Hospital Clínico de la Universidad Católica

Actualmente y no en pocas ocasiones, al sarampión se le considera una enfermedad benigna, aunque esto no siempre fue así, a modo de ejemplo, en Santiago de Chile a comienzos del siglo XX, miles de niños fallecían por epidemias de “alfombrilla”. Comunicaciones nacionales daban cuenta de sus frecuentes complicaciones, muchas de ellas de carácter letal. Estos hallazgos históricos ilustran la magnitud de la carga sanitaria del sarampión en la era pre-vacunas. A inicios de la década del sesenta se inició el programa de vacunación contra el sarampión en la provincia de Santiago, continuando los meses siguientes en el resto del país, siendo esta la primera experiencia mundial de carácter nacional. En 1992 se logró la interrupción de la transmisión autóctona de la infección. En la actualidad el sarampión se está propagando debido a la reducción de su cobertura de vacunación, principalmente ocasionada por la interrupción de los programas locales de inmunización y a la existencia de grupos con baja adherencia o resistencia a la vacunación. El objetivo de esta comunicación es revisar las principales comunicaciones de Revista Chilena de Pediatría referentes a las graves complicaciones ocasionadas por el sarampión durante el siglo pasado.

Abstract Background Sedentarism is prevalent and associated with poorer mental and physical health. Whether everyday physical activity (PA) maps onto computational decision strategies and brain structure/function in non-elderly adults remains unclear. Methods Seventy-one healthy adults (39 women; 18–45 years) completed the Multi-Source Interference Task (MSIT) during fMRI. PA was quantified with the short IPAQ and participants were classified as Active or Sedentary. Behavior (RT, accuracy) was analyzed with frequentist models and a hierarchical Bayesian drift–diffusion model (DDM) estimating drift rate ( v ), boundary separation ( α ), and non-decision time (τ). First-level fMRI modeled congruent/incongruent trials; group-level analyses used FLAME1 with cluster-wise FWE correction (z>3.1, p <.05). Structural MRI was processed with FreeSurfer 7.4.1 (cortical thickness, hippocampal subfields); surface-based GLMs tested group and DDM effects. Results Active participants responded faster overall; incongruent accuracy showed a speed– accuracy trade-off (accuracy increased with slower RTs), with a significant RT × group interaction. In the DDM, boundary separation ( α ) was higher in sedentary individuals (greater caution), whereas drift rate ( v ) differed by sex (males > females). Structurally, the active group showed larger left hippocampal subfields and thicker cortex in posterior temporal & anterior cingulate regions that are negatively related to α . Functionally, boundary-related BOLD modulation encompassed fusiform, posterior cingulate, superior temporal cortex, and SMA; Active > Sedentary contrasts highlighted left occipital and inferior parietal lobe. Conclusions Everyday PA aligns with lower decision thresholds, select structural advantages, and more efficient task-engaged networks, suggesting PA fosters adaptive, resource-efficient cognitive control. These mechanistic links support PA-based strategies to mitigate risks of sedentarism.

Breast cancer treatments often leave survivors feeling disconnected from their bodies, impacting their self-esteem and emotional wellbeing. TACTUS is an innovative sensory toolkit designed to foster reconnection and self-exploration using tactile tools, essential oils, and guided exercises. Feedback from patients and healthcare professionals led to a shift from a prescribed process to a personalized approach, allowing survivors to engage at their own pace. TACTUS is expected to bridge physical and emotional health, offering a holistic and empathetic proof-of-concept that promotes self-awareness and sexual health posttreatment. Future developments include refining the toolkit, exploring massage techniques to enhance recovery and prevent complications, and conducting a formal evaluation.

Breast cancer (BC) treatment often overlooks sexual health, focusing solely on survival indicators. The Explorar-me kit invites BC patients to reconnect with their sexuality through self-exploration tools and accessible education. Patient-centred design revealed cultural barriers and normalized discomforts, highlighting the need for proactive sexual health education. The kit’s tools, including a vibrator and dilators, would allow patients to explore their sexual wellbeing independently and confidently. This replicable model demonstrates how empathy-driven, collaborative design can address stigmatised health topics and improve patient experiences.

El LACRE 2023 marcó el décimo aniversario de este importante congreso latinoamericano, realizado de manera virtual los días 15 y 16 de junio de 2023. Organizado por la Facultad de Medicina de la Universidad Católica de Chile en conjunto con el Royal College of Physicians and Surgeons de Canadá, el congreso reunió a más de 400 participantes de 12 países. El evento incluyó dos presentaciones plenarias, dos mesas redondas, dos simposios, 6 talleres, 24 presentaciones orales y 50 trabajos en modalidad póster. Las presentaciones plenarias fueron lideradas por el Dr. Brian Hodges del Royal College de Canadá, quien abordó los desafíos de la educación de residentes en una era hipertecnologizada, y el Dr. Melchor Sánchez de la Universidad Autónoma de México, quien discutió el rol de los residentes como docentes. Los temas principales abordados incluyeron: Estrategias de apoyo a residentes con dificultades Evaluación de residentes Bienestar y autocuidado post-pandemia Adaptación de la educación basada en competencias al contexto local Balance entre excelencia académica y bienestar integral Los trabajos de investigación presentados reflejaron la evolución de la educación médica de postgrado en América Latina, abarcando temas como: Formación en profesionalismo Autocuidado Simulación Razonamiento clínico Aprendizaje gamificado Estrategias de evaluación basadas en competencias Trabajo en equipo Un aspecto destacable fue cómo la comunidad latinoamericana ha desarrollado una nueva cultura en educación médica de postgrado durante estos diez años, integrando nuevos modelos y conceptos. El congreso también ha servido como plataforma para impulsar otras iniciativas importantes como los Encuentros Internacionales de Líderes en Educación Médica (IMELF) y la creación del Centro de Excelencia para la Educación Médica de Post Grado (CoAE). La pandemia de COVID-19, si bien forzó el formato virtual del congreso, fue aprovechada como una oportunidad para generar aprendizajes que transformaron las prácticas formativas, haciéndolas más creativas y eficientes. Esto se reflejó en el título del congreso: "Nuevas Perspectivas de Educación para Residentes". El LACRE ha evolucionado hasta convertirse no solo en un espacio de intercambio académico sino también en un punto de encuentro para la comunidad médica educativa latinoamericana. Para el próximo congreso, se planea volver a la presencialidad, respondiendo a la solicitud de los participantes de "volver a encontrarse de verdad", manteniendo su compromiso de apoyar a directores de programa, educadores clínicos, diseñadores curriculares y residentes en un mundo en constante cambio.

Abstract Background: Most gallbladder cancer (GBC) cases arise from the metaplasia-dysplasia-GBC sequence, and chronic inflammation has been associated with its development. The use of non-steroidal anti-inflammatory drugs (NSAIDs) has been associated with reduced risk of GBC; however, little is known about these associations with preneoplastic lesions. We thus aimed to study the associations of the use of NSAIDs and inflammatory proteins with gallbladder dysplasia, a precursor to GBC. Methods: Associations of NSAIDs and gallbladder dysplasia were evaluated in 1,925 Chilean cholecystectomy patients, 82 with dysplasia and 1,843 with gallstones but not dysplasia. In addition, we measured 33 circulating inflammatory proteins in a subsample of 68 dysplasia cases diagnosed at the time of sample selection and 136 gallstone controls. Age- and sex-adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated, and associations of inflammatory proteins and gallbladder dysplasia were analyzed. Results: NSAID use was inversely associated with gallbladder dysplasia (OR: 0.48, 95% CI: 0.26-0.83). Comparing the highest versus lowest category of each immune-related protein, eight proteins were inversely associated with dysplasia with ORs ranging from 0.30 (95%CI: 0.12-0.77) for IL-33 to 0.76 (95%CI: 0.59-0.99) for MIP-1B. Of those, GRO remained associated with dysplasia (OR: 0.64, 95%CI: 0.45-0.91) and BCA-1 was borderline-associated (OR: 0.74, 95%CI: 0.54-1.01) in the multivariable logistic regression model additionally adjusted for sex, age and NSAID use. Conclusion: NSAID users were less likely to have gallbladder dysplasia, suggesting that NSAIDs might be beneficial for gallstones patients. Prospective studies are needed to understand the inverse association of immune-related markers and dysplasia, and to evaluate the biological effect of NSAIDs in GBC. Research supported by general funds from the Intramural Research Program of the US National Institutes of Health, National Cancer Institute, Division of Cancer Epidemiology and Genetics, and the Office of Research on Women’s Health, National Institutes of Health. Citation Format: Lorena Rosa, Paz Cook, Ruth M. Pfeiffer, Troy J. Kemp, Allan Hildesheim, Burcin Pehlivanoglu, Volkan Adsay, Enrique Bellolio, Juan Carlos Araya, Ligia Pinto, Catterina Ferreccio, Gloria Aguayo, Eduardo Viñuela, Jill Koshiol. Associations of non-steroidal anti-inflammatory drug use and circulating inflammatory proteins with gallbladder dysplasia [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3446.

In highly marketised higher education systems, massification has afforded greater access, particularly for first-in-generation students. Generally, this expansion has been fuelled by neoliberal ideologies that valorise the notion of choice and promise of social mobility. In this study, using interviews with 25 first-generation students, the issue of choice is critically examined in one of the earliest arenas of neoliberal experimentation: the Chilean higher education system. The study found that these first-in-generation students encountered complex and multi-levelled challenges in making higher education choices. Such choices were firmly anchored in differing levels of aspiration, and were strongly mediated by both family and school social capital. As a result, we propose an addition to traditional conceptions of choice: students (and their families) who act as strategic choosers. This outcome challenges the notion that first-in-generation students encounter unitary trajectories or equitable choices in encountering higher education.