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Diversos estudios advierten de la relación a corto plazo entre el uso de los cigarrillos electrónicos y enfermedades pulmonares, cardiovasculares, además de su potencial adictivo. No existen estudios al respecto en estudiantes universitarios chilenos. MÉTODOS: Este estudio descriptivo transversal, mide la prevalencia de consumo, percepción de riesgo, motivaciones y actitudes del uso de cigarrillos electrónicos en estudiantes de Medicina, mediante un cuestionario online. RESULTADOS: Se analizaron 354 sujetos, 32,9% han utilizado cigarrillos electrónicos alguna vez en la vida, 6,8% en el último año y 1,1% en el último mes. La edad media de inicio fue 18,0 ± 2,2 años. Respecto a las percepciones positivas hacia los cigarrillos electrónicos: 37,1% cree que ayudan a la gente a dejar de fumar; 39,7% que son menos peligrosos que los cigarrillos y 19,0% que son menos adictivos. El consumo de cigarrillos electrónicos alguna vez en la vida se asoció al consumo de tabaco y percepciones positivas hacia cigarrillos electrónicos (efectivo para dejar de fumar y menos adictivos que los cigarrillos). Las principales motivaciones al consumo fueron "simplemente porque sí", "porque me gusta el sabor", "me lo recomendó un amigo/familiar" y "porque me relaja". CONCLUSIÓN: Se sugiere prohibir la promoción de los cigarrillos electrónicos como una opción menos dañina y adictiva que el cigarrillo, tampoco como alternativa para dejar de fumar, puesto que la evidencia científica no es suficiente para respaldar tales afirmaciones. Este estudio puede contribuir a la prevención de consumo de cigarrillos electrónicos en poblaciones jóvenes.

INTRODUCTION: Several studies warn of the short-term relationship between the use of electronic cigarettes and lung and cardiovascular diseases, in addition to their addictive potential. There are no studies in this regard in Chilean university students. METHODS: This cross-sectional descriptive study measures the prevalence of consumption, risk perception, motivations and attitudes of e-cigarette use in medical students, using an online questionnaire. RESULTS: We analyzed 354 subjects, 32.9% have used electronic cigarettes once in their lives, 6.8% in the last year and 1.1% in the last month. The mean age of onset was 18.0 ± 2.2 years. Regarding positive perceptions towards e-cigarettes: 37.1% believe they help people quit smoking; 39.7% that they are less dangerous than cigarettes and 19.0% that they are less addictive. E-cigarette use was once in a lifetime associated with tobacco use and positive perceptions toward e-cigarettes (effective for quitting smoking and less addictive than cigarettes). The main motivations for consumption were "simply because I do", "because I like the taste", "it was recommended to me by a friend/family member" and "because it relaxes me". CONCLUSION: It is suggested to ban the promotion of e-cigarettes as a less harmful and addictive option than cigarettes, nor as an alternative to quitting smoking, since scientific evidence is not sufficient to support such claims. This study may contribute to the prevention of e-cigarette use in young populations.

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BACKGROUND: The place of death is a fundamental indicator for the debate on equity and access to health care. AIM: To describe the place of death of the deceased population over 1 year of age in Chile between the years 1997 and 2014. To analyze tendencies in this variable and its association with socio-demographic characteristics. MATERIAL AND METHODS: Time series study covering deaths occurred between 1997 and 2014 in Chile. National death records were used, provided by the Department of Health Statistics and Information (DEIS) of the Chilean Ministry of Health. The following variables were chosen: place of death (home, hospital, other), sex, marital status, age, level of education, activity and area of residence. Temporal trends were evaluated using Prais Winsten regressions. Logistic regression was used to assess the association of the place of death with socio-demographic characteristics. RESULTS: Between 1997 and 2014 there were 1,576,392 deaths, at a mean age of 69 years (p25-p75:60-83 years). No temporal variations in the place of death were observed with the Prais Winsten regression, hospital (P-W coefficient (coef) = 0.06 (confidence intervals (CI): -0.30; 0.19), p = 0.64), home (P-W coef = -0.03 (CI: -0.15; 0.09), p = 0.57), and other places (P-W coef = 0.07; (CI: -0.08 - 0.22), p = 0.32). The multivariate analysis showed that being women under 70 years of age, being married or widowed, having a higher educational level, being inactive and living in a rural area were factors associated with a greater chance of dying at home. CONCLUSIONS: No significant temporal variation in the place of death was observed.

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Background: The place of death is a fundamental indicator for the debate on equity and access to health care. Aim: To describe the place of death of the deceased population over 1 year of age in Chile between the years 1997 and 2014. To analyze tendencies in this variable and its association with socio-demographic characteristics. Material and Methods: Time series study covering deaths occurred between 1997 and 2014 in Chile. National death records were used, provided by the Department of Health Statistics and Information (DEIS) of the Chilean Ministry of Health. The following variables were chosen: place of death (home, hospital, other), sex, marital status, age, level of education, activity and area of residence. Temporal trends were evaluated using Prais Winsten regressions. Logistic regression was used to assess the association of the place of death with socio-demographic characteristics. Results: Between 1997 and 2014 there were 1,576,392 deaths, at a mean age of 69 years (p25-p75:60-83 years). No temporal variations in the place of death were observed with the Prais Winsten regression, hospital (P-W coefficient (coef) = 0.06 (confidence intervals (CI): −0.30; 0.19), p = 0.64), home (P-W coef = −0.03 (CI: −0.15; 0.09), p = 0.57), and other places (P-W coef = 0.07; (CI: −0.08 - 0.22), p = 0.32). The multivariate analysis showed that being women under 70 years of age, being married or widowed, having a higher educational level, being inactive and living in a rural area were factors associated with a greater chance of dying at home. Conclusions: No significant temporal variation in the place of death was observed.

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Background: Gender may influence the incidence, severity and hospital mortality due to heart failure (HF). Aim: To evaluate the influence of sex on the proportion of patients hospitalized due to heart failure, its incidence and hospital mortality. Methods: Analysis of the hospital discharge database of the Chilean Ministry of Health during 2014. All hospital admissions for HF were considered according to ICD-10 codes, including the discharge diagnosis of congestive HF (I500), left ventricular HF (I501) and non-specified HF (I509). Incidence rates, proportion of discharges due to HF and hospital mortality were calculated according to age and sex. Results: During 2014, there were 1,306,431 discharges from Chilean hospitals. Of these, 125,484 were for cardiovascular disease and 10% of these corresponded to HF (12,825). The incidence rate was slightly higher in men than in women (0.71 and 0.70 per 1,000 admissions respectively). Among patients aged 80 years or more, the prevalence of admissions for HF was higher in women (19.1 and 15.9% respectively, p < 0.01). Hospital mortality was also higher in women (9.7 and 8.6% respectively, p = 0.03). The factors associated with a higher hospital mortality were an age over 80 years (Odds Ratio (OR) 2.11; 95% confidence intervals (CI): 1.87-2.40; p < 0.01), a length of stay over seven days (OR 1.13; 95%CI: 1.01-1.29; p = 0.04), being admitted to high complexity facilities (OR 1.29; 95%CI: 1.12-1.50; p = 0.01) and being insured by the public national health fund (OR 1.94; 95%CI: 1.54-2.43; p < 0.01). Conclusions: The incidence of hospital admissions due to HF is similar in men and women. There is high hospital mortality, especially in women.

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BACKGROUND: Consumption of illicit drugs (ID) has been associated with an increased risk of acute myocardial infarction (AMI). There is limited national evidence about the impact of substance use over the clinical presentation, management and outcomes of AMI patients. AIM: To describe the prevalence of ID consumption in patients within the Chilean Registry of Myocardial Infarction (GEMI), comparing clinical characteristics, management and outcome according to consumption status. MATERIAL AND METHODS: We reviewed data from the GEMI registry between 2001 and 2013, identifying 18,048 patients with AMI. The sample was stratified according to presence or absence of previous ID consumption, comparing different demographic and clinical variables between groups. RESULTS: Two hundred eighty five patients (1.6%) had history of ID consumption (cocaine in 66%, cannabis in 35% and central nervous system stimulants in 24.0%). Compared with non-users, ID consumers were younger, predominantly male and had a lower prevalence of cardiovascular risk factors, except for tobacco smoking (86.3% and 42.5% respectively, p < 0.01). Among consumers, there was a higher percentage of ST segment elevation (85.2% and 67.8% respectively, p < 0.01) and anterior wall AMI (59.9 and 49.5% respectively, p = 0.01). Additionally, they had a higher rate of primary angioplasty (48.8% and 25.5% respectively, p < 0.01). There was no difference in hospital mortality between groups when stratified by age. CONCLUSIONS: A low percentage of patients with AMI had a previous history of ID consumption in our national setting. These patients were younger and had a greater frequency of ST segment elevation AMI, which probably determined a more invasive management.

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Background: Consumption of illicit drugs (ID) has been associated with an increased risk of acute myocardial infarction (AMI). There is limited national evidence about the impact of substance use over the clinical presentation, management and outcomes of AMI patients. Aim: To describe the prevalence of ID consumption in patients within the Chilean Registry of Myocardial Infarction (GEMI), comparing clinical characteristics, management and outcome according to consumption status. Material and Methods: We reviewed data from the GEMI registry between 2001 and 2013, identifying 18,048 patients with AMI. The sample was stratified according to presence or absence of previous ID consumption, comparing different demographic and clinical variables between groups. Results: Two hundred eighty five patients (1.6%) had history of ID consumption (cocaine in 66%, cannabis in 35% and central nervous system stimulants in 24.0%). Compared with non-users, ID consumers were younger, predominantly male and had a lower prevalence of cardiovascular risk factors, except for tobacco smoking (86.3% and 42.5% respectively, p < 0.01). Among consumers, there was a higher percentage of ST segment elevation (85.2% and 67.8% respectively, p < 0.01) and anterior wall AMI (59.9 and 49.5% respectively, p = 0.01). Additionally, they had a higher rate of primary angioplasty (48.8% and 25.5% respectively, p < 0.01). There was no difference in hospital mortality between groups when stratified by age. Conclusions: A low percentage of patients with AMI had a previous history of ID consumption in our national setting. These patients were younger and had a greater frequency of ST segment elevation AMI, which probably determined a more invasive management.

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Antecedentes: Desde el año 2005, se ha implementado en nuestro país un conjunto de políticas públicas para permitir un acceso universal al tratamiento trombolítico a los pacientes con infarto agudo del miocardio (IAM). Para evaluar sus resultados es importante establecer los estándares locales de las distintas opciones de reperfusión. Objetivos: 1) Comparar la mortalidad precoz y alejada de los pacientes con IAM sometidos a angioplastía primaria (angioplastía) versus los sometidos a trombolisis, en Chile. 2) Establecer los factores de riesgo de mortalidad en estos pacientes. Métodos: Utilizando los registros nacionales de angioplastía (RENAC) y de IAM (GEMI), seleccionamos a todos los pacientes con IAM tratados con angioplastía o trombolisis, durante los años 2003 y 2004. Entre ellos, comparamos mediante prueba de t de Student o chi-cuadrado, según correspondiera, sus características basales y su mortalidad hospitalaria, a 30 días, ya 12 y 24 meses. Además se hizo análisis de regresión logística multivariado para identificar los factores que independientemente se asociaron a mayor riesgo de mortalidad. Resultados: En el estudio se incluyeron 857 pacientes con IAM que recibieron trombolisis y 700 tratados con angioplastía. No hubo diferencias entre los grupos en cuanto a edad, sexo, incidencia de diabetes mellitus, hipertensión arterial, hiperlipidemia ni antecedentes de IAM previo. La mortalidad fue significativamente menor en los pacientes tratados con angioplastía (HR crudo: 0,65; 95 por ciento IC: 0,49-0,86, p=0,03). La diferencia fue evidente tanto para la mortalidad precoz como para la alejada. Así, alcanzó un 10,6 vs 6,3 por ciento (p <0,01), durante la hospitalización inicial, un 11,2 vs 8,1 por ciento a los 30 días (p <0,01), un 15,3vs 10,6 por ciento (p<0,01) a los 12 meses, y un 21,1 vs 11,7 por ciento a los 24 meses (p<0,001), para trombolisis y angioplastía respectivamente. Otros factores que independientemente se asociaron...

Background: From 2005, thrombolysis has been made available as a public health policy to treat acute myocardial infarction (AMI) in Chile. A comparison with results obtained locally with primary PTCA is relevant Aim: to compare early and late mortality in AMI between thrombolysis and PTCA treatments and to determine risk factors associated to mortality Methods: Data from national registries of PTCA (RENAC) and trombolysis (GEMI) of patients treated from 2003 through 2004 were analyzed. Early (<30day) and late (12 and 24 months) mortality was compared between groups. Logistic regression analysis was used to identify independent risk factors for mortality. Results: 857 patients received thrombolysis and 700 were treated by PTCA. Age, sex, prevalence of diabetes, hypertension, dyslipidemia and prior AMI were similar in both groups. PTCA was associated to lower mortality rates compared to thrombolysis (crude HR 0.65, 95 percent C. I. 0.49-0.86, p= 0.03). Early, 12month and 24month mortality rates for thrombolysis and PTCA treated patients were 10.6 vs. 6.3 percent, , 15.3 vs. 10.6 percent and 21.1 vs. 11.7 percent, respectively (p<0.01). Increased age, female gender and presence of diabetes were independently associated to mortality, overall. Conclusion: Primary PTCA was associated to lower early and late mortality rates compared to thrombolysis in Chilean registry data.

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