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The Chilean Climate Change Law excludes tree monocultures as a solution to the climate crisis, offering an opportunity for resilience and climate mitigation in Latin America. The Chilean experience with mega-fires in extensive, homogeneous forest plantations provides important lessons that could inform climate policies in other countries.

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PURPOSE: To explore trans men's access and use of healthcare services in Chile, based on the experiences of the trans men themselves, as well as of healthcare professionals. METHODS: A qualitative study with an ethnographic approach was carried out with 30 participants: 14 trans men and 16 healthcare professionals. Semi-structured one-on-one interviews with open-ended questions were used to collect the data. A thematic analysis was carried out with the NVivo Software. RESULTS: Three main themes were identified: (1) failures in the recognition of trans identity, (2) challenges with patient-centered care, and (3) use of other ("non-trans") health services. CONCLUSIONS: The results suggest that not all transition processes are the same, individuals seek different ways; therefore, it is necessary to consider different body types and identities when planning programs and care for men in transition. Moreover, the accompaniment provided during the gender transition process should contemplate emotional and mental support. CLINICAL RELEVANCE: The study outlines the need for all healthcare professionals to have training and knowledge about the transgender population, regardless of whether they are part of the teams supporting gender transition processes. The role of nurses and the contributions that can be made from nursing discipline in this research field are fundamental.

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Las quemaduras son un problema de interés en salud pública ya que generan un alto índice de morbimortalidad a nivel mundial, las quemaduras térmicas son las más prevalentes y pueden alterar la integridad anatómica, funcional y estética de la piel, aspectos fundamentales para la autoestima del paciente y su capacidad para reintegrarse a la sociedad. Al revisar la literatura sobre el tratamiento de estas afecciones encontramos diversos tratamientos, entre ellos el uso de membrana amniótica humana, la cual ha tenido un impacto importante en el manejo de quemaduras al funcionar como andamio biológico con cualidades regenerativas y antiinflamatorias. El presente artículo tiene como objetivo sintetizar la información actual que describe las aplicaciones de membranas amnióticas humanas en quemaduras, realizamos una revisión exploratoria sistemática de la literatura desde 2010 hasta 2021.

Burns are a problem of interest in public health since they generate a high rate of morbidity and mortality worldwide, thermal burns are the most prevalent and can alter the anatomical, functional and aesthetic integrity of the skin, fundamental aspects for the patient's self-esteem and their ability to reintegrate into society. At review literature about the treatment of these conditions, we find various treatments, including the use of human amniotic membrane, which has had a significant impact on burn management by functioning as a biological scaffold with regenerative and anti-inflammatory qualities. The present article aims to synthesize the current information that describes the applications of human amniotic membranes in burns. We carry out a systematic exploratory review of the literature from 2010 to 2021.

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INTRODUCTION AND AIMS: Celiac disease (CD) is an autoimmune enteropathy that develops in genetically susceptible individuals. The typical gastrointestinal manifestation is diarrhea but symptoms of dyspepsia, such as epigastric pain, nausea, or satiety, can sometimes appear. Previous studies have reported that the prevalence of CD in patients with dyspepsia can be as high as 7%. The aim of the present study was to evaluate CD seroprevalence in subjects with dyspeptic symptoms and a control group in a Mexican population. MATERIAL AND METHODS: A case-control study was conducted on blood donors that answered the PAGI-SYM questionnaire for dyspepsia and in whom IgA antibodies to tissue transglutaminase 2 (IgA anti-tTG2) and IgG antibodies to deamidated gliadin peptide (IgG anti-DGP) were determined. CD seroprevalence in subjects with dyspeptic symptoms and in asymptomatic subjects was compared. RESULTS: A total of 427 subjects (76.3% men), with a mean patient age of 34 years (range of 18-65 years) were included. Of those participants, 87 (20.3%) had symptoms of dyspepsia (group A) and 340 (79.6%) were asymptomatic (group B). Antibodies were positive in one (1.15%) of the group A subjects (1/87, 95% CI 0.2-6 %), whereas they were positive in 4 (1.18%) of the group B subjects (4/340, 95% CI 0.4-2.9%, p = 0.59). CONCLUSIONS: CD seroprevalence in the study population with dyspeptic symptoms (1%) was not different from that of the control population. Thus, CD screening in Mexican patients with dyspepsia is not justified.

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RESUMEN Durante los procedimientos intervencionistas que utilizan fluoroscopia, se entrega a los pacientes diferentes niveles de dosis de radiación, que pueden tener un impacto a corto, mediano o largo plazo, así como en su severidad. Esto en función del tipo de radiación utilizada y de la sensibilidad a la radiación del tipo(s) de órgano(s) irradiado, es en este punto que se vuelve determinante conocer la dosis a órganos entregada durante los procedimientos con el fin de asegurar el bienestar de los pacientes, este procedimiento no se puede realizar directamente en los órganos del paciente, por lo que se utilizan programas especializado en cálculos dosimétricos. El software PCXMC 2.0 logra estimar la dosis efectiva a través del método determinístico Monte Carlo, a su vez, agregando la dosis equivalente y evaluación de riesgo para estudios dosimétricos, por lo cual, el objetivo del presente trabajo fue proponer una metodología estandarizada para la utilización del programa PCXMC en el cálculo de estas dos magnitudes

ABSTRACT During interventional procedures that utilize fluoroscopy, patients are exposed to varying levels of radiation doses, which can have short, medium, or long term impacts, as well as varying severities. This depends on the type of radiation used and the radiation sensitivity of the organ(s) being irradiated. At this point, it becomes crucial to determine the organ doses delivered during procedures in order to ensure patient well-being. Since direct measurements cannot be made on the patient's organs, specialized software is used for dosimetric calculations. PCXMC 2.0 software achieves the estimation of effective dose through the deterministic Monte Carlo method, while also incorporating equivalent dose and risk assessment for dosimetric studies. Therefore, the objective of this work was to propose a standardized methodology for the use of the PCXMC 2.0 sofware in the calculation of these two magnitudes.it is important to outline a working method for this software and provide instructions on its operation

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Background: In Mexico less than half of the treated hypertensive patients reach blood pressure (BP) targets. Most hypertensive individuals rely on the standard medical care (SMC) to achieve the BP control goals; however, the efficacy of BP telemonitoring (BPT) to achieve BP targets has been poorly studied. Aim: To compare the efficacy of BPT versus SMC to achieve BP goals in patients with uncontrolled hypertension. Methods: A two-arm, open-label clinical trial was conducted in patients ≥18 years with uncontrolled hypertension. The participants were randomized to 2 arms (BPT vs SMC) and followed for 12 weeks. For the statistical analysis, the chi-squared test and covariance were used. Results: One hundred and seventy-eight participants were included, BPT (n = 94) and SMC (n = 84), after 12 weeks of follow up, we observed a baseline-adjusted reduction in systolic BP with both BPT (-13.5 [1.3] mmHg) and the SMC (-5.9 [1.4] mmHg; p < 0.001) but a greater decrease with BPT (p < 0.001). Likewise, we found a baseline-adjusted reduction of diastolic BP with BPT (-6.9 [0.9] mmHg) and SMC (-2.7 [0.9] mmHg) (p = 0.007) with a more significant percentage change from baseline with BPT (-6.8% [1.0] vs 2.5% [1.1]; p = 0.007). In the BPT arm, a larger proportion of patients achieved the BP target versus SMC (30.5% vs 12.8%; p = 0.005). Conclusion: BPT showed a greater proportion of patients achieving office BP control goals (<140/90 mmHg), compared to standard medical care.

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Introducción: El cáncer gástrico, en Chile, ocupa el primer lugar como causa de mortalidad por tumores malignos, por ello, es de suma importancia conocer la descripción demográfica de esta enfermedad en el país. El periodo en estudio 2017-2021 entrega información actualizada a la salud pública. Metodología: Estudio ecológico, observacional, transversal y descriptivo sobre defunciones por cáncer gástrico en el periodo 2017-2021 en Chile según sexo, grupo etario y regiones (n=15350). Se calculó la tasa de mortalidad (TM). Información obtenida del Departamento de Estadística e Información de Salud e Instituto Nacional de Estadísticas, por lo que no requiere comité de ética. Resultados: Durante el periodo 2017-2021 la TM general fue de 21,84, siendo 21,58 en hombres y 10,68 en mujeres. En edad, el mayor valor se presentó en el grupo de 80 y más años y el menor valor en el grupo de 15-19 años. La TM del periodo general más alta la obtuvo la Región Metropolitana. Discusión: Se evidenció una reducción de la TM entre los años 2017-2021, pudiéndose deber al aumento de tamizaje y tratamiento de Helicobacter pylori. Además, se observó que la TM es mayor en hombres, explicado por su mayor susceptibilidad genética a desarrollar cáncer. La menor TM se registró entre 15-19 años, y la mayor en el grupo 80 y más años, lo que concuerda con literatura internacional. Conclusión: Se necesitan más estudios nacionales para ahondar en los resultados encontrados que permitan darle continuidad a la investigación, y que determinen factores de riesgo específicos de la población chilena.

Introduction: Gastric cancer in Chile takes the first place as a cause of mortality from malignant tumors, therefore it is relevant to know the demographic description of this disease in the country. Studied years go from 2017-2021 in order to get updated data to the Chilean public health. Methodology: Ecological, observational, cross-sectional and descriptive study on deaths due to gastric cancer in 2017-2021 in Chile, according to sex, age group and regions (n=15350). The death rate was calculated. Data was obtained from the Department of Statistics and Health Information and the National Institute of Statistics. It did not require approval from an ethics committee. Results: During the 2017-2021 period the overall death rate was 21.84, 21,58 for men and 10,68 for women. The highest values were in the 80 and older age group and the lowest values in the 15-19 years age group. The highest death rate overall period was registered in the Metropolitan Region. Discussion: There was a reduction in the hospital death rate between 2017-2021, which could be due to the increase in screening and treatment of Helicobacter pylori. Death rate is higher in men, which could be explained because they are more genetically susceptible to developing cancer. The lowest values for death rate were found in the 15-19 years age group, and the highest values in the 80 years and older group, which is consistent with international literature. Conclusion: More studies are required in Chile to broaden the findings to allow investigation continuity and to determine specific risk factors present in the Chilean population.

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Introducción: En la actualidad existen pocos estudios con respecto a la evaluación de actitudes y autopercepción de conocimientos de los profesionales de la salud hacia los pacientes con alguna condición de salud mental, y la relación de estas variables con la toma de decisiones respecto de estos pacientes. Desde la experiencia se conoce la dificultad que tienen médicos que no están relacionados con el área de salud mental de afrontar a pacientes con alguna patología psiquiátrica y más aún en las urgencias, ya sea porque reconocen falta de conocimientos del tema, instancias no adecuadas para evaluación además de la alta exigencia de estos servicios. Metodología: El estudio consistió en una encuesta online de carácter transversal aplicada a profesionales de la salud pertenecientes al Hospital Dr. Hernán Henríquez Aravena, ubicado en la ciudad de Temuco, Chile. La encuesta incluyó preguntas sociodemográficas, caracterización de experiencias asociadas a diagnósticos de salud mental, y escalas dedicadas a medir variables (autopercepción, actitudes y toma de decisiones). Resultados: A medida que la autopercepción de conocimientos es mayor, el efecto de las actitudes sobre la toma de decisiones también es mayor. Conclusiones: Tanto las actitudes de los profesionales de la salud hacia este tipo de pacientes, así como su autopercepción de conocimientos, son dos componentes fundamentales para asegurar un buen manejo clínico. Resulta importante que exista un balance en cómo se manejan ambas dentro de un servicio, con el fin de asegurar una atención apropiada y centrada en el bienestar del paciente.

Introduction: Currently there are few studies regarding the evaluation of attitudes and self-perception of knowledge of health professionals towards patients with some mental health condition, and the relationship of these variables with decision making regarding these patients. From experience, its known the difficulty that doctors who are not related to the area of mental health have in dealing with patients with some psychiatric pathology and even more so in emergencies, either because they recognize a lack of knowledge of the subject and instances that are not suitable for evaluation. in addition to the high demand of these services. Methodology: The study consisted of a cross-sectional online survey applied to health professionals belonging to the Dr Hernán Henriquez Aravena Hospital, located in the city of Temuco, Chile. The survey included sociodemographic questions, characterization of experiences associated with mental health diagnoses, and scales dedicated to measuring variables (self-perception, attitudes and decision making). Results: As self-perception of knowledge grows, the effect of attitudes on decision making also increases. Conclusions: Both the attitudes of health professionals towards this type of patients, as well as their self-perception of knowledge, are two fundamental components to ensure good clinical management. It is important that there is a balance in how both are managed within a service, in order to ensure appropriate care focused on the patient's well-being.