Scielo RSS <![CDATA[Revista médica de Chile]]> https://scielo.conicyt.cl/rss.php?pid=0034-988720080006&lang=pt vol. 136 num. 6 lang. pt <![CDATA[SciELO Logo]]> https://scielo.conicyt.cl/img/en/fbpelogp.gif https://scielo.conicyt.cl <![CDATA[<b><i>Inflammation and endothelial dysfunction in patients with chronic heart failure</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000600001&lng=pt&nrm=iso&tlng=pt Background: In chronic heart failure (CHF), endothelial dysfunction (ED) is a consequence of an imbalance of vascular tone regulating substances. The relationship between ED and inflammation has not been fully investigated. Aim: To assess the association between inflammation and ED in CHF. Material and methods: Forty two patients aged 56±14 years (80% male) with a CHF in functional capacity II-III (New York Heart Association) and an ejection fraction (FE) <40% were consecutively studied. Patients were classified according to the presence or absence of ED, evaluated by reactive vasodilation measured by ultrasound, after brachial artery compression. Circulating levels of highly sensitive C reactive protein (usCRP), tumor necrosis factor a (TNFá) and interleukin-6 (IL-6) were determined by ELISA. A group of 15 healthy subjects of similar age, were studied as controls. Results: Sixty seven percent of patients had ED. Compared to controls, patients with CHF had higher usCRP (0.58±0.4 and 4.9±7.1 mg/dl respectively, p <0.01) and IL-6 (1.38±0.06 and 3.1±1.7 mg/dl respectively, p <0.01). Compared to patients without ED, patients with CHF and ED had higher levéis of usCRP (3.0±0.4 and 6.0±5.7 mg/dl respectively, p <0.01) and TNFá (0.31±0.26 and 1.0±1.1 pg/ml, p =0.02). No differences in IL-6 were found between CHF groups. Conclusions: In CHF patients, the presence of ED was associated with increased levéis of inflammatory markers <![CDATA[<b><i>Clinical features and prognosis of acule myocardial infarction among patients aged 80 years or older</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000600002&lng=pt&nrm=iso&tlng=pt Background: Subjects older than 80 years have more complicated acute myocardial infarctions and are subjected to less reperfusion procedures. Aim: To describe the hospital evolution and follow up of patients older than 80 years, suffering an acute myocardial infarction. Material and methods: Patients older than 80 years, were selected from a prospective registry of acute myocardial infarction. Among these, the hospital evolution, mortality and events during a períod ofñve years of follow up, were recorded. Results: Of a total of 1200 patients, 83 (7%) were aged 80 years or older. Among these, 59% were male and 22% were diabetic. The mean lapse between onset of symptoms and admission was 11 hours and 59% were admitted with less than 6 hours of evolution. Sixty three percent had a history of a previous infarction and 24% had a Killip IV classification on admission. Reperfusion therapy was done in 19% and 70% had heart failure during evolution. A coronary angiography was done in 22% and 6% were subjected to revascularization. Mortality was 34%, specially due to cardiogenic shock or ventricular rupture. Of 55 patients discharged from the hospital, 31% died within one year and 64% within five years, mainly due to cardiac causes. Conclusions: Patients aged 80 years or older have more complicated myocardial infarctions, most of them are managed conservatively andlong term mortality is high <![CDATA[<b><i>Possible pathogenetic role of 11ß-hydroxysteroid dehydrogenase type 1 (11ßHSD1) gene polymorphisms in arterial hypertension</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000600003&lng=pt&nrm=iso&tlng=pt Background: Cortisol has been implicated in hypertension and lately reported to be regulated at the pre-receptor level by the 11ßHSD1 enzyme, which converts cortisone (E) to cortisol (F). Over expression ofthis enzyme in adipose tissue could determine an increase in available cortisol that interacts with the mineralocorticoid receptor (MR) in renal, brain and heart tissue, leading to similar hypertensive effects as in 11ßHSD2 impaired patients. Severa! polymorphisms have been reported in HSDl IB 1 gene (CAI5, CAI9 and InsA83557), which could modify HSDl IB 1 gene expression or activity. Aun: To determine the distribution and prevalence of CAI5, CAI9 and InsA83557 in the HSDl IBl gene, and to correlate these results with biochemical parameters in cortisol/ ACTH (HPA) and renin-angiotensin-aldosterone (RAA) axis in patients with essential hypertension (EH). Patients and Methods: We studied 113 EHpatients (76 non-obese and 37 obese, with a body mass índex >30 kg/m²) and 30 normotensive adults (NT). In each patient, we measured serum levéis of E E, serum aldosterone (SA), plasma renin activity (PRA), adrenocorticotrophic hormone (ACTH), the urinary free cortisol/creatinine (UFF/Cr), F/ACTH and SA/PRA ratios. Each polymorphism was studied by PCR and 8% polyacrylamide gel electrophoresis. Statistical associations were evaluated by Pearson correlations and the genetic equilibñum by the Hardy-Weinberg (H-W) equation. Results: We found all three polymorphisms in the EH and the NT group, both in genetic equilibñum. In obese essential hypertensives, the CAI5polymorphism showed association with SA/PRA ratio (r =0.189, p =0.012) and F/ACTH (r =0.301, p 0.048); CA19 also showed correlation with F/ACTH in obese EH (r = 0.220, p 0.009). The InsA83557polymorphism correlated with UFF/Cr in both EH (r =0.206; p =0.03), and in obese EH (r =0.354; p =0.05). Conclusions: The CAI5 and CAI9 polymorphism correlated with changes in biochemical parameters in HPA and RAA axis of obese essential hypertensives. These changes mayresult of modifications in the expression of 11ßHSD1, leading to increased cortisol and aldosterone levéis independent of ACTH and renin control, respectively <![CDATA[<b><i>Protocol based sedation versus conventional treatment in critically ill patients on mechanical ventilation</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000600004&lng=pt&nrm=iso&tlng=pt Background: Sedatives and analgesic drugs give comfort and allow adequate respiratory support to critically ill patients in mechanical ventilation (MV). Its improper use may increase the duration of MV. Clinical guidelines suggest implementation of protocols, however this is seldom done in clinical practice. Aun: To compare in MV patients, nurse-applied guided by protocol administration of sedatives and analgesic drugs (protocol: group P) with the habitual practice using physicians criteria (control: group C). Material and methods: Inclusión criteria was the need of MV more than 48 h. The exclusión criteria were acute neurological diseases, hepatic cirrhosis, chronic renal failure and limitation of therapeutic efforts. Midazolam and fentanyl were used in both groups. The level of sedation was monitored with the Sedation Agitation Scale (SAS). In the P group, trained nurses applied algorithms to adjust the sedative doses according to a predefined SAS goal. Results: Forty patients were included, 22 aged 65±19 years in group P and 18 aged 54±21 years in group C. Apache II scores were 16±8 and 19±8 in each group. SAS score was more frequently evaluated within goal boundaries in group P than in group C (44% and 32%, respectively p =0.001). No differences in the proportion of patients with inadequate sedation were observed between treatment groups. Midazolam doses were lower in P than in C group (0.04 (0.02-0.07) and 0.06 (0.03-0.08) mg/kg/h respectively, p =0.005). Conclusions: The implementation of sedation protocol applied by nurses improved the quality of sedation and reduced the doses of Midazolam in mechanically ventilated patients <![CDATA[<b><i>Combination of DRD4 and DAT1 genotypes is an important risk factor for attention déficit disorder with hyperactivity families living in Santiago, Chile</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000600005&lng=pt&nrm=iso&tlng=pt Background: Attention deficit/hyperactivity disorder (ADHD) is a common, highly heritable neurobiological disorder of childhood onset, characterized by hyperactivity, impulsiveness, and/or inattentiveness. Aún: To search forpossible associations between dopamine receptor D4 (DRD4) and dopamine transponer 1 (DATl) polymorphisms and ADHD in Chilean families. Material and methods: We extended a previous family-based discordant sib pair analysis that included 26 cases diagnosed according to DSM-IV entena and 25 controls (healthy siblings of cases), adding 14 cases and 11 controls. Results: Both loci, individually classified as homozygotes or heterozygotes for the DRD4 7-repeat and DATl 10-repeat alleles, did not exhibit genotype frequency differences between affected children and their healthy siblings. However, the simultaneous presence of both DRD4 7-repeat heterozygosity and DATl 10 allele homozygosity was significantly higher (22.5%) in cases (40), compared with (2.8%) unaffected siblings (36), with an odds-ratio of 10.16. Conclusions: The genotype combination DRD4/7 heterozygotes and DAT1/10 homozygotes is a high risk factors in Chilean families for ADHD. Increased density of dopamine transporters in ADHD brains, along with abundance of 7-repeat D4 receptors in prefrontal cortex, which is impaired in ADHD patients, make the observed gene-gene interaction worthy of studies to understand the functional basis ofADHD <![CDATA[<b><i>Present situation of hepatitis B in Chile</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000600006&lng=pt&nrm=iso&tlng=pt Background: Hepatitis B virus infection generates carriers and 8% will evolve to a chronic phase. Aim: To perform a compilation of studies on hepatitis B in Chile and other sources of information to estímate the impact of this disease in our country. Material and methods: Published and unpublished evidence about the infection, in the general population and risk groups in our country, was compiled and reviewed critically. Informal interviews to experts, revisión of the mandatory notification book of the Ministry of Health and collection of data from ¡aboratories that study hepatitis B virus, were also carried out. Results: The seroprevalence of chronic carriers in blood donors is nearly O.3%. Among risk groups such as health care personnel, the figure is O.7%, among homosexuals 29%, among HIV positive patients 30%, among sexual workers 2% and among children with chronic hemodialysis, 9%. Prevalence rate according to notified cases in 2004 was 1.8 x 100,000 habitants. Detection of viral hepatitis B surface antigen in ¡aboratories occurs in 0.2% of donors and 1.396 of non donors. Conclusions: The seroprevalence of hepatitis B virus, the lack of notification, and the introduction of hepatitis B vaccine to our Regular Program of Immunizations, are arguments to develop in Chile a hepatitis B and C surveillance system <![CDATA[<b><i>A pilot experience with a tumor bank</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000600007&lng=pt&nrm=iso&tlng=pt Background: Despite having the technical facilities and the knowledge, Chile did not have a tumor bank until recently. Aimn: To describe the results of the first three years of a tumor bank. Material and methods: All cases stored in a tumor bank from June 2004 tojune 2007 were included. Samples were frozen in isopentane, afterwards in liquid nitrogen and finally transferred to freezers at -80°C. Quality controls with DNA and RNA extraction and immunohistochemistry, were per formed. Results: In the study period, 1239 cases were collected and 79% were malignant tumors. In 78% of cases, samples from the tumor and of normal neighaboring tissue, were stored. Twenty six percent of samples were from breast cáncer and 22% for digestive tumors. Immunohistochemical expression ofvimentin was measured in 30 cases and the expression of Ki67 an p53 in 20 cases. Thirteen of 15 breast cáncer samples had expression of estrogen receptors. In 30 cases, DNA and RNA extraction was carried out, amplifying B-globin and B-actin. Moreover RNA was extracted from 63 gastríc cáncer, 30 colon cáncer and gallbladder cáncer samples, for specific projects. Conclusions: The creation of a tumor bank is feasible, preserving samples ofhigh biológical quality <![CDATA[<b>Oral health in Brazilian patients with chronic renal disease</b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000600008&lng=pt&nrm=iso&tlng=pt Background: Poor oral health status mayhave an impact on the health status of patients with chronic renal failure. Aim: To describe the oral health status of a group of Brazilian patients with chronic renal failure. Material and methods: Retrospective review of the medical records of patients with chronic renal failure, ofwhom 13 (4.5%) werein apre dialysis stage, 158 (55%) were on hemodialysis, 23 (8.4%) were on peritoneal dialysis and 92 (32.1%) were transplanted. General oral health, presence of dental calculus, and halitosis were recorded. The number of decayed, missed and filled teeth was analyzed by means of DMF-T (Decayed, Missed and Filled Teeth) índex. Resulte: The sample was composed of 152 men (53%) and 134 women (47%), aged 42±13 years. Oral health status was considered defective in most patients (83%). Eighty-seven percent had dental calculus and 55% had halitosis. Transplant patients reponed significantly less halitosis (40.2%) than the rest of the groups. The DMF-T for the whole population was 20.6 and had a positive correlation with age. Conclusions: This group of patients with chronic renal failure presented a poor oral health status. Dental treatment programs for these patients should be implemented to avoid the exposure to dentalpathogens<hr/>Introducción: Las alteraciones de la cavidad oral pueden tener impacto en la salud de pacientes con insuficiencia renal crónica. Objetivo: Describir la salud oral de pacientes brasileños con insuficiencia renal crónica. Material y métodos: Revisión retrospectiva de las fichas dentales de pacientes con insuficiencia renal crónica, de los cuales 13 (4,5%) estaban en etapa prediálisis, 158 (55%) estaban en hemodiálisis, 23 (8,4%) estaban en peritoneodiálisis y 92 (32,1%) habían sido trasplantados. Se registró la salud oral general, la presencia de tártaro y halitosis. El número de piezas faltantes y obturadas fue analizado utilizando el índice DMF-T (Decayed, Missed and Filled Teeth o dientes con cañes, faltantes y obturados). Resultados: La muestra estaba constituida por 152 hombres y 134 mujeres con una edad promedio de 42±13 años. La salud dental general era deficitaria en 83% y 87% tenía tártaro. El 55% tenía halitosis y ¡os pacientes trasplantados tenían este problema con una frecuencia significativamente menor que el resto de ¡os grupos. El índice DMF-T global fue 20,6 y tuvo una correlación positiva con la edad. Conclusiones: La salud oral de estos pacientes con insuficiencia renal crónica es mala. Es importante implementar programas de tratamiento dental para estos pacientes para evitarla exposición a patógenos que pueden causar complicaciones sistémicas <![CDATA[<b><i>Body distribution and density of acquired melanocytic nevi in adolescents of low socioeconomic stratus of Santiago, Chile</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000600009&lng=pt&nrm=iso&tlng=pt Background: There is an increase in the incidence of malignant melanoma in Chile. Previous studies have shown that the density and size of acquired melanocytic nevi (AMN) are a risk factor for developing malignant melanoma. Aim: To assess the number and anatomical distribution of acquired melanocytic nevi in Chilean adolescents. Material and methods: The number of AMN was counted in 30 anatomical sites in 201 Chilean school children (111 females), aged from 11 to 15 years. The number oí small AMN (2-4.9 mm) and large AMN (>5 mm ofdiameter) was determined. Results: Mean AMN number per person was 32.7 (95% confidence interval (CI) 30.7-42.3) in males and 29 (95% CI 271-38.6) in females (p =NS). Males had a higher number of AMN in the face, neck and trunk. Females had a higher number of AMN in the upper and lower limbs. Older children, adolescents with history of sunburns and with lighter skin had a higher number of total, small and large nevi. Conclusions: The average number ofAMNfound in this study is similar to that reported in the literature. The differences in site distribution between males and femalesmay be explainedby a differentsun exposurepattern <![CDATA[<b><i>Atrial thrombus entrapped in a patent foramen oval</i></b>: <b><i>Report of one case</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000600010&lng=pt&nrm=iso&tlng=pt We report a 63 year-old female with a pulmonary embolism in whom echocardiography revealed the presence ofríght heart thrombus. A section ofthis thrombus was entrapped in a patent foramen oval and floating in both atria. This rare situation, named impending paradoxical embolism, prompted us to perform a surgical intervention, removing the thrombus andrepairing the foramen ovale <![CDATA[<b><i>Hereditary non-polyposis colorectal cancer</i></b>: <b><i>Report of four siblings</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000600011&lng=pt&nrm=iso&tlng=pt Hereditary non-polyposis colorectal cancer (HNPCC) or Lynch Syndrome is an autosomic dominant syndrome involving 596-1096 of colorectal cancer patients. Mutations in MLH1 and MSH2 genes account for most cases. These two genes particípate in the DNA mismatch repair pathway. Therefore mutation carriers show microsatellite instability (MSI) in tumors. This syndrome is characterized by the early development of colorectal cancer (before 50 years) and an increased incidence of cancer in other organs. We report four siblings from a family diagnosed with HNPCC. All of them were subjected to colonic surgery for colorectal cancer Moreover, one patient developed an ampulloma after her colon surgery. The molecular-genetic analysis revealed three brothers with microsatellite instability in the tumor tissue, the absence of the MLH1 protein, and the presence of a germ Une mutation localized in introm 15 ofthe MLH1 gene <![CDATA[<b><i>Isotretinoin embryophaty</i></b>: <b><i>Report of one case</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000600012&lng=pt&nrm=iso&tlng=pt Retinoic acid is a widely used drug in the treatment of cystic acné. It has teratogenic effects that depend on the gestational period in which it is used. We report a seven months of female whose mother was exposed to retinoic acid in both pregestational and gestational periods. She had a retardation of psychomotor development and a brain MRI showed frontal atrophy and a malformation of the posterior fossa. We discuss the mechanisms ofthe teratogenic effeets of retinoic acid <![CDATA[<b><i>Association between indoor contamination and respiratory diseases in children living in Temuco and Padre Las Casas, Chile</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000600013&lng=pt&nrm=iso&tlng=pt Background: Indoor air pollution, is the main cause of population exposure to polluting agents. Aim: To establish an environmental profile of indoor contamination emission sources in families of children under 5years that assist to kindergartens in Temuco and Padre Las Casas. To associate respiratory disease episodes in children with indoor contamination. Material and methods: Cross sectional analysis of 355 family groups subjected to questionnaires about indoor contamination and number of respiratory disease episodes. Results: Forty six percent of mothers or caregivers smoked, 37% smoked at home and 93% smoked one to two cigarettes per day. There was a significant association between respiratory diseases in children and drying clothes in the kitchen, using firewood for heating and the presence of humidity in the dwelling. Mothers identified as indoor contaminants the use of braziers in 76% of cases and firewood stoves in 24%. Ninety seven percent considered that these appliances were detrimental for respiratory health. Conclusions: The lack of awareness about indoor contamination among subjects of low socioeconomic status, should prompt educational campaigns to modify behaviors in their dwellings <![CDATA[<b><i>Pleiotropic effects of statins </i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000600014&lng=pt&nrm=iso&tlng=pt Results of numerous epidemiologic studies indicate that elevated serum cholesterol, especially the LDL fraction, is a major cause of coronary heart disease (CHD). Epidemiologic and angiographic evidence from primary and secondary prevention studies involving several HMG-CoA reducíase inhibitors (statins) indicate that decreasing elevated serum cholesterol concentration (specifically LDL-cholesterol) can reduce the incidence of CHD and/or progression of atherosclerosis and results in a decrease in associated morbidity and mortality. It has been estimated that each 1% reduction in LDL-cholesterol concentration may result in a 1% decrease in the incidence of CHD. Furthermore, an analysis of pooled data from primary and secondary prevention studies found that treatment with a statin for a median duration of 5.4 years was associated with a 31% and 21% reduction in the risk of major coronary events and total mortality, respectively. This paper deals with the pharmacology of statins, specially with the pleiotropic effects ofthese drugs <![CDATA[<b><i>Ontological and ethical statute of anencephalic fetus</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000600015&lng=pt&nrm=iso&tlng=pt Due to advances in prenatal techniques, it is now possible to diagnose malformations in útero, such as anencephaly, which in the past was only known at birth. Having knowledge of a malformation before birth, the moment in which almost every individual obtains social and legal protection, puts the malformed fetus in a vulnerable situation toward possible actions that lead to the interruption of pregnancy. The aim of this article is to analyze different positions about the quality and reality of the anencephalic fetus, its human condition and the care that the fetus and mother deserve <![CDATA[<b><i>Reflections about the obstetric attitude towards anencephalic fetuses</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000600016&lng=pt&nrm=iso&tlng=pt Pregnancy of an anencephalic fetus generates deep thoughts about its diagnosis, treatment and management of maternal risk, having in mind the irreversibility of the fetal situation. At the present moment, there are no guidelines for labor care in these cases, probably because in most developed countries in which abortion is legal, these pregnancies are interrupted earlier. In Chile, where abortion is illegal we must deal with these situations at the end of the pregnancy period. Of 35,682 labors attended at our hospital, 14 were anencephalic fetuses. In 50% of these a cesarean section was done and in one, a hysterectomy was required due to uterine inertia <![CDATA[<b><i>General considerations, indications and contraindications for liver transplantation in Chile</i></b>: <b><i>A multicenter consensus development document</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000600017&lng=pt&nrm=iso&tlng=pt Liver transplantation is an excellent therapeutic option for terminal liver disease. During the last decades the results of liver transplantation have improved significantly with a patient survival rate of nearly 90% at one year and 80% at 5 years of follow-up. The main indications for liver transplantation include: end-stage liver disease associated to cirrhosis, acute liver failure, and hepatic tumors (mainly hepatocarcinoma). The absolute contraindications for a transplant are less frequent than in the past, and include: severe co-morbidity (cardiac or pulmonary), sepsis, advanced HIV disease and extra-hepatic malignancy. This document presents a Consensus of the main groups performing liver transplantation in Chile, about its indications and contraindications. It also reviews general aspects of liver transplantation, including the selection and referral of liver transplant candidates, allocation of organs and the evaluation of severity of liver disease <![CDATA[<b>Chilean National Prize in Medicine, awarded in 2008 to esteban B. Parrochia, M.D.</b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000600018&lng=pt&nrm=iso&tlng=pt Liver transplantation is an excellent therapeutic option for terminal liver disease. During the last decades the results of liver transplantation have improved significantly with a patient survival rate of nearly 90% at one year and 80% at 5 years of follow-up. The main indications for liver transplantation include: end-stage liver disease associated to cirrhosis, acute liver failure, and hepatic tumors (mainly hepatocarcinoma). The absolute contraindications for a transplant are less frequent than in the past, and include: severe co-morbidity (cardiac or pulmonary), sepsis, advanced HIV disease and extra-hepatic malignancy. This document presents a Consensus of the main groups performing liver transplantation in Chile, about its indications and contraindications. It also reviews general aspects of liver transplantation, including the selection and referral of liver transplant candidates, allocation of organs and the evaluation of severity of liver disease <![CDATA[<b><i>To take care of the caregivers</i></b>: <b><i>a challenge for health professionals</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000600019&lng=pt&nrm=iso&tlng=pt Liver transplantation is an excellent therapeutic option for terminal liver disease. During the last decades the results of liver transplantation have improved significantly with a patient survival rate of nearly 90% at one year and 80% at 5 years of follow-up. The main indications for liver transplantation include: end-stage liver disease associated to cirrhosis, acute liver failure, and hepatic tumors (mainly hepatocarcinoma). The absolute contraindications for a transplant are less frequent than in the past, and include: severe co-morbidity (cardiac or pulmonary), sepsis, advanced HIV disease and extra-hepatic malignancy. This document presents a Consensus of the main groups performing liver transplantation in Chile, about its indications and contraindications. It also reviews general aspects of liver transplantation, including the selection and referral of liver transplant candidates, allocation of organs and the evaluation of severity of liver disease <![CDATA[<b><i>A simple strategy to improve searching of indexed anieles in SciELO</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000600020&lng=pt&nrm=iso&tlng=pt Liver transplantation is an excellent therapeutic option for terminal liver disease. During the last decades the results of liver transplantation have improved significantly with a patient survival rate of nearly 90% at one year and 80% at 5 years of follow-up. The main indications for liver transplantation include: end-stage liver disease associated to cirrhosis, acute liver failure, and hepatic tumors (mainly hepatocarcinoma). The absolute contraindications for a transplant are less frequent than in the past, and include: severe co-morbidity (cardiac or pulmonary), sepsis, advanced HIV disease and extra-hepatic malignancy. This document presents a Consensus of the main groups performing liver transplantation in Chile, about its indications and contraindications. It also reviews general aspects of liver transplantation, including the selection and referral of liver transplant candidates, allocation of organs and the evaluation of severity of liver disease <![CDATA[<b><i>A molecular genetic analysis in 2 children with congenital hepatic fibrosis</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000600021&lng=pt&nrm=iso&tlng=pt Liver transplantation is an excellent therapeutic option for terminal liver disease. During the last decades the results of liver transplantation have improved significantly with a patient survival rate of nearly 90% at one year and 80% at 5 years of follow-up. The main indications for liver transplantation include: end-stage liver disease associated to cirrhosis, acute liver failure, and hepatic tumors (mainly hepatocarcinoma). The absolute contraindications for a transplant are less frequent than in the past, and include: severe co-morbidity (cardiac or pulmonary), sepsis, advanced HIV disease and extra-hepatic malignancy. This document presents a Consensus of the main groups performing liver transplantation in Chile, about its indications and contraindications. It also reviews general aspects of liver transplantation, including the selection and referral of liver transplant candidates, allocation of organs and the evaluation of severity of liver disease