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Introduction: Ageism refers to the set of stereotypes, prejudices, and discrimination based on age, which negatively affects healthcare for older adults. In Chile, there is limited evidence on this phenomenon among physiotherapy students.

Objective: To determine the presence of negative stereotypes towards older adults among physiotherapy students at a private university in the Valparaíso region, and to compare these stereotypes according to the level of knowledge in geriatrics and gerontology.

Methods: A cross-sectional observational study was conducted using an online survey of physiotherapy students. The Questionnaire of Negative Stereotypes Towards Ageing was administered, and knowledge in geriatrics and gerontology was assessed based on the completion of specific modules. Descriptive analyses, Student's t-test, and multiple linear regression adjusted for age and sex were performed.

Results: A total of 96 students participated in the study. The average score for negative stereotypes towards ageing was 38.8 (SD = 5.8), classified as a low level, although it was close to the threshold for a high level. 42.7% of students presented high levels of negative stereotypes. Students who had passed both modules scored on average 4.3 points lower in negative stereotypes than those who had passed neither (95% CI: -7.4 to -1.3; p = 0.006).

Conclusions: Physiotherapy students exhibit negative stereotypes towards ageing, especially those without specific training in geriatrics and gerontology. Including these modules in professional education could contribute to improving future healthcare and reducing ageism towards older adults.

Introduction: Since the first description of Thrombotic Thrombocytopenic Purpura, caused by a severe deficiency of ADAMTS13, plasma exchange and immunosuppression have become standard treatments, allowing to decrease its high mortality rate. Prospective records of Thrombotic Thrombocytopenic Purpura have provided valuable information on its pathophysiology, clinical presentation, and outcomes. The objective of this study is to update the local Chilean experience in the diagnosis and management of this disease, through a case series of patients treated between 2017 and 2022.

Methods: Case series study that included patients over 18 years old diagnosed with Thrombotic Thrombocytopenic Purpura, treated between June 2017 and August 2022 at Hospital Clínico UC Christus. Information was collected from clinical records, which were used for cohort description and statistical analysis. Accepted definitions from the literature were used to describe the outcomes. The study was approved by the local ethics committee (ID 220524001).

Results: Our series had higher age and prevalence of comorbidities compared to those reported in the literature. The most important clinical manifestations included constitutional, gastrointestinal, hemorrhagic, and neurological symptoms, with different presentation frequencies than those described internationally. We found a lower capacity of the PLASMIC Score for the detection of Thrombotic Thrombocytopenic Purpura in our series. The predominant therapeutic strategy was a combination of glucocorticoids and plasma exchange (61% of the patients). There was a high mortality rate (56.5%) and adverse events related to plasma exchange, especially of infections related to its use.

Conclusions: This study highlights the diagnostic and therapeutic challenges of Thrombotic Thrombocytopenic Purpura in the local context and the need to improve our management strategies through standardizing care and better application of clinical guidelines to reduce the high mortality rate in these patients.

Introduction: Motor skills encompass a series of movements essential for daily activities and have been associated with well-being and child development. However, there are various external and internal conditions that can affect children's motor development. Therefore, the purpose of our study was to analyze the motor skills of Peruvian children aged three to six years and compare differences based on region, sex, age, and type of educational institution.

Methods: An observational study was conducted with a sample of 265 children aged three to six years from public and private institutions in three regions of Peru: the central region (Metropolitan Lima), the jungle region (Tarapoto), and the southern region (Chincha Alta). The Test of Gross Motor Development, Third Edition (TGMD-3) was applied. Data were processed and analyzed using descriptive statistics and non-parametric tests such as the Mann-Whitney U test and Kruskal-Wallis test (p<0.05). Additionally, a multiple linear regression analysis with robust standard errors was conducted.

Results: The results revealed significant differences between regions. Children from the Selva (Tarapoto) and Sur (Chincha) regions of Peru reported higher scores than those from the central region. In addition, girls reported higher scores than boys in locomotor skills. Also, it was found that motor performance usually reaches better performance after five years and six months of age.

Conclusions: It is concluded that infant motor performance varies by region, age and sex. Therefore, future interventions adjusted for these variables are required to strengthen and improve these skills.

Violence is a pressing global concern, causing more than 475 000 deaths annually and disproportionately affecting women and children. While environmental, genetic, and epigenetic factors contribute to violent behavior, this article focuses on the genetic aspect, particularly the roles of the X and Y chromosomes. The monoamino oxidase A () gene influences neurotransmitter catabolism and is located on the X chromosome. Polymorphisms, such as tandem repeat variants associated with low transcriptional activity, have been linked to aggression, particularly in men, as X chromosome inactivation complicates studies in women. Other variants, including single-nucleotide polymorphisms, have also been associated with violent behavior. Additionally, individuals with fragile X syndrome often exhibit increased aggression patterns. The Y chromosome's sex-determining region Y gene () plays a pivotal role in male sexual development and behavior. Besides directing testicular formation, is expressed in other tissues, influencing violence by modulating catecholamine release and inhibiting the monoamio oxidasa A. Evolutionary hypotheses suggest that may have adapted to promote male aggression for survival. Despite evidence linking the X and Y chromosomes to violence, conflicting findings highlight the need for further research to fully understand their roles in aggressive behavior. This article focuses on the genetic component, specifically analyzing the bibliographic evidence associating Y and X chromosome genetics to violent behavior.

Long QT syndrome is a rare cardiac channelopathy characterized by prolonged QT intervals and altered T wave morphology. The etiology of long QT syndrome is multifactorial, including environmental and genetic factors. In addition, several heart diseases have been associated with the individual's ethnicity. The objective of the present case report is to describe the genetic and clinical findings of a 44-year-old Ecuadorian man who experienced recurrent episodes of syncope, prolonged QT intervals, and emergent arrhythmias. Through next-generation sequencing, genetic analysis identified a p.Val612Met variant in the KCNH2 gene, associated with long QT syndrome type 2. These findings were key in classifying the patient's condition as life-threatening and guiding the implementation of a personalized treatment strategy.

Introduction: Reproductive immunology has advanced significantly, recognizing the immune system as crucial in pregnancy development and facilitating the identification of abnormalities causing recurrent reproductive failure, as well as proposing targeted treatments for these patients.

Methods: This is a descriptive, observational, and retrospective study conducted at the Reproductive Immunology Unit of the Hospital Clínico San Carlos in Madrid. Clinical and analytical data were analyzed for patients diagnosed with recurrent reproductive failure between 2019 and 2023. Data on treatments received as prophylaxis for pregnancy loss and their success rates were also collected. Finally, a comparative study of the two major subgroups in the cohort was performed.

Results: A total of 277 patients were included. The most prevalent diagnosis was recurrent miscarriage (64.2%), followed by recurrent implantation failure (25.2%). Immunological and/or vascular abnormalities were detected in 88.8% of patients. The most prevalent immunological abnormality was the expansion of cytotoxic natural killer cells (49.5%), followed by HLA-C-KIR mismatch (39.1%) and the presence of antiphospholipid antibodies (38.5%). The comparative study between the recurrent miscarriage and the recurrent implantation failure subgroups revealed statistically significant differences regarding the presence of antinuclear antibodies (15.4% vs. 28.3%, p=0.03) and vitamin D deficiency (37.2 vs 60.0%, p=0.01). The most commonly used medications were low-dose acetylsalicylic acid, low-molecular-weight heparin, hydroxychloroquine, and/or prednisone, with an overall success rate of 97.3%. Neither moderate nor severe side effects were reported.

Conclusions: Immunological studies to identify causes of recurrent reproductive failure are highly useful in cases where other etiologies have been excluded. Targeted therapies for addressing these abnormalities have demonstrated significant effectiveness.

The volume of information about medical interventions has grown exponentially in recent decades. The increasing involvement of patients in decision-making creates a scenario in which they can constantly interact with multiple sources of information that can be correct, incorrect or misleading. In this context, promoting knowledge dissemination through reliable sources and fostering health literacy among the general population is crucial. The Informed Health Choices project aims to generate resources that can help individuals cultivate critical thinking about health interventions, thereby reducing unnecessary harm and financial costs. The Key Concepts of Informed Health Choices serve as the foundation for creating these resources. This is a list of principles potentially relevant for people without formal training in health topics to assess the reliability of the information about interventions. Resources based on these Key Concepts have been tested on primary and secondary school students in Africa, showing positive results in the short- and medium-term. This initiative is not free from limitations or considerations concerning its applicability but sheds light on how to face the new challenges that health education brings in times of . This article aims to contextualize the current scenario of health information and to introduce the Key Concepts for making informed health choices and the resources created based on them.The text is part of a methodological series on clinical epidemiology, biostatistics and research methodology conducted by the Evidence-based Medicine team at the School of Medicine of the University of Valparaíso, Chile.

Background: In Chile, despite high obstetric coverage and consolidated registration systems, there has been a stagnation in the reduction of maternal mortality, reflecting the need to identify social factors and determinants. These are often overlooked by traditional surveillance systems.

Objective: To adapt and validate, through expert consensus, a verbal autopsy instrument based on the three delays model, with a gender and intercultural approach.

Methods: Expert validation study using the Delphi method in three phases, carried out between June and October 2024. Forty experts in maternal health, epidemiological surveillance, gender, and interculturality participated. Seven criteria were evaluated: clarity, relevance, cultural relevance, socio-health relevance, regulatory relevance, and the incorporation of gender and intercultural approaches. The process sought to reach consensus to ensure the methodological and contextual quality of the instrument.

Results: The final instrument includes 95 items organized into six thematic blocks. An overall consensus of 85% was achieved on the evaluated criteria. The adaptation incorporated variables such as mental health, gender-based violence, ethnic identity, and perceived quality of care. Operational validation identified implementation, logistical, and ethical challenges, leading to a gradual implementation plan in regulatory, pilot, and national expansion phases.

Conclusions: The instrument adapted and validated by experts offers a complementary tool for monitoring maternal mortality in Chile. Its comprehensive approach would allow identifying social and structural factors associated with maternal deaths, favoring more equitable and culturally relevant interventions aimed at preventing avoidable maternal deaths. Field validation is essential to assess the impact of its application.

Introduction: According to the World Health Organization (WHO), 2.8 million mothers and newborns die each year from preventable causes, highlighting inequalities in access to quality healthcare services. The study describes the factors that limit institutional childbirth among Ashaninka mothers in the Peruvian Amazon.

Methods: The research was descriptive, using a questionnaire administered to 152 Ashaninka mothers from five communities in Río Tambo.

Results: Most Ashaninka mothers who gave birth at home were between 25 and 29 years old, lived with their partners, came from the Koterini Tarzo community, were Catholic, had incomplete secondary education, were housewives, and had a paternal income of less than or equal to 1000 PEN. They chose home birth for cultural reasons such as privacy, tradition, and economics, preferring traditional birth attendants because of their cultural acceptance and experience. Cultural practices included the burial of the placenta, the use of herbs such as "piri piri," and vertical births. The perception of inadequate facilities and the prevalence of cesarean sections limit the acceptance of institutional childbirth. Added to this is a preference for female healthcare personnel, a lack of information about health procedures, and the prohibition of cultural practices.

Conclusions: There is a need to reform the maternal care model in Indigenous contexts, involving healthcare personnel, policymakers, and local authorities to create culturally relevant and accessible services. It is suggested that an intercultural approach be integrated into professional training and that traditional medicine be combined with the healthcare system. Future studies should evaluate the impact of these interventions on maternal and perinatal outcomes in Indigenous communities.