- ritariamente mujeres (85,2%). No se observaron diferencias en el uso de las informaciones del envase entre las personas responsables de niños/as. Conclusiones: Tras la implementación de la ley, los sellos de advertencia se convirtieron en una fuente importante de información para la compra. Aunque la legislación se enfoca en la protección de menores de 14 años, no se encontró uso diferencial del envase por responsables de niños/as, lo que puede relacionarse con factores intrafamiliares y sociales que influyen en esas decisiones.
Advantages of the upper eyelid approach with lateral canthotomy in the resolution of complex fronto-orbito-zygomatic fractures: bibliographic review of conventional approaches and a case report
(2025) Tapia, Pedro; Díaz, Fernanda; Zeballos, Jessica; Díaz, Sofía; Jollán, Florencia; Ossandón-Zúñiga, Benjamín
This study presents a modified upper eyelid approach incorporating a lateral canthotomy to improve surgical access in complex fronto-orbital fractures. A 69-year-old male patient with no comorbidities was admitted to the regional hospital of Rancagua with a left fronto-orbital-zygomatic fracture. Surgery was performed under general anesthesia using an upper eyelid incision combined with a lateral canthotomy to enhance exposure of the fracture site. Reduction and osteosynthesis of the lateral orbital wall and part of the frontal bone were successfully achieved without complications. The modified approach provided wide and direct access to the affected areas, particularly beneficial in cases with comminuted fractures requiring the placement of multiple osteosynthesis elements. The lateral canthotomy significantly expanded the surgical field, facilitating accurate reconstruction. Additionally, the eyelid incision, placed along the natural palpebral crease, offered excellent aesthetic results with a nearly imperceptible scar. This technique proves to be a valuable option for the management of complex fronto-orbital injuries, combining effective exposure with favorable cosmetic outcomes. It is especially useful in extended fractures where optimal visualization is critical for successful repair. The upper eyelid approach with lateral canthotomy thus stands out as a reliable and aesthetically conscious alternative for orbital fracture surgery.
Enhancing Disaster Preparedness and Community Safety Through Virtual Simulation: A Scoping Review in Undergraduate Health Education
(2025) Torres-Agüero, Daniel; Armijo-Rivera, Soledad; Vicencio-Clarke, Scarlett; Norte, Gustavo; Herrera, Eduardo; Lagos Cordero, Andrés
Objectives: Disaster medicine (DM) prepares health care professionals to manage emergencies caused by significant societal disruptions. Training recent graduates and final-year students is an essential element of disaster preparedness. This review aims to examine the use of Virtual Simulation (VS) in undergraduate students' DM training. Methods: The research team searched Scopus, PubMed, WOS, and Scielo. The team followed the 6-step approach described by Mak to conduct Scoping Reviews. We identified 262 reports, and 17 articles met the inclusion criteria. We extracted and analyzed data, focusing on educational settings, professions involved, and intervention characteristics. The report followed PRISMA guidelines. Results: The implementation of VS in DM training has been geographically concentrated, with most studies focused on nursing education. Most programs use virtual reality, with limited augmented or mixed reality integration, principally in nursing students. The training focused primarily on triage, disaster preparedness, evacuation, decontamination, improving knowledge retention, self-confidence, and decision-making. Conclusions: Although VS has effectively enhanced technical skills and disaster preparedness, its use remains limited in undergraduate health education. Further research is needed to expand its application in interprofessional and non-nursing contexts, with deliberate practice principles to maximize efficiency. Integrating VS into community training can reduce costs and enhance large-scale emergency response.
Mucormicosis en cirugía maxilofacial. Una revisión de la literatura
(2025) Herrera-Barraza, Víctor; Donoso-Rebolledo, Felipe; Morales-Romero, Javiera; Ferrer-Valdivia, Nicolás
Introducción: La mucormicosis es una infección fúngica de baja prevalencia, con alta mortalidad, que afecta principalmente a pacientes inmunocomprometidos, como diabéticos y pacientes COVID-19. En el área maxilofacial, se presenta con dolor facial, aumento de volumen y úlceras, siendo crucial un diagnóstico temprano y un tratamiento oportuno. El objetivo de este estudio fue realizar una revisión de la literatura que describiera las implicancias de la mucormicosis en cirugía maxilofacial, abarcando su epidemiología, diagnóstico y tratamiento. Materiales y Métodos: Se realizó una revisión narrativa de la literatura utilizando las palabras claves “Mucormycosis” and “ Maxillofacial Surgery” en las bases de datos PubMed, SciELO, Scopus, ScienceDirect y Google Académico. Se incluyeron artículos relevantes publicados en los últimos 10 años, considerados desde enero del 2015 a marzo del 2025, sobre la epidemiología, diagnóstico y tratamiento de la mucormicosis en cirugía maxilofacial. Resultados: La mucormicosis rino-orbito-cerebral (ROCM) es la forma más común en cirugía maxilofacial, especialmente en pacientes con diabetes y aquellos tratados inmunosuprimidos con corticoesteroides y afectados por COVID-19. El diagnóstico consiste en anamnesis clínica, imágenes y análisis histopatológicos, y se complementa con tratamiento farmacológico y quirúrgico. Conclusión: La mucormicosis es una patología compleja y desafiante en cirugía maxilofacial, con alta mortalidad. Un manejo multidisciplinario que combine diagnóstico temprano, tratamiento quirúrgico y antifúngico adecuado es esencial para mejorar la supervivencia y reducir las secuelas de la infección.
STatin TReatment for COVID- 19 to Optimise NeuroloGical recovERy (STRONGER): study protocol for a randomised, open label clinical trial in patients with persistent neurological symptoms after COVID- 19 infection
(2025) Delfino, Carlos; Carcel, Cheryl; Lin, Xiaolei; Munoz Venturelli, Paula; Naismith, Sharon; Woodward, Mark; Peters, Ruth; Wijesuriya, Nirupama; Law, Meng; Harding, Ian; Wang, Xia; Elliott, Julian; Leder, Karin; Hutchings, Owen; Stecher, Ximena; Zoungas, Sophia; Anderson, Craig
Introduction Increasing awareness of the high frequency, wide spectrum and disabling nature of symptoms that can persist following COVID-19 infection has prompted the investigation of management strategies. Our study aims to determine the effectiveness of atorvastatin on cognitive function, physical activity, mood, health-related quality of life and features of neurovascular impairment and neuroinflammation in adults with ongoing neurological symptoms after COVID-19 infection. Methods and analysis The STatin TReatment for COVID-19 to Optimise NeuroloGical recovERy study is an ongoing international, investigator-initiated and conducted, multicentre, prospective, randomised, open label, blinded endpoint trial with fixed time points for outcome assessments. A total of 410 participants with long covid neurological symptoms were planned to be randomly assigned to either the intervention group to receive 40 mg atorvastatin for 12 months or to a control group of no treatment, on top of usual care. Ethics and dissemination This study protocol was designed, implemented and reported, in accordance with the International Conference on Harmonisation guidelines for Good Clinical Practice, the National Health and Medical Research Council of Australia, the National Statement on Ethical Conduct in Human Research and with the ethical principles laid down in the World Medical Association Declaration of Helsinki. Central ethics committee approval was obtained from Sydney Local Health District Royal Prince Alfred Hospital Ethics (No: X21-0113 and 2021/ETH00777 10) in Australia. Site-specific ethics committee approvals were obtained elsewhere before any local study activities. All participants provided written informed consent.
Bladderpreservationalternativesin non-metastaticmuscle-invasivebladder tumor:Asystematicreviewand meta-analysis
(2025) Parrao, Diego; Lizana, Nemecio; Saavedra, Catalina; Fernandez, Valentina; Lindsay, Carolina; Larrañaga, Matıas; Fernández Arancibia, Mario; Bravo. Juan
Objective: To systematically review the most recent scientific literature regarding modern strategies for organ preservation in the treatment of non-metastatic muscle-invasive bladder cancer. Methods: Literature search was made using PubMed, Google Scholar, EMBASE, Wiley Library, and ClinicalTrials.gov following the recommendations of the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement. The primary outcome was 5-year overall survival rate, which was addressed by a systematic review and meta-analysis. The risk of bias and quality of evidence were assessed according to the Cochrane Collaboration and the Grading of Recommendations, Assessment, Development and Evaluation system. Results: The evidence is consistent in showing that 5-year survival of trimodality therapy is similar to radical cystectomy in selected patients, ranging between 29% and 73%. Patients undergoing bladder-sparing therapy were found to have better outcomes in terms of quality of life and sociability than those undergoing radical cystectomy. Immunotherapy is establishing itself as a strategy for organ-preservation treatment, showing complete response rates between 42% and 100%. However, most of these results have been obtained from ongoing clinical trials. Furthermore, there are still no studies comparing the efficacy among the different available therapies. Conclusion: Although radical cystectomy remains the gold standard treatment for muscle-invasive bladder cancer, its significant morbidity has prompted the exploration of alternative therapies. In this context, bladder preservation therapies, though supported by limited literature, emerge as a potential alternative that could offer comparable oncological outcomes in selected patients.
Exploring empathy in simulation-based health education: instructor profiles and training implications
(2025) Armijo-Rivera, Soledad; Vicencio-Clarke, Scarlett; Riffo-Saldías, Nancy; Caamaño, Hernán; Díaz, Pía; Caldo, Francesca; Pino, Carla
Introduction: Empathy has cognitive and emotional dimensions that healthcare professionals needEmpathy has cognitive and emotional dimensions that healthcare professionals need to develop. Empathy also influences the learning environment and student outcomes in simulation-to develop. Empathy also influences the learning environment and student outcomes in simulation-based education. This study explored the empathy profiles of simulation instructors and analyzedbased education. This study explored the empathy profiles of simulation instructors and analyzed how cognitive and affective dimensions correlate with demographic characteristics.how cognitive and affective dimensions correlate with demographic characteristics. Methods:Methods: Quantitative, observational, cross-sectional study conducted with 36 novice simulationQuantitative, observational, cross-sectional study conducted with 36 novice simulation instructors. Empathy was evaluated using the Test of Cognitive and Affective Empathy, whichinstructors. Empathy was evaluated using the Test of Cognitive and Affective Empathy, which assesses four dimensions of empathy: Perspective Adoption (PA), Emotional Understanding (EU),assesses four dimensions of empathy: Perspective Adoption (PA), Emotional Understanding (EU), Empathic Distress (ED), and Empathic Joy (EJ). Statistical analysis was conducted using Kruskal-Empathic Distress (ED), and Empathic Joy (EJ). Statistical analysis was conducted using Kruskal-Wallis and Spearman’s Rho tests in JASP (v0.19.1).Wallis and Spearman’s Rho tests in JASP (v0.19.1). Results:Results: Most participants were women (83.33%), aged 30–34 years (41.67%), and held a master’sMost participants were women (83.33%), aged 30–34 years (41.67%), and held a master’s degree (80.56%). One-third of the participants (33%) scoreddegree (80.56%). One-third of the participants (33%) scored ≥94th percentile on total empathy. PA94th percentile on total empathy. PA and EJ scores were consistently high, while EU and ED showed greater variability. Gender differencesand EJ scores were consistently high, while EU and ED showed greater variability. Gender differences were significant, with men scoring higher in total empathy, EU, and ED (pwere significant, with men scoring higher in total empathy, EU, and ED (p <0.05). Structured training0.05). Structured training correlated with higher ED; lack of conference attendance correlated with higher EU. There were nocorrelated with higher ED; lack of conference attendance correlated with higher EU. There were no associations between empathy scores and years of experience or academic qualifications.associations between empathy scores and years of experience or academic qualifications. Conclusions:Conclusions: Simulation instructors in this study exhibited high cognitive empathy, with variableSimulation instructors in this study exhibited high cognitive empathy, with variable levels of affective empathy. Empathy profiling can be an integral part of tailored instructor traininglevels of affective empathy. Empathy profiling can be an integral part of tailored instructor training that strikes a balance between emotional responsiveness and psychological safety. These resultsthat strikes a balance between emotional responsiveness and psychological safety. These results highlight the importance of including strategies to improve emotional resilience and promotehighlight the importance of including strategies to improve emotional resilience and promote effective educator-student interactions in simulation faculty development programs.effective educator-student interactions in simulation faculty development programs.
Utility of opportunistic CT Hounsfield Units determined bone quality in chilean women
(2025) Yurac, Ratko; Mardones, Paula; Núñez, Marilaura; Bravo, Oscar; Quinteros, Guísela; Ariztía, Antonio; Nazar, Catalina; Marré, Andrea
Objective: To describe the correlation between Hounsfield Units in opportunistic computed tomography (CT scan) and T-score measured by dual energy X-ray absorptiometry (DXA) in the Chilean population. Method: Female patients over 50 years old with CT scan and DXA performed within 6 months. Hounsfield units (HU) were measured by circular regions-of-interest placed on axial slice image of the L1 vertebral body in the CT scan. T-score was obtained through DXA scan in L1-L4 vertebrae. Results: 144 female patients were included with a mean age in years of 68.39 ± 8.75. A moderate correlation was found between T-score and HU (Pearson coefficient of 0.6, p < 0.001). The mean values of HU differ significantly between the groups of Osteoporosis (OP) (89.46 ± 20.20), Osteopenia (110.87 ± 30.74) and normal bone mineral density (154.53 ± 38.90) (p < 0.01). The area under curve for diagnostic capacity was 0.81 (95% CI 0.72-0.9). The HU thresholds for the diagnosis of OP were 101 (sensitivity 75%, specificity 75%). Conclusion: Opportunistic CT scan is a useful tool in Chilean population to perform a screening for OP.
Cyanoacrylate Tissue Adhesives in Peri‐Implant Surgery: A Case Report and Surgical Technique
(2025) Vicencio, Patricio; Marinkovic, Dusan; Guler, Hans; Miranda, Claudio
Cyanoacrylate tissue adhesives have been proposed as an adjunct or alternative to sutures in periodontal and peri-implant surgery, offering hemostasis, bacterial sealing, and improved wound healing. However, their clinical application remains scarcely documented. This case describes the adjunctive use of n-butyl-2-cyanoacrylate in combination with sutures for donor site stabilization during peri-implant soft tissue grafting in a 67-year-old female patient rehabilitated with implants in the maxillary right quadrant. A free gingival graft was harvested from the palatal premolar region and secured with sutures and cyanoacrylate ad- hesive, while the recipient site received a split-thickness flap under local anesthesia. Healing was uneventful, with complete graft integration and stable keratinized mucosa formation in the donor site after 30 days. No inflammation, infection, or necrosis was observed, and postoperative discomfort was minimal. The adjunctive use of cyanoacrylate provided rapid hemostasis, effective wound protection, and enhanced patient comfort, suggesting a simple and clinically feasible approach to soft tissue management around implants. However, these findings are based on a single case and should be interpreted descriptively.
Risk and impact of stroke across 38 countries and territories of the Americas from 1990 to 2021: a population-based trends analysis from the Global Burden of Disease Study 2021
(2025) Martinez, Ramón; Munoz Venturelli, Paula; Ordunez, Pero; Fregni, Felipe; Abanto, Carlos; Alet, Matias; Alvarez, Tony; Amaya, Pablo; Ameriso, Sebastian; Arauz, Antonio; Barboza, Miguel; Bayona, Hernán; Ortiz, Antonio; Calleja, Juan; Cano, Vanessa; Carbonera, Leonardo; Carrillo, Rodrigo; Corredor, Angel; De Souza, Ana; Jimenez, Claudio; Lanas, Fernando; Martins, Sheila; Navia, Víctor; Novarro, Nelson; Olavarría, Verónica V.; Ovbiagele, Bruce; Pachecho, Kevin; Pontes, Octavio; Pujol, Virginia; Rabinstein, Alejandro; Rosales, Julieta; Rosende, Andrés; Sampaio, Gisele; Saposnik, Gustavo; Sen, Souvik; Testai, Fernando; Urrutia, Victor; Anderson, Craig; Lavados, Pablo
Background: Despite substantial declines in burden over time, stroke remains a public health threat in the Americas. This study aimed to assess the current magnitude, trends, and disparities in the estimates of stroke burden by sex and age in the Americas from 1990 to 2021. Methods: Estimates from the Global Burden of Disease, Injuries and Risk Factors Study 2021 were used to analyze incidence, prevalence, mortality, years of life lost due to premature death, years lived with disabilities, and disability-adjusted life years (DALYs) caused by stroke and its major subtypes stratified by age, and sex in the Americas from 1990 to 2021. We used Joinpoint regression analysis to estimate the average annual percent change (AAPC) of stroke mortality and disease burden outcomes and assessed trends. Findings: In 2021, there were 1.1 million (95% uncertainty interval: 1.0-1.2) new cases, 12.9 million (12.3-13.7) prevalent cases, 0.5 million (0.5-0.6) deaths, and 11.4 million (10.6-12.1) DALYs due to stroke in the Americas. The absolute number of stroke burden outcomes increased from 1990 to 2021, but their corresponding age-standardized rates significantly declined. A deceleration in reduction rates of burden outcomes for all strokes and most stroke subtypes occurred over the last decade, with pronounced difference between sexes mainly in incidence among younger groups. From 2015 to 2021, trends in incidence rates from all stroke and stroke subtypes reversed to increase in most age groups, and strikingly, trends in mortality and DALY rates from ischemic stroke among younger populations reversed to upward with AAPC over 1.4%. A substantial number of countries contributed to these increasing trends. Interpretation: Regionally, the annual number of stroke cases and deaths significantly increased from 1990 to 2021, despite reductions in age-standardized rates. The declining pace in age-standardized stroke rates has decelerated in recent years, while trends in incidence, and ischemic stroke mortality and DALY among middle-aged adults and adults, reversed towards upward in the period 2015-2021. Further studies are needed to understand the determinants of this recent pattern and identify the most cost-effective interventions to stem this alarming trend. Funding: There was no funding source for this study.
Exploring Lumbar Spine Posture and Movement in Sitting: A Comparison Between Laboratory and Real-World Measures
(2025) Abdullah Alshehri, Mansour; Riddick, Ryan; Besomi, Manuela; Hoorn, Wolbert van den; Klyne, David M.; Hodges, Paul W.
Background/Objectives: Sitting is linked to health problems, including back pain. Sitting posture is commonly measured in the laboratory, but it remains unclear how this relates to real-world spine posture. Methods: A cross-sectional study of pain-free adults conducted measurements in “laboratory” and “real-world” settings. Wearable motion sensors recorded lumbar spine angular orientation to compare lumbar spine flexion angle during sitting postures in between settings. Gaussian mixture models defined participant-specific modes and overall probability distributions of real-world sitting posture. Measures included periods of real-world sedentary/activity behaviours and trunk postural control (laboratory). Results: Laboratory measures of lumbar angle were more flexed during questionnaire (30.0◦) than upright (19.8◦) sitting. The angle in unstable sitting was intermediate (27.1◦). Spine posture in unstable sitting correlated with real-world overall mean posture (r = 0.49–0.54) and most frequent mode (r = 0.47). Upright laboratory sitting posture correlated with real-world second most frequent mode (r = 0.54). Sitting less (r = 0.45) and walking more (r = 0.41) in the real world related to better balance performance and lumbar spine coordination. Conclusions: Spine posture in an unstable sitting laboratory task had the closest association with real-world sitting but does not replicate the diversity of spine postures adopted in real-world sitting. Wearable sensors are viable to study real-world postures.
Molecular and clinical registry of Chilean patients diagnosed with BRAF-mutated colorectal cancer
(2025) García-Bloj, Benjamín; Mayo Glaser, Tomás de; Sigler Chávez, Fernando; Muñoz-Medel, Matías; Cueto, Nicolás; Pinto, Felipe; Aravena, Paola; Retamal, Ignacio N.; Gómez-Valenzuela, Fernán; Silva, Ian; Garrido, Javiera; Corvalán, Ignacio; Avendaño, María E.; San Martin Abello, Cristopher; Sabioncello, Andrea C.; Garrido Villanueva, Marcelo; Erpel, José M.; Henríquez, Jenny F.; Godoy, Juan A.; Garrido, Marcelo
Background: In recent years, the epidemiological trend of colorectal cancer (CRC) in Chile has become increasingly concerning, particularly due to the high costs associated with managing advanced-stage disease, which places a significant strain on the national healthcare system. In 2012, 2,417 new CRC cases were reported across both sexes in Chile. However, current projections estimate a sharp rise to 5,914 new cases, corresponding to an incidence rate of 20.7 per 100,000 individuals. This study aims to register the presence of BRAF mutations in Chilean patients to better characterize the molecular epidemiology of CRC in the local population. BRAF mutations are associated with poor prognosis, with affected patients typically exhibiting a median overall survival (OS) of less than 12 months. Methods: We present a cohort study that included 23 Chilean patients newly diagnosed with CRC and recruited up to April 1, 2024. Patients with a history of another malignant neoplasm diagnosed within the previous three years were excluded. BRAF mutations were analyzed in all participants treated within the public and private healthcare systems in Santiago, Chile. Results: Despite the rising prevalence of CRC in Chile, the frequency and distribution of BRAF mutations in the local population are unknown. Median OS differed by sex, with female patients showing a shorter OS of 24 months compared to 75 months in male patients (P=0.16). When stratified by stage at diagnosis, patients with stage II–III disease demonstrated a markedly longer median OS of 134 months, whereas those with stage IV disease had a median OS of only 24 months (P=0.12; not significant). Conclusions: Establishing comprehensive records of the most prevalent BRAF mutations in Chilean patients with CRC is essential for advancing precision oncology research. This knowledge has the potential to transform clinical management strategies and enhance treatment outcomes and the quality of life of patients. Consequently, an accurate assessment of BRAF gene mutations tailored to the molecular and clinical characteristics of each patient is crucial for optimizing treatment outcomes.
Good Treatment by Teachers as Perceived by Medical Students in Chile: A Survey-Based Study
(2025) Vicencio-Clarke, Scarlett; Armijo-Rivera, Soledad; Pérez- Villalobos, Cristhian; Bastías-Vega, Nancy; Ortega-Bastidas, Javiera; Schilling- Norman, Mary Jane; Hechenleittner-Carvallo, Marcela; Soto-Faúndes, Catherine; Williams-Oyarce, Carolina; Peralta-Camposano, José; Ríos-Teillier, María Isabel
The perception of academic mistreatment among medical students is associated with burnout, emotional disorders, and poorer professional performance. Conversely, a positive environment that promotes respectful teaching can enhance empathy, reduce burnout, and increase student satisfaction. This study examines perceptions of respectful teaching and its associations with demographic and academic characteristics among medical students in Chile. Aim: To evaluate perceptions of respectful teaching among medical students in Chile and their relationship with sociodemographic, academic, and personal satisfaction factors. Methods: A cross-sectional study was conducted across six Chilean universities, involving 443 medical students. We used the Good Teaching Practices Questionnaire (40 items in 9 dimensions) and tools for sociodemographic characterization and academic satisfaction. Data were analyzed using descriptive statistics, reliability coefficients, Spearman correlations, and ANOVA, with significance set at p<0.05. Results: Younger students, those in earlier years, or those recently admitted reported better perceptions of respectful teaching (p<0.05). Men perceived greater support in flexible planning, feedback, and concern for students (p<0.01). Theoretical and synchronous courses were associated with better perceptions of class agility and teaching passion (p<0.001). The highest-rated dimension was subject mastery (Md= 4.00), while concern for students received the lowest score (Md= 3.00). Conclusion: Higher life satisfaction and work-life balance levels are related to respectful teaching. Differences between universities and demographic groups highlight the need for inclusive institutional policies and faculty training to foster equitable and empathetic environments in medical education.

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