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Respiratory rehabilitation in COPD patients: Experience in a rural Primary Health Care Center Respiratory rehabilitation improves physical capacity and quality of life in COPD patients as it has been previously reported. In Chile there are few and unpublished experiences on respiratory rehabilitation programs (RRP) implemented in primary health care (PHC). Our aim was to evaluate RRP outcome in COPD patients carried out in a rural PHC center. Methods: A prospective descriptive study of RRP in a PHC center implemented in Talagante (a village located 40 km from Santiago). COPD patients were enrolled in the study from July 2012 to May 2014. Patients having the inclusion criteria were admitted to a 12 weeks-long RPP. This program included a 90 minute-long sessions of aerobic training (walking), strength training of upper and lower limbs (dumbbell, ankle support and elastic bands) and respiratory muscle training (threshold valve), twice a week. Quality of life, strength of trained muscles, six-minutes walking test (TM6), BODE index and dyspnea index, were measured before and after completing RRP. Results were expressed as mean ± SD. Results: Out of 79 patients initially assessed, 54 were admitted to the RRP and 39 patients completed the program and were included in the analysis. Their mean age was 67.

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Objectives: Asthma, a public health problem, has variable global mortality rates. In Chile, there are no studies to report on the national situation. This study analyzes the mortality trend in Chilean adults over a period of 26 years. Methods: Using data from the Department of Health Statistics and Information and the National Institute of Statistics, asthma mortality rates 1992-2017 were calculated in people ≥ 15 years-old. To avoid the impact of age changes, adjusted mortality rates were calculated using a direct adjustment method using the 2017 population as a reference. Joinpoint was used to calculate the slope of adjusted rates, and Excel STATA version13 was used for data analysis. Results: Over the 26-year period, there were 5,749 asthma-related deaths, with an average of 221 events per year. Age-adjusted mortality rates decreased significantly from 3.26 in 1992 to 1.4 per 100,000 inhabitants in 2017, with an average annual decline of -3.3%. The highest proportion of deaths occurred in people 65 years of age or older, accounting for 79% of cases in 1992 and 88% of cases in 2017. Conclusions: In Chile trends in asthma mortality rates age-adjusted show a significant decrease in the 26 years covered by this study, a decrease that is less pronounced in the last 15 years.

Fatality rate and survival amongst discharged inpatients with tuberculosis, Instituto Nacional del Torax, Chile Background: Tuberculosis (TB) still is a public health issue in Chile. In the year 2015 TB incidence rate was 16 cases per 100.000 habitants and case fatality rate reached 10,8% of patients belonging to the last TB treatment follow-up of pulmonary cases cohort (2013). It is well noted higher case fatality rate in TB hospitalized patients. The aim of this study is to determine our hospital case-fatality rate, recognize main risks factors involved and establish survival at 6 months since hospital discharge. Methods: We conducted an observational retrospective study in the Instituto Nacional del Tórax (INT) including inpatients adults over 15 years old between July 2012 and June 2015 whose diagnosis at discharge time was tuberculosis. Demographic data, comorbidities, laboratory, microbiological and radiological test, hospital stay, treatment, complications and mortality at 6 months were recorded. We used a logistic regression model to identify mortality-associated factors and to analyze the survival using Kaplan-Meier's method. Results: 100 patients whose average age was 46 ± 19 years-old were included. 64% were male. Pulmonary tuberculosis predominated (79 cases). The hospital stay was 27 ± 32 days. In-hospital case fatality rate was higher in pulmonary TB compared to other TB forms (11.4% and 8% respectively). Survival at 6 months was 91%. Multivariate analysis showed that increased case fatality rate was associated with albumin ≤ 3.0 g/dL, thrombocytopenia, and shock. Conclusions: case fatality rate in our hospitalized TB patients is similar to that described in the country. We must pay attention in pulmonary TB inpatients, which have decreased levels of albumin and platelet, or develop septic shock.