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Resumen Introducción: Las dismorfosis dentofaciales (DDF) corresponden a un conjunto de alteraciones en la forma, posición o tamaño de los huesos maxilares. La cirugía ortognática es el tratamiento quirúrgico de elección para tratar este tipo de alteraciones, permitiendo la reposición de los maxilares y restitución de las funciones masticatorias, fonéticas y respiratorias, así como la estética facial. Objetivo: Describir resultados posoperatorios y el grado de satisfacción de los pacientes que optaron por la cirugía ortognática durante los años 2011-2018 por el equipo de Cirugía Maxilofacial del Hospital San José. Material y Método: Estudio retrospectivo, se evaluaron los protocolos operatorios de 44 pacientes operados de cirugía ortognática. Criterio de inclusión: pacientes mayores de 15 años con diagnóstico de DDF clases II y III no asociado a síndrome craneofacial. Se aplicó una encuesta a estos pacientes para conocer el grado de satisfacción con respecto a la cirugía ortognática efectuada, presencia de pérdida de sensibilidad neurológica y localización anatómica de ésta si la hubiese. Posteriormente, se relacionaron las variables género, edad del paciente al momento de la cirugía, pérdida de sensibilidad neurológica, tiempo de evolución posoperatorio y clase esqueletal con el nivel de satisfacción del paciente respecto a la cirugía ortognática. Resultados: Un 90,9% de los pacientes está satisfecho con los resultados de la cirugía. No existe una relación estadísticamente significativa entre el grado de satisfacción con la cirugía ortognática y las variables, sexo, edad de operación, pérdida de sensibilidad neurológica (del nervio mentoniano, que da inervación sensitiva al tejido blando del mentón, labio inferior, encía por vestibular de incisivos, canino y primer premolar inferior), tiempo de evolución posterior a la cirugía y clase esqueletal. Conclusión: Existe un alto nivel de satisfacción en los pacientes intervenidos mediante cirugía ortognática. Las cinco variables analizadas no influyen en el nivel de satisfacción de los pacientes posterior a la cirugía ortognática.

Abstract Introduction: Dentofacial deformities are a set of alterations in the shape, position or size of the maxillary bones. Orthognathic surgery is the surgical treatment of choice for this type of alterations, allowing the replacement of the maxillary and restitution of masticatory, phonetic and respiratory functions, as well as facial aesthetics. Aim: Describe post-operative results and level of satisfaction in patients who opted for orthognathic surgery during the years 2011-2018 by the Maxillofacial Surgery team of San José Hospital. Material and Method: Retrospective study, the surgical protocols of 44 patients who underwent orthognathic surgery were evaluated. Inclusion criteria: patients over 15 years old with diagnosis of DDF class II and III not associated with any craniofacial syndrome. A survey was applied to these patients to know the degree of satisfaction with respect to the orthognathic surgery carried out, the presence of loss of neurological sensitivity and its anatomical location, if any. Subsequently, the variables gender, patient age at the time of surgery, loss of neurological sensitivity, time of postoperative evolution and skeletal class were related to the level of satisfaction of patients with orthognathic surgery. Results: 90.9% of patients are satisfied with the results of the surgery. There is no statistically significant relationship between the level of satisfaction patients with orthognathic surgery and the variables, gender, age at the time of surgery, loss of neurological sensitivity (of the mentonian nerve, that gives sensitive innervation to the soft tissue of the chin, lower lip, gum by vestibular of incisors, canine and first lower premolar), time of postoperative evolution and skeletal class. Conclusion: There is a high level of satisfaction in patients undergoing orthognathic surgery. The five variables analyzed do not influence the level of patient satisfaction after orthognathic surgery.

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El bazo se localiza en el cuadrante superior izquierdo del abdomen, relacionándose posteriormente con la 9a a 11a costilla, de las que se separa por el diafragma y el receso costodiafragmático, se localiza por detrás del estómago y lateralmente al riñón izquierdo. Por alteraciones en su desarrollo pueden generarse bazos accesorios (BA), considerándose un tejido ectópico del bazo. Se consideran tejido normal, con los mismos procesos fisiológicos que el bazo principal. Con el propósito de localizar y determinar aspectos biométricos de los mismos, se realizó un estudio de corte transversal y de carácter descriptivo, sobre una muestra de 220 exámenes de TC pertenecientes a pacientes mayores de 18 años del Hospital Regional Hernán Henríquez Aravena, Temuco, Chile. Para este estudio se excluyeron toda aquellas TC con antecedentes de esplenectomía y lesiones de Bazo o peri-esplénicas. El análisis de los datos mostró una prevalencia de 32,3 % de BA, pudiendo ser de una única presencia, dos e incluso tres BA por paciente.De un total de 71 personas que tienen al menos un BA, 34 (47,89 %) fueron de sexo femenino y 37 (52,11 %) de sexo masculino. Hubo 56 pacientes (78,9 %) con un BA, 29 (40,85 %) del sexo femenino y 27 (38,03 %) del masculino; 15 (21,1 %) presentaron más de un BA, 5 (7,04 %) de sexo femenino y 10 (14,08 %) de sexo masculino, si bien se puede observar variación en la cantidad de BA según sexo, no existe una relación estadísticamente significativa entre dichas variables. La ubicación más frecuente encontrada en el plano axial fue la zona antero-medial con 59 casos (66,29 %); asimismo, en el plano sagital, la localización más frecuente fue en el polo inferior con 40 casos (44,44 %). Datos biométricos de estos BA son mostrados en Tablas. Esta información será de gran valor morfológico y médico debido a la escasa literatura existente sobre esta materia en individuos chilenos.

The spleen is located in the upper left quadrant of the abdomen, subsequently related to the 9th to 11th rib, from which it is separated by the diaphragm and the cost-diaphragmatic recess, it is located behind the stomach and laterally to the left kidney. Due to alterations in its development, accessory spleens (AS) can be generated, being considered an ectopic tissue of the spleen. The AS are considered normal tissue, with the same physiological processes as the main spleen. With the purpose of locating and determining biometric aspects of them, a cross-sectional and descriptive study was carried out on a sample of 220 CT scans belonging to patients over 18 years of age at the Hernán Henríquez Aravena Regional Hospital, Temuco, Chile. For this study, all CT scans with a history of splenectomy and spleen or peri-splenic lesions were excluded. The analysis of the data showed a prevalence of 32.3 % of AS, being able to be of a single presence, two and even three AS per patient. Of a total of 71 people who have at least one AS, 34 (47.89 %) were female and 37 (52.11 %) male. There were 56 patients (78.9 %) with a one AS, 29 (40.85 %) of the female sex and 27 (38.03 %) of the male; 15 (21.1 %) presented more than one AS, 5 (7.04 %) female and 10 (14.08 %) male, although variation in the amount of AS according to sex can be observed, no there is a statistically significant relationship between these variables. The most frequent location found in the axial plane was the anteromedial zone with 59 cases (66.29 %); also, in the sagittal plane, the most frequent location was in the lower pole with 40 cases (44.44 %). Biometric data of these AS are shown in tables. This information will be of great morphological and medical value due to the limited existing literature on this subject in Chilean individuals.

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El presente artículo indaga la aparición de dos instituciones de control de la higiene pública en Chile entre los años 1879 y 1920: los protomedicatos y lazaretos. El objeto de estudio utiliza como caso la presencia de la viruela en La Araucanía. Se abordan las características y contexto que adquirió la instalación de estos dispositivos que permitieron al Estado de Chile operacionalizar el asunto de la higiene pública, lo que interpeló a los profesionales de la salud para avanzar a mayores niveles de perfeccionamiento del ejercicio profesional de la medicina. El Estado liberal positivista de fines de siglo XIX comprendió que el tema de la higiene no era solamente una cuestión de responsabilidad individual, sino que tenía una dimensión social, pública y medio ambiental. No sólo había personas que eran higiénicas, sino también ambientes higiénicos y antihigiénicos. Por tanto, se estudia la higiene, el tribunal del protomedicato, la hoja sanitaria, lazaretos, médicos y vacunadores; quienes estuvieron en permanente tensión con las autoridades del gobierno central debido a los insuficientes recursos proporcionados por el Estado para la atención de los enfermos contagiados con viruela. El estudio se orienta desde una metodología cualitativa con un diseño historiográfico con alcances descriptivos densos. Se han utilizado fuentes primarias y secundarias disponibles en archivos en Chile y Alemania. Los resultados evidencian que la presencia de viruela apareció violentamente en el centro sur de Chile en la segunda mitad del siglo XIX y permaneció en la Araucanía hasta la primera mitad del siglo XX. La violencia con que se desarrolló la viruela generó miedo e incertidumbre afectando a personas de diferentes clases sociales, y tuvo como una de sus causas principales las precarias condiciones de salubridad de la población.

This article investigates the emergence of two institutions for the control of public hygiene in Chile between 1879 and 1920: colleges of royal physicians and isolation hospitals using the case of smallpox in La Araucanía, a region located in the South of Chile. We cover the characteristics and context of these institutions that allowed the State of Chile to address the problems of public hygiene and to prompt health professionals to professionalize the practice of medicine. The liberal positivist state of the late nineteenth century understood that the issue of hygiene was not only a matter of individual responsibility but had a social, public, and environmental dimension. People practiced hygiene alongside the existence of hygienic and anti-hygienic environments. Therefore, hygiene, the royal colleges of physicians, health records, isolation hospitals, doctors, and vaccinators are studied. All of these components of the health care system of the time were in permanent tension with the central government authorities due to the insufficient resources provided by the state for the care of infected patients with smallpox. The study follows a qualitative methodology with a descriptive historiographic design. We used archival primary and secondary sources available in Chile and Germany. The results show that the presence of smallpox appeared ferociously in South-Central Chile in the second half of the 19th century and remained in La Araucanía until the first half of the 20th century. The extent to which smallpox spread, spawning fear and insecurity in people of different social classes, had as one of its leading causes the precarious conditions of health and hygiene of the population.

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The different morphological characteristics of five bacterial pathogen strains were analyzed through transmission electron microscopy for addressing the particular relationship between optical density and colony-forming units for each strain. Generated linear equations will allow a reliable calculation of bacterial concentrations through simple optical density measurements.

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Pollen is one of the primary causes of allergic rhinoconjunctivitis in urban centers. In the present study, the concentrations of 39 different pollens in the Santiago de Chile metropolitan area over the period 2009-2013 are characterized. The pollen was monitored daily using Burkard volumetric equipment. The contribution of each type of pollen and the corresponding time trends are evaluated. The concentrations of the pollens are compared with the established threshold levels for the protection of human health. The results show that the total amount of pollen grains originating from trees, grasses, weeds and indeterminate sources throughout the period of the study was 258,496 grains m-3, with an annual average of 51,699 ± 3,906 grains m-3 year-1. The primary source of pollen is Platanus orientalis, which produces 61.8% of the analyzed pollen. Grass pollen is the third primary component of the analyzed pollen, with a contribution of 5.82%. Among the weeds, the presence of Urticacea (3.74%) is remarkable. The pollination pattern of the trees is monophasic, and the grasses have a biphasic pattern. The trends indicate that the total pollen and tree pollen do not present a time trend that is statistically significant throughout the period of the study, whereas the grass pollen and weed pollen concentrations in the environment present a statistically significant decreasing trend. The cause of this decrease is unclear. The pollen load has doubled over the past decade. When the observed concentrations of the pollens were compared with the corresponding threshold levels, the results indicated that over the period of the study, the pollen concentrations were at moderate, high and very high levels for an average of 293 days per year. Systematic counts of the pollen grains are an essential method for diagnosing and treating patients with pollinosis and for developing forestation and urban planning strategies.

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BACKGROUND: With a population of >112 million persons, all Mexicans are entitled to receive medical care by the state and more than half have limited access to healthcare. From January 1985 to March 2009, 40 renal transplants were performed from living donors with a high percentage of complications. In April 2009, a new Solid Organ Transplantation Program was started; herein, we present this enterprise to the international community and briefly present a perspective on the Mexican transplant situation. MATERIALS AND METHODS: We performed a retrospective chart review of kidney and liver transplant recipients from April 2009 to November 2011, including demographic features, immunosuppression, complications as well as initial and 1 month function. RESULTS: We performed 68 kidney (59 living and 9 deceased donors) and 5 liver transplants (cadaveric donors). The kidney transplant recipients were 73.5% males and showed an overall mean age of 29.77 years (range, 18-60). The donor mean age was 34.08 years. Mean recipient creatinine pretransplant was 13.32 mg/dL, while at day 5 it was 2.33 and at month one, 1.32 mg/dL. Five grafts were lost (7.3%): 4 due to death with a functioning graft and 1 due to acute pyelonephritis. Five patients experienced delayed graft function Basiliximab induction was required in all but one who received thymoglobulin owing to a high panel reactive antibody. Maintenance therapy included a calcineurin inhibitor, mycophenolate mofetil (MMF), and prednisone. Liver transplant recipients were 83.6% women. The etiologies were alcoholic cirrhosis (n = 2), primary billiary cirrhosis (n = 1) and hepatitis C virus infection (n = 2). Complications included: reperfusion syndrome (n = 1), convulsive crisis (medication; n = 1), acute respiratory distress syndrome (n = 1), and death (n = 1). Their Model for End-Stage Liver Disease scopes were 10-21. After basiliximab induction, they had maintenance therapy with tacrolimus, MMF, and steroids. The donor mean age was 26.2 years. All survivors show normal liver function tests currently. CONCLUSIONS: From 1985 to 2009, 40 kidney transplants were performed, with multiple complications including donor deaths. Our current results were comparable to international standards, with <15% complication rate.

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BACKGROUND: The Nissen fundoplication procedure is the most widely used type of antireflux surgery. The results are not always as good as expected, and several modifications to the original technique have been proposed. Long-term effectiveness studies comparing different techniques of antireflux surgery are limited. Our group developed a new concept in antireflux surgery (complete fixed "nondeformable" fundoplication) in order to improve its outcome; we present the long-term comparative results of this novel concept/technique. METHODS: Overall, 512 patients were included in the study and assigned into 1 of 3 fundoplications groups: partial (131), Nissen (133), and fixed "nondeformable" (121). We compared the groups with each other and with a group who chose to receive medical treatment (MT) (127). All patients underwent clinical evaluation, upper gastrointestinal endoscopy, esophageal manometry, 24-hour esophageal pH monitoring, and the SF-36 health status survey prior to operation and at 1, 5, 10, and 15 years of follow-up. RESULTS: At the 15-year follow-up, we were able to complete the protocol in 319 patients: 103 patients from the partial group, 102 patients from the Nissen group, 97 patients from the fixed "nondeformable" group, and 17 patients from the medical treatment group. A lower prevalence of erosive gastroesophageal reflux disease (GERD) was observed in the fixed "nondeformable" group (7.20%) versus 21.56% for Nissen, 39.80% for partial, and 47.05% for MT (P < .01). Lower esophageal sphincter (LES) pressure and LES length were more constant in the fixed "nondeformable" group (14.7 mm Hg/2.2 cm) compared with the Nissen (9 mm Hg/0.7 cm), partial (7 mm Hg/2 cm), and MT (5.64 mm Hg/1.3 cm) groups (P < .01). Reflux recurrence was observed in 168 patients (13 in fixed "nondeformable," 41 in Nissen, and 98 in partial (P < .01). CONCLUSION: The complete fixed "nondeformable" fundoplication showed best results in studied parameters and had a lower long-term recurrence compared with Nissen and partial techniques.

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Knowledge of physiological behavior of indigenous tequila yeast used in fermentation process is still limited. Yeasts have significant impact on the productivity fermentation process as well as the sensorial characteristics of the alcoholic beverage. For these reasons a better knowledge of the physiological and metabolic features of these yeasts is required. The effects of dilution rate, nitrogen and phosphorus source addition and micro-aeration on growth, fermentation and synthesis of volatile compounds of two native Saccharomyces cerevisiae strains, cultured in continuous fed with Agave tequilana juice were studied. For S1 and S2 strains, maximal concentrations of biomass, ethanol, consumed sugars, alcohols and esters were obtained at 0.04 h⁻¹. Those concentrations quickly decreased as D increased. For S. cerevisiae S1 cultures (at D=0.08 h⁻¹) supplemented with ammonium phosphate (AP) from 1 to 4 g/L, concentrations of residual sugars decreased from 29.42 to 17.60 g/L and ethanol increased from 29.63 to 40.08 g/L, respectively. The S1 culture supplemented with AP was then micro-aerated from 0 to 0.02 vvm, improving all the kinetics parameters: biomass, ethanol and glycerol concentrations increased from 5.66, 40.08 and 3.11 g/L to 8.04, 45.91 and 4.88 g/L; residual sugars decreased from 17.67 g/L to 4.48 g/L; and rates of productions of biomass and ethanol, and consumption of sugars increased from 0.45, 3.21 and 7.33 g/L·h to 0.64, 3.67 and 8.38 g/L·h, respectively. Concentrations of volatile compounds were also influenced by the micro-aeration rate. Ester and alcohol concentrations were higher, in none aerated and in aerated cultures respectively.

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