1.  Title: Interventions for pain with intrauterine device insertion. Author: Allen RH; Bartz D; Grimes DA; Hubacher D; O'Brien P Source: Cochrane Database of Systematic Reviews. 2009;(3):CD007373. Abstract: BACKGROUND: Fear of pain during intrauterine device (IUD) insertion is a barrier to use of this contraceptive method. Interventions for pain during IUD insertion include non-steroidal anti-inflammatory drugs (NSAIDs), local cervical anesthetics, and cervical ripening agents such as misoprostol. OBJECTIVES: To review all randomized controlled trials that have evaluated a treatment for IUD insertion-related pain. SEARCH STRATEGY: We searched the computerized databases MEDLINE, POPLINE, CENTRAL, and EMBASE for relevant trials. We also examined reference lists of pertinent articles and wrote to known investigators for information about other published or unpublished trials. SELECTION CRITERIA: We included all randomized controlled trials in any language that evaluated a treatment for IUD insertion-related pain. The intervention could be compared to a placebo or another active intervention. DATA COLLECTION AND ANALYSIS: Two authors independently abstracted data from relevant trials and data were entered into RevMan 5.0 for analysis. For dichotomous variables, the Peto odds ratios with 95% confidence intervals was calculated. For continuous variables, the mean differences with 95% confidence interval was computed. MAIN RESULTS: Four trials met the inclusion criteria; the total number of participants was 2204. Nonsteroidal anti-inflammatory drugs of varying types and doses were not effective for reducing pain during IUD insertion. Misoprostol for cervical ripening did not reduce pain with IUD insertion in nulliparous women. Two trials evaluated pain that occurs after IUD insertion using nonsteroidal anti-inflammatory drugs. In one trial, naproxen taken prior to IUD insertion was effective in reducing pain compared with placebo in the first two hours after IUD insertion in mostly nulliparous women. However, this trial utilized the Dalkon Shield, an IUD with a wider diameter than modern IUDs. In another trial, ibuprofen 600 mg taken before IUD insertion did not show evidence of an effect on pain four to six hours after IUD insertion. AUTHORS' CONCLUSIONS: No interventions that have been properly evaluated reduce pain during or after IUD insertion. One poorly controlled trial suggested that topical lidocaine gel may reduce insertion-related pain and warrants further investigation. Language: English Keywords: UNITED STATES OF AMERICA | CHILE | DENMARK | SWEDEN | LITERATURE REVIEW | CLINICAL TRIALS | IUD | INSERTION | PAIN | DRUGS | ADMINISTRATION AND DOSAGE | MISOPROSTOL | Developed Countries | North America | Americas | Developing Countries | South America, Southern | South America | Latin America | Europe, Northern | Europe | Clinical Research | Research Methodology | Contraceptive Methods | Contraception | Family Planning | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Signs and Symptoms | Diseases | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology Document Number: 342475 |
| 2. Peer Reviewed Title: Tackling health inequities in Chile: maternal, newborn, infant, and child mortality between 1990 and 2004. Author: Gonzalez R; Requejo JH; Nien JK; Merialdi M; Bustreo F; Betran AP Author: Chile Maternal, Newborn, and Child Health Writing Group Source: American Journal of Public Health. 2009 Jul;99(7):1220-6. Abstract: OBJECTIVES: We analyzed trends in maternal, newborn, and child mortality in Chile between 1990 and 2004, after the introduction of national interventions and reforms, and examined associations between trends and interventions. METHODS: Data were provided by the Chilean Ministry of Health on all pregnancies between 1990 and 2004 (approximately 4,000,000). We calculated yearly maternal mortality ratios, stillbirth rates, and mortality rates for neonates, infants (aged > 28 days and < 1 year), and children aged 1 to 4 years. We also calculated these statistics by 5-year intervals for Chile's poorest to richest district quintiles. RESULTS: During the study period, the maternal mortality ratio decreased from 42.1 to 18.5 per 100,000 live births. The mortality rate for neonates decreased from 9.0 to 5.7 per 1000 births, for infants from 7.8 to 3.1 per 1000 births, and for young children from 3.1 to 1.7 per 1000 live births. The stillbirth rate declined from 6.0 to 5.0 per 1000 births. Disparities in these mortality statistics between the poorest and richest district quintiles also decreased, with the largest mortality reductions in the poorest quintile. CONCLUSIONS: During a period of socioeconomic development and health sector reforms, Chile experienced significant mortality and inequity reductions. Language: English Keywords: CHILE | RESEARCH REPORT | DATA ANALYSIS | INFANT | CHILDREN | CHILD MORTALITY | MATERNAL MORTALITY | DEATH RATE | PARITY SPECIFIC BIRTH RATE | INEQUALITIES | PREVENTION AND CONTROL | Developing Countries | South America, Southern | South America | Latin America | Americas | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Mortality | Population Dynamics | Fertility Rate | Birth Rate | Fertility Measurements | Fertility | Socioeconomic Factors | Economic Factors | Diseases Document Number: 342239 |
| 3. Title: Comparative performance of a combined injectable contraceptive (50 mg norethisterone enanthate plus 5mg estradiol valerate) and a combined oral contraceptive (0.15 mg levonorgestrel plus 0.03 mg ethinyl estradiol) in adolescents. Author: Molina RC; Sandoval JZ; Montero AV; Oyarzun PG; Molina TG; Gonzalez EA Source: Journal of Pediatric and Adolescent Gynecology. 2009 Feb;22(1):25-31. Abstract: STUDY OBJECTIVE: To compare in a regular non-clinical trial experience the efficacy, acceptability, and continuation rates of an injectable contraceptive containing 50 mg norethisterone enanthate plus 5mg estradiol valerate (IC) and an oral contraceptive containing 0.15 mg levonorgestrel plus 0.03 mg ethinyl estradiol (OC), among adolescent users. DESIGN: A total of 251 adolescents ages 14-19 were followed during 12 months. The IC group (124 subjects) was studied for 1044 cycles and the OC group (127 subjects) was studied for 1368 cycles. The users were not assigned in a random selection. Information was collected from clinical records. Groups were compared using Pearson chi-square, odds ratio (95% confidence interval), t-test, and proportion difference test. RESULTS: The IC group had significant differences in baseline social risk, confidence, psychiatric problems, consumption of alcohol, and number of sexual partners. At 12 months, the IC group showed significant decrease in weight and increase in hypermenorrhea. In the OC group, dysmenorrhea decreased, and hypomenorrhea and regular cycles were significantly more frequent. One pregnancy occurred in the OC group (Pearl Index: 0.88). Final continuation rates at 12 months were 41.9% and 37.8% for IC and OC, respectively. CONCLUSIONS: The monthly injectable is a recommended contraceptive option for adolescents, especially for those facing psychosocial risk factors. Language: English Keywords: CHILE | RESEARCH REPORT | CLINICAL RESEARCH | COMPARATIVE STUDIES | ADOLESCENTS, FEMALE | INJECTABLES | NORETHINDRONE ENANTHATE | ORAL CONTRACEPTIVES, COMBINED | LEVONORGESTREL | ETHINYL ESTRADIOL | ADMINISTRATION AND DOSAGE | TIME FACTORS | CONTRACEPTIVE EFFECTIVENESS | CONTRACEPTIVE SAFETY | Developing Countries | South America, Southern | South America | Latin America | Americas | Research Methodology | Studies | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Norethindrone | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Oral Contraceptives | Contraceptive Agents, Estrogen | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Population Dynamics | Safety | Public Health Document Number: 330349 |
| 4. Title: Immunogenicity, safety, and interchangeability of two inactivated hepatitis A vaccines in Chilean children. Author: Abarca K; Ibanez I; Perret C; Vial P; Zinsou JA Source: International Journal of Infectious Diseases. 2008 May;12(3):270-277. Abstract: The objectives were to compare the immunogenicity, safety, and interchangeability of two pediatric hepatitis A vaccines, Avaxim 80U-Pediatric and Havrix 720, in Chilean children. In this randomized trial, 332 hepatitis A virus (HAV) seronegative children from 1 to 15 years of age received two doses of Avaxim, two doses of Havrix, or Havrix followed by Avaxim, 6 months apart. Anti-HAV antibody titers were measured before and 14 days after the first dose of vaccine, and before and 28 days after the second dose of vaccine. Immediate reactions were monitored; reactogenicity was evaluated from parental reports. Seroconversion rates after the first vaccination were 99.4% and 100% for Avaxim and Havrix, respectively. Anti-HAV geometric mean concentrations (GMCs) were 138 mIU/ml for Havrix (95% confidence interval (CI): 120; 159) and 311 mIU/ml for Avaxim (95% CI: 274; 353). GMCs increased to 4008 mIU/ml after two doses of Havrix, 8537 mIU/ml following two doses of Avaxim, and 7144 mIU/ml in children who received Havrix with Avaxim as the second dose. Following the first injection, 36% of subjects given Avaxim and 44% given Havrix reported local reactions; 38% of subjects in the Avaxim group and 40% in the Havrix group reported systemic reactions related to vaccination. Solicited reactions were less frequent after the second dose of Avaxim or Havrix, occurring in 27% to 37% of subjects. No significant difference in seroconversion rates was seen 14 days after a single dose of vaccine. A two-dose schedule with either vaccine or with Havrix/Avaxim provided a strong booster response. Both vaccines were well tolerated and can be recommended for routine vaccination of Chilean children. Avaxim 80 may be used to complete a vaccine schedule begun with Havrix 720. (author's) Language: English Keywords: CHILE | RESEARCH REPORT | CLINICAL TRIALS | CHILD | HEPATITIS | VACCINES | ADMINISTRATION AND DOSAGE | IMMUNIZATION SCHEDULE | SAFETY | EVALUATION | Developing Countries | South America, Southern | South America | Latin America | Americas | Clinical Research | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Drugs | Treatment | Immunization | Primary Health Care | Public Health Document Number: 326211 |
| 5. Title: Factors associated with exclusive breastfeeding at 3 months postpartum in Valdivia, Chile. Author: Barria RM; Santander G; Victoriano T Source: Journal of Human Lactation. 2008 Nov;24(4):439-45. Abstract: A prospective cohort study was conducted in 315 mother-newborn dyads from Valdivia, Chile. A questionnaire was administered to mothers before 48 hours postpartum, and sociodemographic, obstetric, and neonatal data were collected. At 3 months postpartum, a follow-up by telephone interview or home visit was made, determining the proportion of mothers providing exclusive breastfeeding. Multivariate logistic regression was carried out to identify variables significantly associated with exclusive breastfeeding. Follow-up data showed 98.1% were breastfeeding, and exclusive breastfeeding reached 69.5%. Withdrawal of exclusive breastfeeding was positively associated with single marital status (odds ratio, 2.49; 95% confidence interval: 1.48-4.20) and smoking during pregnancy (odds ratio, 2.61; 95% confidence interval: 1.48-4.60), while maternal education greater than 8 years was associated with continuation of exclusive breastfeeding (odds ratio, 0.45; 95% confidence interval: 0.24-0.84). Breastfeeding education strategies addressed to high-risk pregnant women (single with a low education level) must be emphasized in addition to prevention of nonhealthy habits, such as tobacco and alcohol consumption during gestation. Language: English Keywords: CHILE | RESEARCH REPORT | KAP SURVEYS | PROSPECTIVE STUDIES | COHORT ANALYSIS | FOLLOW-UP STUDIES | MULTIVARIATE ANALYSIS | POSTPARTUM WOMEN | WOMEN IN DEVELOPMENT | BREASTFEEDING, EXCLUSIVE | MARITAL STATUS | TOBACCO USE | EDUCATIONAL STATUS | ALCOHOL USE AND ABUSE | HEALTH EDUCATION | Developing Countries | South America, Southern | South America | Latin America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Data Analysis | Puerperium | Reproduction | Economic Development | Economic Factors | Breastfeeding | Infant Nutrition | Nutrition | Health | Nuptiality | Demographic Factors | Population | Behavior | Socioeconomic Status | Socioeconomic Factors | Education Document Number: 329186 |
| 6. Title: HIV issues and Mapuches in Chile. Author: Cianelli R; Ferrer L; Cabieses B; Araya A; Matsumoto C Source: Journal of the Association of Nurses in AIDS Care. 2008 May-Jun;19(3):235-241. Abstract: Chile is a country with an incipient HIV epidemic. Just as in other countries, disadvantaged groups in Chile are contributing to the increased incidence of the disease. The Mapuche indigenous population is one such group that has been affected by the spread of HIV. However, no prevention programs are tailored to the culturally specific needs of this community. In recognition of this discrepancy, an academic-community partnership was formed to develop an HIV educational module for a Mapuche community. The module was developed for use as part of an already established health-related program. The aims of the module were to identify perceptions about HIV among Mapuches and present information specific to HIV and its prevention. Focus was placed on cultural sensitivity. A total of 16 Mapuches participated voluntarily and showed some knowledge regarding HIV, but they lacked an overall understanding as to how it is transmitted and why prevention strategies are effective. Continued collaboration between academia and affected communities as well as incorporating HIV information into established programs are effective strategies for delivering prevention information to disadvantaged populations and for further understanding their perceptions and health care needs. (author's) Language: English Keywords: CHILE | RESEARCH REPORT | INCIDENCE | INDIGENOUS POPULATION | PERCEPTION | CULTURE | HIV INFECTIONS | AIDS | Developing Countries | South America, Southern | South America | Latin America | Americas | Measurement | Research Methodology | Population Characteristics | Demographic Factors | Population | Psychological Factors | Behavior | Sociocultural Factors | Viral Diseases | Diseases Document Number: 326650 |
| 7. Peer Reviewed Title: HIV prevention and low-income Chilean women: Machismo, marianismo and HIV misconceptions. Author: Cianelli R; Ferrer L; McElmurry BJ Source: Culture, Health and Sexuality. 2008 Apr;10(3):297-306. Abstract: Socio-cultural factors and HIV-related misinformation contribute to the increasing number of Chilean women living with HIV. In spite of this, and to date, few culturally specific prevention activities have been developed for this population. The goal of the present study was to elicit the perspectives of low-income Chilean women regarding HIV and relevant socio-cultural factors, as a forerunner to the development of a culturally appropriate intervention. As part of a mixed-methods study, fifty low-income Chilean women participated in a survey and twenty were selected to participate in prevention, in-depth interviews. Results show evidence of widespread misinformation and misconceptions related to HIV/AIDS. Machismo and marianismo offer major barriers to prevention programme development. Future HIV prevention should stress partner communication, empowerment and improving the education of women vulnerable to HIV. (author's) Language: English Keywords: CHILE | RESEARCH REPORT | SURVEYS | INTERVIEWS | WOMEN | LOW INCOME POPULATION | HIV | AIDS | HIV PREVENTION | KNOWLEDGE | MISINFORMATION | SOCIOCULTURAL FACTORS | GENDER ISSUES | INEQUALITIES | MALE ROLE | FEMALE ROLE | Developing Countries | South America, Southern | South America | Latin America | Americas | Sampling Studies | Studies | Research Methodology | Data Collection | Demographic Factors | Population | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | HIV Infections | Viral Diseases | Diseases | Communication | Social Behavior | Behavior Document Number: 326382 |
| 8. Peer Reviewed Title: Safety and efficacy of a single-rod etonogestrel implant (Implanon): Results from 11 international clinical trials. Author: Darney P; Patel A; Rosen K; Shapiro LS; Kaunitz AM Source: Fertility and Sterility. 2008;:[9] p. Abstract: The objective was to present efficacy, safety, and bleeding profile results from the clinical trials that supported the U.S. Food and Drug Administration filing for the approval of a single-rod etonogestrel (ENG) contraceptive implant (Implanon). The design used was an integrated analysis of 11 international clinical trials. The setting was contraceptive clinics in U.S., Chile, Asia, and Europe. A total of 942 healthy women, aged 18 to 40 years were examined. Insertion of an ENG implant. Most women were enrolled in studies lasting either 2 or 3 years. Efficacy was measured by the cumulative Pearl Index in women %35 years old. Safety was primarily assessed by incidence of adverse events. Bleeding profiles were analyzed via reference period analyses. No pregnancies were reported while the ENG implants were in place. Six pregnancies occurred during the first 14 days after ENG implant removal. Including these six pregnancies, the cumulative Pearl Index was 0.38 (year 1 and 2 Pearl Indexes were 0.27 and 0.30, respectively). Common drug-related adverse events were headache, weight gain, acne, breast tenderness, emotional lability, and abdominal pain. Bleeding pattern changes were observed, but no one pattern predominated. The ENG implant is an efficacious and safe method of contraception which does not require patients' consistent action. (author's) Language: English Keywords: UNITED STATES OF AMERICA | CHILE | EUROPE | ASIA | RESEARCH REPORT | CLINICAL TRIALS | CONTRACEPTIVE IMPLANTS | CONTRACEPTIVE SAFETY | CONTRACEPTIVE EFFECTIVENESS | CONTRACEPTIVE AGENTS, SIDE EFFECTS | BLEEDING | Developed Countries | North America | Americas | Developing Countries | South America, Southern | South America | Latin America | Clinical Research | Research Methodology | Contraceptive Methods | Contraception | Family Planning | Safety | Public Health | Health | Contraceptive Agents | Signs and Symptoms | Diseases Document Number: 326597 |
| 9. Title: Maternal, perinatal and infant outcome of spontaneous pregnancy in the sixth decade of life. Author: Donoso E; Carvajal JA Source: Maturitas. 2008 Apr 20;59(4):381-386. Abstract: Pregnancy in the older woman is a well-known risk factor for perinatal morbidity and mortality. Objective: To evaluate perinatal and infant morbidity and mortality in women 50 or more years old. Methods: A retrospective population based study (1990-2004) evaluating spontaneously pregnant Chilean women more than 50 years old (217 live or stillbirths) compared to women 20-34 years old (2,817,742 neonates, control group). The comparison was performed using Chi Square with Yates's correction or exact Fisher test as appropriate. The risk analysis was performed by odds ratio (OR) and confidence interval of 95% (CI 95%). Results: Women over 50 had a significantly greater risk of fetal (OR: 3.7; CI 95%: 1.2-10.5), neonatal (OR: 10.4; CI 95%: 5.7-18.7), post-neonatal (OR: 9.5; CI 95%: 4.6-19.1) and infant death (OR: 10.5; CI 95%: 6.6-16.7). There were no differences between groups in the incidences of low and very low birth weight. Conclusion: Pregnancy over 50 years of age entails a very high risk of fetal, neonatal and early childhood death. Unprotected sexual life for these women should be considered only after evaluation of their potential fertility. (author's) Language: English Keywords: CHILE | RESEARCH REPORT | RETROSPECTIVE STUDIES | LONGITUDINAL STUDIES | COMPARATIVE STUDIES | EPIDEMIOLOGIC METHODS | PREGNANT WOMEN | WOMEN IN DEVELOPMENT | INFANT | MATERNAL AGE, 35 AND OVER | RISK ASSESSMENT | FETAL DEATH | PREVALENCE | INFANT MORTALITY | NEONATAL MORTALITY | Developing Countries | South America, Southern | South America | Latin America | Americas | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Youth | Age Factors | Maternal Age | Parental Age | Evaluation | Mortality | Population Dynamics | Measurement Document Number: 327386 |
10.  Peer Reviewed Title: Baseline assessment of the prevalence and geographical distribution of HPV types in Chile using self-collected vaginal samples. Author: Ferreccio C; Corvalan A; Margozzini P; Viviani P; Gonzalez C Source: BMC Public Health. 2008 Feb 28;8(78):[34] p. Abstract: Chile has broad variations in weather, economics and population from the far desert north (Region 1) to the cold, icy south (Region 12). A home-based self-collected vaginal sampling was nested in the 2003 Chilean population-based health survey in order to explore the possibility of a type-specific geographical variation for human papillomavirus The population was a national probability sample of people 17 years of age and over. Consenting women provided self-collected cervicovaginal swabs in universal collection media (UCM). DNA was extracted and typed to 37 HPV genotypes using PGMY consensus PCR and line blot assay. Weighted prevalence rates and adjusted OR were calculated. Of the 1,883 women participating in the health survey, 1,219 (64.7%) provided a cervicovaginal sample and in 1,110 (56.2% of participants and 66.5% of those eligible) the samples were adequate for analysis. Refusal rate was 16.9%. HPV prevalence was 29.2% (15.1% high-risk HPV and 14.1% low-risk HPV). Predominant high-risk types were HPV 16, 52, 51, 56 and 58. Predominant low-risk HPVs were HPV 84, CP6108, 62, 53 and 61. High-risk and low-risk HPV rates were inversely correlated between the regions. High-risk HPV prevalence was highest among the youngest women, whereas low-risk HPV increased slightly with age. Self-obtained vaginal sampling is adequate for monitoring HPV in the community, for identifying high-risk areas, and for surveying the long term impact of interventions. (author's) Language: English Keywords: CHILE | RESEARCH REPORT | METHODOLOGICAL STUDIES | WOMEN | HPV | TESTING | PREVALENCE | GEOGRAPHIC FACTORS | RISK FACTORS | Developing Countries | South America, Southern | South America | Latin America | Americas | Demographic Factors | Population | Viral Diseases | Diseases | Measurement | Research Methodology | Biology Document Number: 324387 |
| 11. Peer Reviewed Title: An international, randomized, double-blind, placebo-controlled, study of valacyclovir for the suppression of herpes simplex virus type 2 genital herpes in newly diagnosed patients. Author: Fife KH; Warren TJ; Justus SE; Heitman CK Source: Sexually Transmitted Diseases. 2008 Jul;35(7):668-73. Abstract: BACKGROUND: Antiviral suppressive therapy of genital herpes is often initiated based on the established pattern of recurrences in an individual. Because most persons with first episode herpes simplex virus type 2 (HSV-2) infection experience recurrences and because viral shedding occurs frequently in the first year after infection, we examined the strategy of initiating suppressive therapy shortly after diagnosis of genital HSV-2 infection. SUBJECTS AND METHODS: From June 16, 2004 to July 26, 2006, 384 subjects from 74 sites in the United States, Canada, Argentina, Brazil, and Chile who were newly diagnosed with a first recognized episode of genital herpes at the time of the screening visit or within 3 months before the screening visit were randomized (2:1) to receive valacyclovir 1 g once daily or placebo for 24 weeks. Subjects were instructed to return to clinic during suspected genital herpes outbreaks for clinician confirmation of recurrences. RESULTS: Valacyclovir significantly prolonged the time to first recurrence of HSV-2 genital herpes in newly diagnosed subjects compared with placebo, with approximately 43% of subjects on placebo and 71% of subjects on valacyclovir recurrence-free at 24 weeks (P <0.001). Valacyclovir significantly reduced the mean number of genital HSV-2 recurrences per month occurring during the 24-week study period (0.11 for valacyclovir, 0.48 for placebo, P <0.001). Adverse events were comparable in the valacyclovir and placebo arms. CONCLUSION: Valacyclovir 1 g once daily administered for 24 weeks was well-tolerated and effective in suppressing genital herpes recurrences in immunocompetent newly diagnosed persons without an established recurrence pattern. Language: English Keywords: BRAZIL | UNITED STATES OF AMERICA | CHILE | ARGENTINA | CANADA | RESEARCH REPORT | CLIENTS | HERPES GENITALIS | TREATMENT | SCREENING | EXAMINATIONS AND DIAGNOSES | ANTIVIRAL DRUGS | Developing Countries | South America, Eastern | South America | Latin America | Americas | Developed Countries | North America | South America, Southern | North America, Northern | Program Activities | Programs | Organization and Administration | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Drugs Document Number: 328375 |
| 12. Peer Reviewed Title: Estimation of individual neonatal survival using birthweight and gestational age: A way to improve neonatal care. Author: Mardones F; Marshall G; Viviani P; Villarroel L; Burkhalter BR Source: Journal of Health, Population and Nutrition. 2008 Mar;26(1):54-63. Abstract: The study was conducted to determine the combined effect of birthweight and gestational age at birth on neonatal mortality using individually-identified livebirths. Logistic regression was used for studying the interactive effect of birthweight and gestational age on the individual probability of neonatal death. All livebirths from Chile in 2000 were included in a linked file. Odds ratio models for birthweight and gestational age were developed for each sex. The probability of neonatal death by sex was presented using contour plots. The models were statistically significant, and odds ratios were different and non-linear for the effects of birthweight and gestational age. Contour plots of constant neonatal mortality according to birthweight and gestational age were presented; they were similar for each sex. A single graph for both sexes that estimates the survival potential of infants born too early or too small would improve neonatal care in developing countries. (author's) Language: English Keywords: CHILE | RESEARCH REPORT | ESTIMATION TECHNIQUES | STATISTICAL REGRESSION | MATHEMATICAL MODEL | INFANT | BIRTH WEIGHT | GESTATIONAL AGE | NEONATAL MORTALITY | PERFORMANCE IMPROVEMENT | MORTALITY DETERMINANTS | PROBABILITY | SEX FACTORS | Developing Countries | South America, Southern | South America | Latin America | Americas | Research Methodology | Data Analysis | Theoretical Models | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Body Weight | Physiology | Biology | Fetus | Pregnancy | Reproduction | Infant Mortality | Mortality | Population Dynamics | Management | Organization and Administration | Statistical Studies | Studies Document Number: 308652 |
| 13. Title: [HIV vulnerability in women at social risk] Vulnerabilidade ao HIV em mulheres em risco social. Author: Morales AU; Barreda PZ Source: Revista de Saude Publica. 2008 Oct;42(5):822-9. Abstract: OBJECTIVE: To evaluate HIV/AIDS vulnerability by risk factors in women at social risk. METHODS: Study conducted in a sample of 178 female homemakers (n=101) and female health providers (n=77) from Antofagasta, Chile, in 20062007. Homemakers were considered at social risk. HIV vulnerability was estimated through a 21-item instrument comprising three domains: gender roles; relationship with the partner; and attitude toward condom use. For determining the relative weight of each dimension to total vulnerability a multiple regression analysis was carried out using the instrument's total score as dependent variable and each domain as independent variable. RESULTS: Overall, the domain showing the highest relative weight was attitude toward condom use (0.542), followed by relationship with the partner (0.453) and gender roles (0.379). There were weight differences between homemakers: relationship with the partner (0.597), attitude toward condom use (0.508) and gender roles (0,403); and health providers: attitude toward condom use (0.638), relationship with the partner (0.397), and gender roles (0.307). CONCLUSIONS: The study results allows to inferring that there are differences in factors that determine HIV vulnerability among women and gender role is the best predictor of risk among those at social risk. Language: Spanish Keywords: CHILE | RESEARCH REPORT | EVALUATION | WOMEN | RISK FACTORS | HIV INFECTIONS | ATTITUDES | CONDOM USE | MALE ROLE | FEMALE ROLE | Developing Countries | South America, Southern | South America | Latin America | Americas | Demographic Factors | Population | Health | Viral Diseases | Diseases | Psychological Factors | Behavior | Risk Reduction Behavior | Social Behavior Document Number: 331164 |
| 14. Title: Knowledge of HIV/AIDS among adolescents in Chillan, Chile. Author: Perez V R; Barrales C I; Jara P J; Palma R V; Ceballos M A Source: Midwifery. 2008 Dec;24(4):503-8. Abstract: OBJECTIVE: to analyse adolescents' knowledge of preventive sexual practices related to human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) by means of a questionnaire recommended by the Joint United Nations Programme on HIV/AIDS (UNAIDS). METHOD: non-experimental, cross-sectional, descriptive and analytical investigation. SETTING: four schools in Chillan, Chile, 2005. PARTICIPANTS: a total of 480 adolescents aged between 15 and 19 years. Students completed a questionnaire recommended by UNAIDS in order to develop basic indicators. FINDINGS: the indicator of preventive sexual practices related to HIV/AIDS was 32.5%; forms of prevention (62.5%) were better known than erroneous ideas about transmission (46%). Adolescents from the only private school in the study demonstrated greater knowledge (43.3%) than students from the public schools (25%) (p<0.01). No significant differences were found in knowledge according to age, sex or educational level. CONCLUSION: adolescents have poor knowledge of preventive sexual practices related to HIV and AIDS. It is necessary to implement an indicator of knowledge that allows for the creation and monitoring of sexual education programmes. Language: English Keywords: CHILE | RESEARCH REPORT | KAP SURVEYS | CROSS SECTIONAL ANALYSIS | ADOLESCENTS | KNOWLEDGE | SAFER SEX | HIV PREVENTION | PRIVATE SECTOR | SECONDARY SCHOOLS | Developing Countries | South America, Southern | South America | Latin America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Sociocultural Factors | Sex Behavior | Behavior | HIV Infections | Viral Diseases | Diseases | Macroeconomic Factors | Economic Factors | Schools | Education Document Number: 330298 |
| 15. Title: A longitudinal study of angiogenic (placental growth factor) and anti-angiogenic (soluble endoglin and soluble vascular endothelial growth factor receptor-1) factors in normal pregnancy and patients destined to develop preeclampsia and deliver a small for gestational age neonate. Author: Romero R; Nien JK; Espinoza J; Todem D; Fu W Source: Journal of Maternal-Fetal and Neonatal Medicine. 2008 Jan;21(1):9-23. Abstract: Accumulating evidence suggests that an imbalance between pro-angiogenic (i.e., vascular endothelial growth factor (VEGF) and placental growth factor (PlGF)) and anti-angiogenic factors (i.e., soluble VEGF receptor-1 (sVEGFR-1, also referred to as sFlt1)) is involved in the pathophysiology of preeclampsia (PE). Endoglin is a protein that regulates the pro-angiogenic effects of transforming growth factor b, and its soluble form has recently been implicated in the pathophysiology of PE. The objective of this study was to determine if changes in maternal plasma concentration of these angiogenic and anti-angiogenic factors differ prior to development of disease among patients with normal pregnancies and those destined to develop PE (preterm and term) or to deliver a small for gestational age (SGA) neonate. This longitudinal nested case-control study included 144 singleton pregnancies in the following groups: patients with uncomplicated pregnancies who delivered appropriate for gestational age (AGA) neonates (n = 46); patients who delivered an SGA neonate but did not develop PE (n = 56); and patients who developed PE (n = 42). Longitudinal samples were collected at each prenatal visit, scheduled at 4-week intervals from the first or early second trimester until delivery. Plasma concentrations of soluble endoglin (s-Eng), sVEGFR-1, and PlGF were determined by specific and sensitive ELISA. Patients destined to deliver an SGA neonate had higher plasma concentrations of s-Eng throughout gestation than those with normal pregnancies; patients destined to develop preterm PE and term PE had significantly higher concentrations of s-Eng than those with normal pregnancies at 23 and 30 weeks, respectively (for preterm PE: p < 0.036 and for term PE: p = 0.002); patients destined to develop PE (term or preterm) and those who delivered an SGA neonate had lower plasma concentrations of PlGF than those with a normal pregnancy throughout gestation, and the maternal plasma concentration of this analyte became detectable later among patients with pregnancy complications, compared to normal pregnant women; there were no significant differences in the plasma concentrations of sVEGFR-1 between patients destined to deliver an SGA neonate and those with normal pregnancies; patients destined to develop preterm and term PE had a significantly higher plasma concentration of sVEGFR-1 at 26 and 29 weeks of gestation than controls (p = 0.009 and p = 0.0199, respectively); and there was no significant difference in the increment of sVEGFR-1 between control patients and those who delivered an SGA neonate (p = 0.147 at 25 weeks and p = 0.8285 at 40 weeks). Changes in the maternal plasma concentration of s-Eng, sVEGFR-1, and PlGF precede the clinical presentation of PE, but only changes in s-Eng and PlGF precede the delivery of an SGA neonate; and differences in the profile of angiogenic and anti-angiogenic response to intrauterine insults may determine whether a patient will deliver an SGA neonate, develop PE, or both. (author's) Language: English Keywords: CHILE | RESEARCH REPORT | LONGITUDINAL STUDIES | CASE CONTROL STUDIES | PREGNANT WOMEN | PREECLAMPSIA | INTRAUTERINE GROWTH RETARDATION | PREMATURE BIRTH | BLOOD PROTEINS | FETAL MEMBRANES | LOW BIRTH WEIGHT | Developing Countries | South America, Southern | South America | Latin America | Americas | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Pregnancy Complications | Diseases | Congenital Abnormalities | Neonatal Diseases and Abnormalities | Pregnancy Outcomes | Pregnancy | Reproduction | Hemic System | Physiology | Biology | Fetus | Birth Weight | Body Weight Document Number: 323404 |
| 16. Title: [Prevalence of tuberculosis and its impact on mortality among HIV infected patients in Chile] Tuberculosis en individuos con infeccion por VIH en Chile: Estudio de prevalencia Author: Villarroel L; Rabagliati R; Balcells ME; Karzulovic L; Perez C Source: Revista Medica De Chile. 2008 May;136(5):578-86. Abstract: BACKGROUND: Tuberculosis (TB) in Chile is reaching the elimination phase; however, in HIV positive individuals the incidence of TB in still very high. AIM: To describe the association between TB and HIV in different geographical regions in Chile, and to determine the association between TB and HIV/AIDS mortality. PATIENTS AND METHODS: A retrospective study that included individuals from the main HIV clinics from four regions with different TB prevalence in the general population (per 100,000): Arica (>30), Concepcion/Arauco (25-29), Valparaiso/San Antonio (20-24) and Metropolitana Sur-Oriente (SSMSO) (<20), attended between January 1998 and September 2004. RESULTS: Nine hundred and twelve HIV positive individuals were included. Global prevalence of TB was 6.2% [95% confidence intervals (Cl) 5.2-7.2%]. TB was more common in older subjects (p =0.039) and those with lower CD4 counts (p <0.001) and higher HIV viral load (p =0.033). In 66% of cases, the disease had a pulmonary localization. TB was the recorded cause of death in 7.4% of subjects. Only 29% of patients had a tuberculin skin test performed at the moment of HIV diagnosis. The prevalence of TB in HIV positive patients, followed the trend of TB prevalence in the general population: Concepcion/Arauco (11.9%), Valparaiso/San Antonio (7.1%) and SSMSO (3.9%). However HIV positive subjects from Arica showed an unexpectedly low TB prevalence (5.5%). CONCLUSIONS: TB in HIV/AIDS patients included in this study is over 300 times more prevalent than in the general population. TB prevalence in HIV positive subjects follows regional TB prevalence, excepting Arica. Effectiveness and feasibility of latent TB diagnostic strategies and treatment in HIV positive individuals should be reviewed. Language: Spanish Keywords: CHILE | RESEARCH REPORT | RETROSPECTIVE STUDIES | INCIDENCE | PERSONS LIVING WITH HIV/AIDS | TUBERCULOSIS | EXAMINATIONS AND DIAGNOSES | TREATMENT | Developing Countries | South America, Southern | South America | Latin America | Americas | Studies | Research Methodology | Measurement | HIV Infections | Viral Diseases | Diseases | Infections | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 331115 |
| 17. Title: Early identification of at-risk youth in Latin America: an application of cluster analysis. Author: Bagby E; Cunningham W Source: Washington, D.C., World Bank, Latin America and the Caribbean Region, Human Development Department, 2007 Oct. 55 p. (Policy Research Working Paper No. 4377) Abstract: A new literature on the nature of and policies for youth in Latin America is emerging, but there is still very little known about who are the most vulnerable young people. This paper aims to characterize the heterogeneity in the youth population and identify ex ante the youth that are at-risk and should be targeted with prevention programs. Using non-parametric methodologies and specialized youth surveys from Mexico and Chile, the authors quantify and characterize the different subgroups of youth, according to the amount of risk in their lives, and find that approximately 20 percent of 18 to 24 year old Chileans and 40 percent of the same age cohort in Mexico are suffering the consequences of a range of negative behaviors. Another 8 to 20 percent demonstrate factors in their lives that pre-dispose them to becoming at-risk youth - they are the candidates for prevention programs. The analysis finds two observable variables that can be used to identify which children have a higher probability of becoming troubled youth: poverty and residing in rural areas. The analysis also finds that risky behaviors increase with age and differ by gender, thereby highlighting the need for program and policy differentiation along these two demographic dimensions. (author's) Language: English Keywords: MEXICO | CHILE | RESEARCH REPORT | METHODOLOGICAL STUDIES | MATHEMATICAL MODEL | HEALTH SURVEYS | KAP SURVEYS | YOUTH | RISK ASSESSMENT | WORLD BANK | RISK BEHAVIOR | AGE FACTORS | SEX FACTORS | North America | Americas | Developing Countries | South America, Southern | South America | Latin America | Theoretical Models | Research Methodology | Health | Surveys | Sampling Studies | Studies | Population Characteristics | Demographic Factors | Population | Evaluation | International Agencies | Organizations | Political Factors | Sociocultural Factors | Behavior Document Number: 322873 |
| 18. Peer Reviewed Title: HIV prevalence, AIDS knowledge, and condom use among female sex workers in Santiago, Chile. Author: Barrientos JE; Bozon M; Ortiz E; Arredondo A Source: Cadernos de Saude Publica. 2007 Aug;23(8):1777-1784. Abstract: This paper describes HIV seroprevalence, knowledge of HIV transmission, and condom use among female sex workers (FSW) attending five specialized sexually transmitted disease (STD) clinics in Santiago, Chile. A short questionnaire with socio-demographic, AIDS knowledge, and condom-use variables was administered to 626 FSW. HIV seroprevalence was estimated with a blood test sent to the Chilean Public Health Institute. ELISA was used to confirm HIV in suspected cases. HIV prevalence was 0%. FSW showed adequate overall knowledge of HIV, even better than reported for the Chilean general population on some items. Condom use with clients was high ("always" = 93.4%), although regular use with steady partners was low ("always" = 9.9%). The zero HIV seroprevalence and consistent condom use with clients confirms the positive impact of intervention strategies for FSW, increasing both correct knowledge of AIDS and condom use with clients and helping decrease these women's HIV/ AIDS vulnerability. (author's) Language: English Keywords: CHILE | RESEARCH REPORT | QUESTIONNAIRES | PREVALENCE | SEX WORKERS | WOMEN | AIDS | HIV TRANSMISSION | CONDOM USE | KNOWLEDGE | HIV TESTING | SEX BEHAVIOR | Developing Countries | South America, Southern | South America | Latin America | Americas | Measurement | Research Methodology | Behavior | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Risk Reduction Behavior | Sociocultural Factors | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 319138 |
| 19. Peer Reviewed Title: Effect of a single vaginal administration of levonorgestrel in Carraguard gel on the ovulatory process: A potential candidate for “dual protection” emergency contraception. Author: Brache V; Croxatto H; Sitruk-Ware R; Maguire R; Montero JC Source: Contraception. 2007 Aug;76(2):111-116. Abstract: The study was conducted to evaluate the effect of Carraguard vaginal gel containing 0.75 mg of levonorgestrel (CARRA/LNG gel) administered in a single dose at different stages of follicle development over subsequent follicle rupture and hormonal levels. Randomized, blinded, cross-over study comparing the effects of a single administration of CARRA/LNG gel or Carraguard (CARRA) gel. Twenty-four healthy women were enrolled in two centers. The gels were administered when the follicle had reached diameters of 12-14, 15-17 and >/= 18 mm in eight women each. Volunteers were followed for one treatment, one washout cycle and a second treatment cycle. Follicle rupture or nonrupture was assessed by transvaginal ultrasound. Luteinizing hormone, estradiol and progesterone levels were measured daily for 5 days following treatment, and three times per week until menses. No follicular rupture within the 5-day period following administration was observed in 74% and 30% of the CARRA/LNG and CARRA gel treatment cycles, respectively, while ovulation was documented in 4% and 61%, respectively. The overall proportion of cycles with lack of follicular rupture or ovulatory dysfunction (follicle rupture preceded by an inadequate LH surge) was 96% for CARRA/LNG and 39% in the CARRA gel cycles. Single vaginal administration of 0.75 mg LNG in CARRA gel in the late follicular phase is effective for interfering with the ovulatory process. (author's) Language: English Keywords: CHILE | DOMINICAN REPUBLIC | RESEARCH REPORT | PROSPECTIVE STUDIES | DOUBLE-BLIND STUDIES | WOMEN | VAGINAL GEL | LEVONORGESTREL | ADMINISTRATION AND DOSAGE | OVULATION | EMERGENCY CONTRACEPTION | CONTRACEPTIVE USE-EFFECTIVENESS | Developing Countries | South America, Southern | South America | Latin America | Americas | Caribbean | Studies | Research Methodology | Demographic Factors | Population | Vaginal Spermicides | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Reproduction | Contraceptive Effectiveness Document Number: 318907 |
| 20. Title: [Pulmonary complications in children with human immunodeficiency virus infection] Compromiso pulmonar en la infeccion por virus de inmunodeficiencia humana en ninos. Author: Brockmann P; Viviani T; Pena A Source: Revista Chilena de Infectología. 2007 Aug;24(4):301-305. Abstract: Pulmonary complications in children infected by human immunodeficiency virus (HIV) are common and may be the first manifestation of acquired immunodeficiency syndrome (AIDS). The aim of our study was to review pulmonary diseases and complications in pediatric patients with HIV infection in a large tertiary hospital in Santiago, Chile. We performed a retrospective, descriptive analysis of 17 patients with HIV infection controlled at the Hospital Dr. Sotero del Río. Respiratory complications/diseases were: overall pneumonia (n: 14), recurrent pneumonia (n: 10), citomegalovirus associated pneumonia (n: 4), Pneumocystis jiroveci associated pneumonia (n: 1) pulmonary tuberculosis (n: 1), lymphoid interstitial pneumonia (n: 3) and chronic pulmonary disease (n: 7). Microorganisms isolated were mostly atypical and frequently associated with severe and chronic pulmonary damage. A high degree of suspicion is required to detect atypical microorganisms promptly, in order to rapidly implement pathogen targeted therapy that could potentially decrease the possibility of sequelae. Language: Spanish Keywords: CHILE | RESEARCH REPORT | RETROSPECTIVE STUDIES | CLIENTS | CHILDREN | PERSONS LIVING WITH HIV/AIDS | PULMONARY EFFECTS | Developing Countries | South America, Southern | South America | Latin America | Americas | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Physiology | Biology Document Number: 324806 |
| 21. Title: [Changes in vertically transmitted human immunodeficiency virus infection Chile] Evolucion de la transmision vertical de la infeccion por virus de inmunodeficiencia humana en Chile. Author: Chavez A; Alvarez AM; Wu E; Pena DA; Vizueta RE Source: Revista Chilena de Infectiologia. 2007 Oct;24(5):368-371. Abstract: The identification of various risk factors of vertical human immunodeficiency virus (HIV) transmission resulted in the development of strategies whose aim was to decrease the mother's viral load, to reduce her child's exposure to it during delivery, and to avoid the subsequent viral exposure due to breastfeeding. The administration of antiretroviral treatment during pregnancy, delivery and to the neonate (PACTG 076) proved to be useful. At a first stage, zidovudine was used. A triple combination therapy was then administered. Initially, the viral transmission in mothers who were enrolled in protocols for vertically transmitted HIV prophylaxis was reduced to 9.5%, whereas the last measurement carried out between 1998 and 2005, the initial figure was brought down to 2%. Nevertheless, the delivery of infected children whose mother's HIV status was unknown is still considered likely to happen. The main step to be taken to reduce HIV infection among children is to perform universal HIV tests during pregnancy, so that HIV positive pregnant patients conveniently receive proper prophylaxis. We look forward to achieving this by following the new prevention guidelines of vertically-transmitted HIV infection, developed by the Comision Nacional del SIDA of the Chilean Health Ministry. Language: Spanish Keywords: CHILE | RESEARCH REPORT | PREGNANT WOMEN | MOTHERS | PERSONS LIVING WITH HIV/AIDS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | HIV INFECTIONS | ANTIRETROVIRAL THERAPY | TREATMENT | Developing Countries | South America, Southern | South America | Latin America | Americas | Population Characteristics | Demographic Factors | Population | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Disease Transmission Control | Prevention and Control | HIV | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 324807 |
| 22. Title: Quantitative assessment of postovulatory effects of levonorgestrel emergency contraception [letter] [reply] Author: Croxatto H Source: Contraception. 2007 May;75(5):402. Abstract: I have several objections to the conclusions presented in the letter to the editor entitled Postovulatory effects of levonorgestrel in emergency contraception (LNG EC), signed by Dr. Carlos Valenzuela. The first objection is to the first sentence that cites as evidence of postovulatory action of LNG three efficacy studies (references 2-4 in his letter) that have no built-in mechanism of action studies. It is a sound and rigorous practice in science today that the only valid method for testing a hypothesis or answering a defined question based on scientific evidence requires an appropriate specific experimental design. Neither one of those studies comes close to meet even at a minimal level a specific design to test mechanism of action hypotheses. The second objection is to a serious misuse of Wilcox et al. data, which becomes obvious upon examination of the second column headed OP Wil in Table 1. The figures quoted there correspond to probabilities of conception, which result from detection of hCG in urine and not to probabilities of clinical pregnancy, which are much lower. As a consequence, the expected pregnancy rate in his calculations has no relevance to the clinically observed pregnancies reported in efficacy studies reported in references 2 to 4 in his letter, which are used in Table 2. (excerpt) Language: English Keywords: CHILE | CRITIQUE | RELIABILITY | DATA QUALITY | EMERGENCY CONTRACEPTION | LEVONORGESTREL | PREGNANCY RATE | MEASUREMENT | CONTRACEPTIVE USE-EFFECTIVENESS | Developing Countries | South America, Southern | South America | Latin America | Americas | Research Methodology | Data Analysis | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Contraceptive Effectiveness Document Number: 315411 |
| 23. Peer Reviewed Title: Identification of patients at risk for early onset and /or severe preeclampsia with the use of uterine artery Doppler velocimetry and placental growth factor. Author: Espinoza J; Romero R; Nien JK; Gomez R; Kusanovic JP Source: American Journal of Obstetrics and Gynecology. 2007 Apr;196(4):326.e1-326.e13. Abstract: Preeclampsia has been proposed to be an antiangiogenic state that may be detected by the determination of the concentrations of the soluble vascular endothelial growth factor receptor-1 (sVEGFR-1) and placental growth factor (PlGF) in maternal blood even before the clinical development of the disease. The purpose of this study was to determine the role of the combined use of uterine artery Doppler velocimetry (UADV) and maternal plasma PlGF and sVEGFR-1 concentrations in the second trimester for the identification of patients at risk for severe and/or early onset preeclampsia. A prospective cohort study was designed to examine the relationship between abnormal UADV and plasma concentrations of PlGF and sVEGFR-1 in 3348 pregnant women. Plasma samples were obtained between 22 and 26 weeks of gestation at the time of ultrasound examination. Abnormal UADV was defined as the presence of bilateral uterine artery notches and/or a mean pulsatility index above the 95th percentile for the gestational age. Maternal plasma PlGF and sVEGFR-1 concentrations were determined with the use of sensitive and specific immunoassays. The primary outcome was the development of early onset preeclampsia (= 34 weeks of gestation) and/or severe preeclampsia. Secondary outcomes included preeclampsia, the delivery of a small for gestational age (SGA) neonate without preeclampsia, spontaneous preterm birth at = 32 and = 35 weeks of gestation, and a composite of severe neonatal morbidity. Contingency tables, chi-square test, receiver operating characteristic curve, and multivariate logistic regression were used for statistical analyses. A probability value of < .05 was considered significant. (1) The prevalence of preeclampsia, severe preeclampsia, and early onset preeclampsia were 3.4% (113/3296), 1.0% (33/3296), and 0.8% (25/3208), respectively. UADV was performed in 95.4% (3146/3296) and maternal plasma PlGF concentrations were determined in 93.5% (3081/3296) of the study population. (2) Abnormal UADV and a maternal plasma PlGF of < 280 pg/mL were independent risk factors for the occurrence of preeclampsia, severe preeclampsia, early onset preeclampsia, and SGA without preeclampsia. (3) Among patients with abnormal UADV, maternal plasma PlGF concentration contributed significantly in the identification of patients destined to develop early onset preeclampsia (area under the curve, 0.80; P < .001) and severe preeclampsia (area under the curve, 0.77; P < .001). (4) In contrast, maternal plasma sVEGFR-1 concentration was of limited use in the prediction of early onset and/or severe preeclampsia. (5) The combination of abnormal UADV and maternal plasma PlGF of < 280 pg/mL was associated with an odds ratio (OR) of 43.8 (95% CI, 18.48-103.89) for the development of early onset preeclampsia, an OR of 37.4 (95% CI, 17.64-79.07) for the development of severe preeclampsia, an OR of 8.6 (95% CI, 5.35-13.74) for the development of preeclampsia, and an OR of 2.7 (95% CI, 1.73-4.26) for the delivery of a SGA neonate in the absence of preeclampsia. The combination of abnormal UADV and maternal plasma PlGF concentration of < 280 pg/mL in the second trimester is associated with a high risk for preeclampsia and early onset and/or severe preeclampsia in a low-risk population. Among those with abnormal UADV, a maternal plasma concentration of PlGF of < 280 pg/mL identifies most patients who will experience early onset and/or severe preeclampsia. (author's) Language: English Keywords: UNITED STATES OF AMERICA | CHILE | RESEARCH REPORT | PROSPECTIVE STUDIES | PREGNANT WOMEN | PREECLAMPSIA | PREVALENCE | RISK FACTORS | PREGNANCY, SECOND TRIMESTER | EXAMINATIONS AND DIAGNOSES | ULTRASONICS | HYPERTENSION | PREGNANCY OUTCOMES | North America | Americas | Developed Countries | Developing Countries | South America, Southern | South America | Latin America | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Pregnancy Complications | Diseases | Measurement | Biology | Pregnancy | Reproduction | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Vascular Diseases Document Number: 313314 |
| 24. Title: Chilean university students: Knowledge and concern about HIV / AIDS. Author: Ferrer L; Cianelli R; Guzman E; Cabieses B; Irarrazabal L Source: Journal of the Association of Nurses in AIDS Care. 2007 Sep-Oct;18(5):51-56. Abstract: According to a 2004 report by the Joint United Nations Programme on HIV/AIDS, Chile has an incipient HIV/AIDS epidemic. Regardless of the classification, every year the cumulative incidence of HIV/AIDS increases. Young Chileans have been the most affected group; still, their knowledge, attitudes, and concerns about HIV/AIDS are not known. This study describes Chilean university students' HIV/ AIDS-related knowledge, their worry about getting the virus, and the correlation between both variables. A convenience sample of 45 university students responded to an anonymous self-administered questionnaire after orally consenting to participate in this study. Overall, students had good levels of HIV/ AIDS-related knowledge, with 77% responding correctly to at least 85% of the questions. Despite this knowledge, almost 56% of students stated that they were not worried about getting HIV/AIDS. The situation was corroborated by a nonsignificant statistical correlation between both variables (p greater than .05). These results are congruent with literature from other countries and strengthen the need for further research to clarify why university students, the majority of whom are well-educated and engage in behaviors that place them at risk for contracting the virus, do not worry about HIV. (author's) Language: English Keywords: CHILE | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | QUESTIONNAIRES | YOUTH | STUDENTS | UNIVERSITIES | HIV | AIDS | KNOWLEDGE | ATTITUDES | PERCEPTION | RISK ASSESSMENT | Developing Countries | South America, Southern | South America | Latin America | Americas | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Education | Schools | HIV Infections | Viral Diseases | Diseases | Sociocultural Factors | Psychological Factors | Behavior | Evaluation Document Number: 313865 |
| 25. Peer Reviewed Title: Levonorgestrel pharmacokinetics in plasma and milk of lactating women who take 1.5 mg for emergency contraception. Author: Gainer E; Massai R; Lillo S; Reyes V; Forcelledo ML Source: Human Reproduction. 2007 Jun;22(6):1578-1584. Abstract: Progestin-only methods are among the contraceptive options available for breastfeeding women, however the doses of progestin used in emergency contraception (EC) have not been evaluated in nursing mothers. We therefore investigated the pharmacokinetics of 1.5 mg levonorgestrel (LNG) in lactating women. Twelve healthy exclusively breastfeeding volunteers received 1.5 mg LNG. Women refrained from nursing for 72 h after dosing and fed their infants with milk frozen beforehand. Serial blood and milk samples were collected for 120 h and assayed for LNG and sex hormone binding globulin. LNG concentrations peaked in plasma and in milk 1-4 h and 2-4 h after dosing, respectively. Concentrations in milk (M) paralleled those in plasma (P) but were consistently lower (mean M:P ratio 0.28). Estimated infant exposure to LNG is 1.6 mg on the day of dosing (1 mg in the first 8 h), 0.3 mg on the second day and 0.2 mg on the third day. Nursing mothers may need EC. These results suggest that to limit infant exposure to the period of maximum LNG excretion in milk, mothers should discontinue nursing for at least 8 h, but not more than 24 h, after EC. (author's) Language: English Keywords: CHILE | RESEARCH REPORT | ANALYSIS | MOTHERS | INFANT | BREASTFEEDING | HUMAN MILK | LACTATION | EMERGENCY CONTRACEPTION | LEVONORGESTREL | Developing Countries | South America, Southern | South America | Latin America | Americas | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Infant Nutrition | Nutrition | Health | Maternal Physiology | Physiology | Biology | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents Document Number: 317099 |
| 26. Title: Relation between insulin resistance and breast cancer among Chilean women. Author: Garmendia ML; Pereira A; Alvarado ME; Atalah E Source: Annals of Epidemiology. 2007 Jun;17(6):403-409. Abstract: In Chile, diabetes and breast cancer are important public health problems. The association between insulin resistance and breast cancer, however, remains largely unexplored. We conducted a case-control study to assess the relationship of insulin resistance (IR) and breast cancer in Chilean premenopausal and postmenopausal women. We compared 170 women, 33 to 86 years old, with incident breast cancer and 170 normal mammography controls, matched by 5-year age interval. Plasmatic insulin and glucose were measured and IR was calculated by the homeostasis model assessment method. Anthropometric measurements and sociodemographic and behavioral data were also collected. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by multivariable conditional logistic regression. IR was independently associated with breast cancer in postmenopausal women (OR = 2.70, 95% CI = 1.10-6.63), but not in premenopausal women (OR = 0.84, 95% CI = 0.20-3.52). Obesity was not associated with breast cancer at any age (OR = 0.68, 95% CI = 0.39-1.20). In this sample, IR increased the risk of breast cancer among postmenopausal women. (author's) Language: English Keywords: CHILE | RESEARCH REPORT | CASE CONTROL STUDIES | WOMEN | BREAST CANCER | RISK FACTORS | AGE FACTORS | GLUCOSE TOLERANCE TEST | TREATMENT | South America, Southern | South America | Latin America | Americas | Developing Countries | Studies | Research Methodology | Demographic Factors | Population | Cancer | Neoplasms | Diseases | Biology | Population Characteristics | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 317122 |
| 27. Title: Excluded from health? Informal workers' access to health care in Chile. Author: Gideon J Source: Bulletin of Latin American Research. 2007 Apr;26(2):238-255. Abstract: The Pan American Health Organisation recently highlighted the increased exclusion of low income households in Latin America from health care. The rise in informal employment and sub-contracting of workers means that many employees lack formal contracts and are excluded from health insurance programmes. Feminist research suggests low income women are often most at risk of exclusion. Simultaneously, deeply entrenched inequalities within health systems across the region have not been addressed by health sector reforms. Drawing on the case of Chile, this paper examines the extent to which informal workers have indeed been excluded and how far these processes are gendered. (author's) Language: English Keywords: CHILE | RESEARCH REPORT | INFORMAL SECTOR | LABOR FORCE | PRIMARY HEALTH CARE | INEQUALITIES | GENDER ISSUES | PROGRAM ACCESSIBILITY | Developing Countries | South America, Southern | South America | Latin America | Americas | Macroeconomic Factors | Economic Factors | Human Resources | Health Services | Delivery of Health Care | Health | Socioeconomic Factors | Sociocultural Factors | Program Evaluation | Programs | Organization and Administration Document Number: 325367 |
| 28. Title: Preventing of neural-tube defects in Chile. Author: Gottlieb J Source: Washington, D.C., Center for Global Development, [2007]. 7 p. (Millions Saved Initiative Case 16) Abstract: Neural-tube defects (NTDs), the second most common congenital malformation after congenital heart disease, affected about 400 babies in Chile per year in the years before the fortification intervention. The NTD rate of 17.2 per 10,000 live births had been unchanged from 1967 to 1999. Each year, neural-tube defects affect more than 300,000 newborns worldwide. Anencephaly and spina bifida, the two most common NTDs, are important contributors to infant and fetal mortality: all infants with anencephaly are stillborn or die shortly after birth, and those born with spina bifida suffer lifelong disabilities and require extensive medical care. Aware of the effect of folic acid on the prevention of neural-tube defects and encouraged by public health experts, the Chilean Ministry of Health introduced new legislation in early 2000 stipulating that all domestically produced wheat flour must be fortified with folic acid. Flour mills began producing, distributing, and marketing wheat flour in compliance with the new legislation, and the government helped to regulate and monitor the quality of fortified flour. With existing technologies, the cost of adding folic acid to the pre-mix for fortified flour is approximately 15 cents per ton of wheat flour, making the cost of fortification only 16 cents per woman of reproductive age receiving the target amount of folic acid. With the total cost of rehabilitation for a child affected with spina bifida averaging $100,000, Chile's health system saved an estimated $11 million per year (based on 110 cases in one year). Shortly after the fortification legislation was passed, 91 percent of wheat bread was being produced with fortified flour. A year later, blood folate levels in women of reproductive age increased three- to four-fold. Chile's fortification intervention produced a dramatic decrease of the NTD rate-a reduction of approximately 51 percent for spina bifida and 46 percent for anencephaly. (author's) Language: English Keywords: CHILE | RESEARCH REPORT | EVALUATION | INFANT | CONGENITAL ABNORMALITIES | VITAMINS AND MINERALS | FOOD SUPPLEMENTATION | LEGISLATION | COST EFFECTIVENESS | Developing Countries | South America, Southern | South America | Latin America | Americas | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Neonatal Diseases and Abnormalities | Diseases | Physiology | Biology | Nutrition Programs | Primary Health Care | Health Services | Delivery of Health Care | Health | Political Factors | Sociocultural Factors | Evaluation Indexes | Quantitative Evaluation Document Number: 320730 |
| 29. Peer Reviewed Title: Sexual behaviour and knowledge about HIV / AIDS and sexually transmitted infections among health sciences students from Chile. Author: Guerrero-Lillo L; Medrano-Diaz J; Perez F; Perez C; Bizjak-Gomez A Source: Sexually Transmitted Infections. 2007;83:592-593. Abstract: The aim of AIDS educational campaigns is to reduce the spread of HIV infection by changing attitudes and practices related to high-risk behaviours. However, before such programmes can be implemented, certain assessments should be conducted. These include assessments of the existing knowledge, attitudes and sexual practices of specific risk groups. Among those groups assessed should be professionals and volunteers who are engaged in managing patients with AIDS. For these reasons, we evaluated the knowledge and practice about HIV/AIDS and sexually transmitted infections (STIs) in health sciences students from Chile. We adapted, modified and then validated the World Health Organization's standardised survey inventories assessing AIDS-related knowledge, attitudes, beliefs and practices for adolescents. A 23-question survey, conducted among students from the schools of medicine and attention to mental retardation (AMR; known as Parvularia in Spanish, studied during first and fifth years) at the Antofagasta University (northern Chile) was used to evaluate knowledge and practice about HIV/AIDS and STIs. This evaluation was performed during 2005. The total registered number of students for both careers was obtained, then using this as the universe population, with a confidence level of 99.99%, we calculated the probabilistic sample to survey. The required survey sample size was calculated using Epi Info V.6.0. Statistical analysis with SPSS V.10.0 involved use of the x/2 test, Student's t test and Fisher's test using 95% CIs (significant at p < 0.05). (author's) Language: English Keywords: CHILE | RESEARCH REPORT | NEEDS ASSESSMENT | STUDENTS | YOUTH | SCHOOLS, MEDICAL | HEALTH EDUCATION | KNOWLEDGE | ATTITUDE | BELIEFS | SEX BEHAVIOR | HIV PREVENTION | RISK BEHAVIOR | HIV TRANSMISSION | HIV INFECTIONS | SEXUALLY TRANSMITTED DISEASES | Developing Countries | South America, Southern | South America | Latin America | Americas | Evaluation | Education | Age Factors | Population Characteristics | Demographic Factors | Population | Schools | Sociocultural Factors | Psychological Factors | Behavior | Culture | Viral Diseases | Diseases | Reproductive Tract Infections | Infections Document Number: 322780 |
| 30. Title: [Microbiologic and molecular diagnostic of cariogenic bacteria in pregnant women from the Araucania Region of Chile] Diagnostico microbiologico y molecular de bacterias cariogenicas en mujeres embarazadas de la Region de La Araucania, Chile. Author: Herrera CL; Pantoja P; de La Maza T; Sanhueza A; Salazar LA Source: Revista Chilena de Infectología. 2007 Aug;24(4):270-275. Abstract: Dental caries is a transmissible infectious disease in which Streptococcus mutans is a principal protagonist. Although it is widely believed that pregnancy is harmful to teeth, the effect of pregnancy on the development of caries is not clear. Considering this situation, the aim of the present study was to evaluate the levels of infection and to differentiate bacterial species with cariogenic potential in pregnant women from the Araucania region in Chile, by bacteriological and molecular analysis. In this work, we evaluated 51 pregnant women aged 15 to 40 years. The results show that 100% of women are infected by mutans streptococci Group, and 70.6% exhibited high levels of infection (> 500.000 cfu/mL). The molecular analysis shows that Streptococcus mutans and Streptococcus sobrinus frequencies were 92.1% and 1.9%, respectively. In conclusion, our data suggest that pregnant women are a high risk group for caries development. Language: Spanish Keywords: CHILE | RESEARCH REPORT | DATA ANALYSIS | EVALUATION | PREGNANT WOMEN | HIGH RISK WOMEN | BACTERIAL AND FUNGAL DISEASES | INFECTIONS | Developing Countries | South America, Southern | South America | Latin America | Americas | |