Scielo RSS <![CDATA[Revista médica de Chile]]> https://scielo.conicyt.cl/rss.php?pid=0034-988720080002&lang= vol. 136 num. 2 lang. <![CDATA[SciELO Logo]]> https://scielo.conicyt.cl/img/en/fbpelogp.gif https://scielo.conicyt.cl <![CDATA[<b><i>ln-hospital mortality after ST-segment elevation myocardial infarction according to reperiusion therapy</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000200001&lng=&nrm=iso&tlng= Primary angioplasty is considered the best reperiusion therapy in the treatment of ST-segment elevation myocardial infarction (STEMI). However, thrombolysis is the reperiusion method most commonly used, due to its wide availability, reduced costs and ease of administration. Aim: To compare inhospital mortality in STEMI patients according to reperiusion therapy. Material and Methods: Patients admitted to Chilean hospitals participating in the GEMI network, from 2001 to 2005, with STEMI were included. They were divided in three groups: a) treated with thrombolytics, b) treated with primary angioplasty, c) without reperiusion procedure. Inhospital mortality according to gender, was analized in each group, using a logistic regression method, to assess risk factors associated with mortality. Results: We included 3,255 patients. Global mortality was 9.9% (7.5% in men and 16.7% in women, p <0.001). Mortality in patients treated with thrombolytics, was 10.2% (7.6% in men and 18.7% in women, p <0.01). The figure for patients treated with primary angioplasty, was 4.7% (2.5% in men and 13% in women, p <0.01), and in patients without reperiusion, was 11.6% (9.8% in men and in 15.4% women, p <0.01). In each group women were older, had a higher prevalence of hypertension and a higher percentage of Killip 3-4 infarctions. Logistic regression showed that angioplasty, compared with no reperiusion, was associated with a reduced mortality only in men. The use oí thrombolytics in women was associated with a higher mortality. Conclusions: Primary angioplasty was the reperiusion therapy associated to the lower mortality in STEMI. Use of thrombolytics in women was associated with a higher mortality rate than in non reperfused women <![CDATA[<b><i>Porphyria and pregnancy. Review of 17 women</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000200002&lng=&nrm=iso&tlng= Hormonal changes, prolonged fasting due to vomiting and some medications used during pregnancy, may cause an acute crisis of porphyria, sometimes unveiling a latent disease. Porphyria may also affect the evolution of pregnancy. Aim: To study the reciprocal influence in the evolution of both pregnancy and porphyria. Material and methods: Retrospective review of medical records of women with porphyria followed by the authors. If additional information was required, an additional visit to the clinic was scheduled. The characteristics of pregnancy, delivery and the newborn were analyzed. Results: Information about 60 pregnancies in 17 women aged 18 to 43 years was gathered. Among women with acute porphyria, one with coproporphyria had four pregnancies, nine with variegate porphyria had a total of 34 pregnancies and two with acute intermittent porphyria had six pregnancies. Five women with porphyria cutánea had a total of 16 pregnancies. Influence of porphyria in pregnancy: Compared to the general population, no differences were observed in birth weight of newborns, frequency of gestational hypertension, term or preterm deliveries of live newbornss, spontaneous abortions nor in tubal pregnancies; there was a high frequency of hyperemesis gravidarum. Influence of pregnancy in porphyria: 5 of the 12 patients with acute porphyria, had an acute porphyria crisis, 3 during the puerperal period and 2 during pregnancy (42% of women, 11% of pregnancies). All these crisis were associated to the administration of medications. All patients survived. Two of these women had six ulterior pregnancies without complications. Conclusions: Women with porphyria that become pregnant have a higher frequency of hyperemesis gravidarum. Crises among women with acute porphyrias, were always associated with the use of potentially dangerous medications <![CDATA[<b><i>Cystic fibrosis mortality in Chile between 1997 and 2003</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000200003&lng=&nrm=iso&tlng= Cystic fibrosis (CF) is the most common lethal autosomic recessive disease among Caucasians. In Chile, its incidence is estimated in 1/4,000 newborns and it is possibly underestimated. Aim: To analyze CF mortality in Chile during the period 1997-2003. Material and methods: Demographic and CF mortality data reported by the National Institute of Statistics during the period 1997-2003 were recorded, according to sex and age. Overall mortality rate for each year was estimated, as well as the average mortality rate during the same period in patients younger than 1 year, 1-4 years, 5-9 years, 10-14 years and older than 15 years. Results: One hundred and three deaths (56 females) due to CF occurred during 1997-2003. Sixty-eight deaths corresponded to patients younger than 15years (66.0%). Overall mortality rate ranged from 0.82 to 1.33 per 10(6) inhabitants in 1997 and 1999, respectively. Average mortality rate ranged from 0.46 to 9.81 per ^inhabitants among patients older than 15 years and younger than 1 year, respectively. Conclusions: Most CF deaths occurred in the pediatric age group <![CDATA[<b><i>Bouveret syndrome</i></b>: <b><i>Report of four cases</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000200004&lng=&nrm=iso&tlng= Bouveret syndrome is a duodenal obstruction caused by a biliary stone. Aim: To report patients with Bouveret syndrome. Material and Methods: Retrospective review of medical records of patients with Bouveret syndrome treated between 1976 and 2006. Results: We report three women and one man with a mean age of 62.5 years. None had a previous diagnosis of cholelithiasis. AH presented with colicky pain in the right upper quadrant and vomiting, suggesting gastric retention. The diagnosis was suspected after a barium meal in two patients and with a CT scan on the other two. The endoscopical extraction or fragmentation of stones was attempted in three patients but was successful only in one. Three patients were operated and a stone impacted in the first portion of the duodenum was identified, along with a cholecystoduodenal fistula. A duodenostomy and stone extraction was performed. One patient was subjected to a cholecystectomy fistula repair and gastrojejunoanastomosis. No patient died and all were discharged within 8 to 12 days after surgery. Conclusions: Bouveret syndrome is an uncommon complication of cholelithiasis. Endoscopy can be diagnostic and therapeutic. Surgery is the other therapeutic option <![CDATA[<b><i>Social support as a protective factor of recurrence after drug addiction treatment</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000200005&lng=&nrm=iso&tlng= Lack of social support can be one of the factors that influences recurrences of drug consumption after treatment of addictions. Aim: To assess the role of social support in maintaining drug abstinence after treatment. Material and methods: We studied 306 subjects that were treated in drug addiction centers, financed by the National Council for Drug Control (CONACE). At discharge, social and demographic data were recorded and the Medical Outcomes Study (MOS) questionnaire was given to evaluate social support. Subjects that achieved abstinence at the moment of discharge were contacted six months later and interrogated about eventual drug consumption thereafter. Results: One hundred fifty three (76% male, aged 32 ± 10 years) of 197 abstinent subjects at discharge, were located six months later. Of these, 108 (71%) were not consuming drugs. On univariate analysis, social support had a protective effect against recurrence of drug consumption (OR - 0.98; CI 95% = 0.96-0.99). This effect remained significant after adjusting for age, sex, occupational situation, mental health self-assessment, family history of alcohol and drug consumption, type of drug treatment and type of discharge as confounding variables (OR = 0.97; CI 95% = 0.94-0.99). Conclusions: These data provide evidence that social support protects against recurrence into drug consumption at ¡east up to six months. Long-term effects should be evaluated <![CDATA[<b><i>Factors associated with abstinence in a smoking cessation program</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000200006&lng=&nrm=iso&tlng= Smoking cessation programs have an efficacy of approximately 30%. Different factors related to the patients may influence this figure. Aim To identify determinant factors for smoking cessation after one year of treatment and to determine if bupropion and nicotine substitutes are effective in smoking cessation treatments. Material and methods: Follow up of 68 patients that attended a smokers clinic at a General Hospital. The patients filled up a questionnaire which included demographic, morbid and smoking habits data. They were subjected to a psychiatric interview to determine their treatment. One year later, patients were contacted by telephone and were asked if they remained without smoking. Results: After one year, 41% of patients responded that they were abstinent. On univariate analysis, male gender appeared as a protective factor associated to abstinence. On multivariate analysis, the use of bupropion appeared as a protective factor. A high score on the automatic item of the smoking motivation questionnaire appeared as a risk factor. The presence of respiratory diseases and the male gender were borderline significant protective factors. Nicotine substitutes were not associated with better abstinence rates. Conclusions: In this sample of smokers, the use of bupropion was associated with better abstinence rates and a high motivation to smoke appeared as a risk factor to continue smoking <![CDATA[<b><i>High prevalence of specific language impairment in Robinson Crusoe Island. A possible founder effect</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000200007&lng=&nrm=iso&tlng= Specific language impairment (SLI) occurs in 2% to 8% of preschool children. Major and candidate genes are probably involved. Genetic drift is a cause for the presence of high frequencies of deleterious alíeles of a specific disease and the founder effect is one of its forms. Robinson Crusoe Island has 633 inhabitants and its actual population began with 8 families that repopulated the island at the end ofXIXth century. Aim To assess the frequency of specific language impairment among children living in Robinson Crusoe Island. Material and methods: All 66 children aged between 3 and 9 years living in the island, were studied. Parents were interviewed and in children, non verbal intelligence, audiometric parameters, comprehension and expression of oral language were assessed. Extended genealogies were also performed. Results: Forty children had at least one parent that was descending of founder families. Among these, 35% had SLI. Eighth five percent of SLI affected children came from the same colonizer family. Conclusions: The prevalence of SLI in Robinson Crusoe Island is higher than that reponed in mainland Chile and abroad. This high prevalence, associated to a high frequency of consanguinity, supports the influence of genetic mechanisms in SLI transmission, based on a founder effect <![CDATA[<b><i>Kinship determination using DNA markers</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000200008&lng=&nrm=iso&tlng= Autosomal and Y chromosome short tandem repeats (STRs) and mitochondrial DNA polymorphisms are the most commonly used molecular tools for determination of kinship. Aim: To report a revision of 1,120 kinship cases (paternity and others) analyzed in our laboratory. Material and methods: Revision of all kinship cases analyzed between years 2001-2006. Autosomal and Y chromosome STRs and mitochondrial DNA polymorphisms were analyzed in DNA extracted from blood samples. Results: Paternity was excluded in 27.2% of cases. This figure did not change significantly along years. Most paternity exclusions were confirmed by the discordance in 5 genetic markers (30.5%), followed by exclusion of 4 and 6 genetic markers (20.3 and 20% respectively). Two studied cases were paternal and maternal exclusions, corresponding to a change of children between two families. In one case, the paternal line was assessed through Y chromosome markers, studying 16 STRs of this chromosome, positively confirming this paternal relationship. Another case was analyzed for maternal line using mitochondrial DNA analysis. In six cases, a genetic marker with a paternal-sibling mutation, was observed. The criteria for the determination of mutation was the finding of only one discordant marker between at ¡east thirteen markers analyzed in each case. Also, an increase or decrease in one unit repeated in tandem (tetranucleotide) between the alleged father and the son was also required. One subject had a double mutation. In this case, paternity was confirmed analyzing thirteen autosomic STRs and five Y-STRs. Conclusions: The authors have acquired great expertise in kinship analysis and had established criteria to solve complex kinship cases <![CDATA[<b><i>Paternal age as a risk factor for congenital malformations</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000200009&lng=&nrm=iso&tlng= The role of advanced maternal age as a risk factor for congenital malformations in offspring is known. However, the influence of paternal age is not clear. Aim: To evaluate the association between advanced paternal age and the risk for congenital malformations. Patients and Methods: Analysis of maternal and paternal age of cases (malformed newborns) and controls from ECLAMC Database (Latin American Collaborative Study of Congenital Malformations) registered at the University of Chile Clinical Hospital during the decade from Jan 1 1997 to Dec 31 2006. Newborns and stillborns were grouped according to maternal age into 6 intervals. In each interval, paternal ages of cases and controls were compared. The inverse procedure was performed to assess maternal age effect. Other variables as gestational age and birth weight were analyzed for the intervals of maternal and paternal ages. Results: No significant differences were observed in paternal age between cases and controls in any of the intervals of maternal age. However, mean maternal age was higher for cases than for controls (p =0,0149). Gestational age and birth weight depend more on being case or control than on the age of parents. Conclusions: No differences in paternal age were observed between cases and controls in this series of newborns <![CDATA[<b><i>Histiocytic necrotizing lymphadenitis</i></b>: <b><i>Report of three cases</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000200010&lng=&nrm=iso&tlng= Histiocytic necrotizing lymphadenitis (HNL), also known as Kikuchi 5 disease is a rare condition of unknown etiology. Patients present with cervical lymph node enlargement, fever and malaise. The diagnosis is made by excision biopsy. However, this entity must be distinguished from both reactive processes and malignant tumors such as lymphoma. The clinical course is self limited with spontaneous resolution within a few months. We report three patients with the disease. A 37 year-old woman with a 4 months history of a painless submaxillary mass of 2.5 cm diameter, attached to the deep tissues of the neck. The mass was excised and the biopsy report was HNL. After 26 months of follow up, the patient is asymptomatic. A 30 year-old woman with a history of 2 months of a painless lateral cervical mass and aspiration biopsy was reported as suspicious for lymphoma. An excision biopsy was performed, that was reported as HNL. In both patients, lymphoma was ruled out by immunohistochemistry. A 33 year-old woman with a 3 weeks history of an asymptomatic lateral cervical mass. Biopsy was reported as HNL. This condition must be included in the differential diagnosis of cervical asymptomatic masses. The clinician must be aware of it to avoid long-term, costly treatments <![CDATA[<b><i>Recurrent left lung atelectasis caused by an endobronchial metastasis of a colon cancer</i></b>: <b><i>Report of one case</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000200011&lng=&nrm=iso&tlng= Endobronchial location of metastases is uncommon. We report a 83 year-old woman with a history of a ¡eft hemicolectomy due to tubular colon adenocarcinoma, three years ago. She consulted in the emergency room for progressive dyspnea, cough an mucous sputum. There was abolition of breath sounds and dullness in the ¡eft hemithorax. Chest X ray examination showed a complete opacity of the ¡eft lung. She was treated as a pneumonia and her left lung expanded again. Three weeks later, left lung atelectasis relapsed. A bronchial biopsy showed a moderately differentiated adenocarcinoma, compatible with colon adenocarcinoma. Immunohistochemistry confirmed the colonic origin of the tumor. The patient rejected radiotherapy and is alive after 11 months of follow up <![CDATA[<b>Case Report Unsuspected and widespread colon cancer in a young woman</b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000200012&lng=&nrm=iso&tlng= Liver and lung metastasis and local lymph node invasion are reported in a 26-year-old Brazilian woman with an asymptomatic colon cancer. She was admitted complaining of right upper quadrant pain, and the diagnostic procedures revealed an unsuspected adenocarcinoma (stage IV) in the descending colon. This malignancy is more frequent in patients older than 40 years, but it usually follows a more aggressive course in young people. Late detection of colon cancer usually results in worst prognosis<hr/>Se presenta un caso en que se demuestran metástasis de un cáncer del colon asintomático en hígado y pulmones, además de invasión ¡ocal de ¡infonodos en una mujer brasileña de 26 años de edad. Al ingresar al hospital, la paciente se quejaba de dolor en hipocondrio derecho. Los procedimientos diagnósticos revelaron un adenocarcinoma no sospechado (fase IV) en el colon descendente. Esta malignidad es más frecuente en ¡os pacientes mayores de 40 años, pero suele tener un curso más agresivo en personas jóvenes. La detección tardía del cáncer del colon habitualmente condiciona un peor pronóstico <![CDATA[<b><i>Primary Listeria monocytogenes infection in a cirrhotic woman</i></b>: <b><i>Report of one case</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000200013&lng=&nrm=iso&tlng= L. monocytogenes infections are infrequent. Sepsis in pregnant women and newborns and central nervous system infections in the elderly are the most common clinical manifestations. We report a 61 years old woman with diabetes Mellitus and a Child B hepatic cirrhosis, admitted for persistent fever. Blood cultures were positive for Listeria monocytogenes. Cerebrospinal fluid was normal and sterile. She was treated with ampicillin and amikacin with a good response. Control blood cultures were negative. She was discharged 14 days after in good conditions <![CDATA[<b><i>Social capital and mental health in low income urban communities in Santiago, Chile</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000200014&lng=&nrm=iso&tlng= Many studies suggest that social capital, defined as those intangible resources of a society or community (trust, participation and reciprocity), that might facilitate collective action, can be associated with positive health effects. Aim: To explore the relationship between social capital an the level of mental health, in urban communities of Santiago, Chile. Material and methods: In a qualitative-quantitative cross-sectional design, two low income neighborhoods in the municipality of Puente Alto were selected. Interviews to key agents and focus groups, as well as surveys (407) to adults from a representative random sample of households, were conducted, measuring social capital, using a locally devised questionnaire and mental health using the General Health Questionnaire (GHQ-12 instrument). A qualitative analysis based on the «grounded theory» and a quantitative analysis through correlations and simple and logistic regression models were applied. Results: The quantitative analysis found an association between female gender, education and having a chronic disease, with low levels of mental health. At the same time, the trust component of social capital might be associated with a better mental health status. Qualitatively, all the components of social capital were identified as important for a better mental health. Conclusions: This study suggests the existence of a positive relationship between social capital and mental health. Developing trust in a community might be a useful tool to work in mental health at the community level <![CDATA[<b><i>Cholangiocarcinoma</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000200015&lng=&nrm=iso&tlng= Cholangiocarcinoma is a malignant lesion of the bile duct epithelium. Its incidence and prevalence are low. It appears from the sixth decade of life and there is slight male predominance. It is most frequently found in the confluence of the hepatic ducts, where it is called hilar cholangiocarcinoma or Klatskin tumor. Its etiology is unknown but there are predisposing conditions and environmental risk factors such as primary sclerosing cholangitis, Caroli's disease, bile duct malformations, industrial toxins and parasitic infections. The classic presentation of cholangiocarcinoma includes jaundice, weight loss and right upper quadrant pain. These, in addition to laboratory exams, endoscopical and imaging procedures, lead to the diagnosis. Hilar cholangiocarcinoma must be distinguished from other malignant or benign causes of biliary obstruction. Cholangiocarcinoma of the distal common bile duct must be differentiated from other periampullary tumors and intrahepatic cholangiocarcinoma can be confused with a hepatocellular carcinoma. Two classifications are used for clinical staging: TNM and Bismuth-Corlette. The best treatment is the complete surgical excision with negative histological margins, although the resectability index is low. The type and size of surgery depends on the location and extent of the tumor. Patients with unresectable tumors can be subjected to palliative procedures such as biliary-enteric bypass, endoscopic or pecutaneous stent placement. Chemotherapy is not effective. Recently, endoscopic phototherapy has emerged as a better alternative for palliative care <![CDATA[<b><i>Sport dermatoses</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000200016&lng=&nrm=iso&tlng= Sports practice has become a part of modern life. As a result, the association of dermatoses with sports increases continuously. Proper diagnosis and treatment of these skin lesions requires familiarity with their characteristics clinical presentations. This article reviews the cutaneous manifestations of traumatic and environmental injuries, infections, and exacerbation of preexisting dermatoses <![CDATA[<b><i>Dr Guillermo Contreras Da Silva, a relevant figure in the development of Chilean microbiology</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000200017&lng=&nrm=iso&tlng= The influence of the work of Dr. Guillermo Contreras Da Silva and his colaborators on the evolution of microbiology in Chile is briefly analyzed. Dr. Contreras was trained in modern virology at Yale University with Dr. J. Melnick under the sponsorhip of the Rockefeller Foundation. During this training, he used serological methods to classify Cocksakie viruses. After his return to Chile, he studied the epidemiology of enteroviruses, including poliovirus. His laboratory, the country's first in modern virology, took an active role in Chile's first Sabin polio vaccination in 1961. Dr. Contreras and his group transformed the teaching and the character of microbiology in Chile from a descriptive medically oriented discipline into an autonomous, quantitative and experimental science. They modernized microbiology with the introduction of molecular biology and microbial genetics and fostered collaborations with allied biological sciences. Dr. Contreras was a Guggenheim Fellow, and until his retirement, was the Chief of the Viral Products Division, Bureau of Biologies, Ottawa, Canada <![CDATA[<b><i>Academic challenges in a School of Medicine</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000200018&lng=&nrm=iso&tlng= Developing a School of Medicine involves being aware of the changes that have taken place in the past years, particularly those concerning the characteristics of students and young faculty, their main motivations and the research, teaching and professional practice scenarios that are being offered by Chilean medical schools and clinical sites. Inspired by these challenges, and from the viewpoint of the generational differences, this article discusses the present development of an academic career founded on humanistic and university values, the tutorial teaching model, academic medicine, and the concept of professionalism <![CDATA[<b><i>Charles II of Spain, «the bewitched»</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000200019&lng=&nrm=iso&tlng= The death of King Charles II, «the Bewitched», ended two centuries of sovereignity of the Habsburg dynasty in Spain. Since his birth in 1661, he presented a peculiar set of physical, psychiatric and behavioral signs, such as respiratory and diarrheal diseases, recurrent seizures and deep developmental delay. It was not until his adulthood when his infertility became evident, being incapable of conceiving a heir, even though he married twice. Such a constellation of ominous signs motivated a curious investigation, which concluded that the king was hexed at the age of 14 years in order to take away his throne, his health and his capacity to procreate. Based on contemporary medical knowledge, it is possible that Charles IIhad a rare autosomal recessive inherited genopathy asa consequence of the frequent inbreeding among his ancestors. On the other hand, its is also possible that Charles IIpresented Klinefelter Syndrome, the most frequent sex chromosome disorder in humans and the most common cause of hypogonadism and infertility in males. The hypothesis that Charles II was bewitched reflects a deep belief in supernatural phenomena among the Castilian society at the beginning of the 18th century, an idea transmitted across generations, currently present in many societies worldwide <![CDATA[<b><i>250 years of medical teaching in Chile</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000200020&lng=&nrm=iso&tlng= The death of King Charles II, «the Bewitched», ended two centuries of sovereignity of the Habsburg dynasty in Spain. Since his birth in 1661, he presented a peculiar set of physical, psychiatric and behavioral signs, such as respiratory and diarrheal diseases, recurrent seizures and deep developmental delay. It was not until his adulthood when his infertility became evident, being incapable of conceiving a heir, even though he married twice. Such a constellation of ominous signs motivated a curious investigation, which concluded that the king was hexed at the age of 14 years in order to take away his throne, his health and his capacity to procreate. Based on contemporary medical knowledge, it is possible that Charles IIhad a rare autosomal recessive inherited genopathy asa consequence of the frequent inbreeding among his ancestors. On the other hand, its is also possible that Charles IIpresented Klinefelter Syndrome, the most frequent sex chromosome disorder in humans and the most common cause of hypogonadism and infertility in males. The hypothesis that Charles II was bewitched reflects a deep belief in supernatural phenomena among the Castilian society at the beginning of the 18th century, an idea transmitted across generations, currently present in many societies worldwide <![CDATA[<b>PSICOLOGÍA GENERAL Y EVOLUTIVA</b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000200021&lng=&nrm=iso&tlng= The death of King Charles II, «the Bewitched», ended two centuries of sovereignity of the Habsburg dynasty in Spain. Since his birth in 1661, he presented a peculiar set of physical, psychiatric and behavioral signs, such as respiratory and diarrheal diseases, recurrent seizures and deep developmental delay. It was not until his adulthood when his infertility became evident, being incapable of conceiving a heir, even though he married twice. Such a constellation of ominous signs motivated a curious investigation, which concluded that the king was hexed at the age of 14 years in order to take away his throne, his health and his capacity to procreate. Based on contemporary medical knowledge, it is possible that Charles IIhad a rare autosomal recessive inherited genopathy asa consequence of the frequent inbreeding among his ancestors. On the other hand, its is also possible that Charles IIpresented Klinefelter Syndrome, the most frequent sex chromosome disorder in humans and the most common cause of hypogonadism and infertility in males. The hypothesis that Charles II was bewitched reflects a deep belief in supernatural phenomena among the Castilian society at the beginning of the 18th century, an idea transmitted across generations, currently present in many societies worldwide