Objective: To determine availability and characteristics of pulmonary rehabilitation programs performed in 2019 in family health centers and hospitals from Chile. Methodology: A descriptive and retrospective study was designed, considering PR programs operated in 2019. A non-probability and convenience sample was obtained. Availability and characteristics of centers and PR were measured using a questionnaire translated, modified, validated, and sent by email. Results: Out of 80 responses (22.8%), 60% of centers offered PR program, where the lack of time was the greatest barrier. The programs were mainly outpatient, non-personalized, with 10(IQR 4–11) participants, 12 (IQR 12–16) weeks of length, with 2.4 ± 0.6 session/week, and 1 (IQR 1–2) hours/session. Chronic Obstructive Pulmonary Disease (COPD) was the most frequent diagnostic. The programs were mainly comprised of strength training exercises of lower extremity, upper extremity, walking and education. Team was constituted of physiotherapist and physician, with completed training, and directed by a physiotherapist. Modified Borg, MRC dyspnea scale, six-minute walking test and oximetry were used in the assessments. Between 40-80% of patients completed PR, and the major barrier was patient relocated. Conclusion: Increasing PR availability, homogenization of exercises and education, prioritization of assessments supported by scientific evidence, and inclusion of follow-up could be useful to improve the access, quality and results of the treatment, considering new models of PR that allow greater access and acceptability.

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is the third leading cause of death in the world. Pulmonary rehabilitation (PR) reduces COPD hospitalisations, although its use is low. Telerehabilitation is effective; however, in Chile the development of remote PR technology is incipient. Therefore, the aim of the study was to validate conceptual aspects of an innovative remote PR solution for COPD.Methods: This mixed study used a nonprobabilistic sample of PR professionals and people with COPD (PwCOPD) from Santiago. The perception of a conceptual solution for PR through a semi-structured interview was determined. Professionals were also asked about willingness to use technology using a questionnaire designed and validated in 75 professionals in this study. The study was approved by the Ethics Committee and data were collected after informed consentResults: Twenty-two participants were recruited, of which 14 were professionals and eight were PwCOPD. Among professionals and patients, the willingness to use the solution is positive because it would reduce visits and improve self-management, although it should include a remote/in-person combination, training, and user-friendly interface. Most of the professionals were willing to use technology for pulmonary rehabilitation.Conclusions: The development of telehealth technologies should consider the expectations of patients and professionals and may incorporate elements of persuasive technologies in the design. The results could contribute to the development of digital solutions for remote PR in PwCOPD.

Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of death, associated with remodeling and pulmonary arterial hypertension (PAH), and characterized by increased vascular tone and vascular structural alterations. Purinergic receptor P2Y6 is expressed in the vascular wall and has been implicated in fibrotic and contractile responses; however, its role in COPD-associated PAH remains poorly understood. To determine the association of P2Y6 receptor expression with PAH and vascular remodeling, following cigarette smoke (CS) exposure in mice. After Ethics Committee approval, 60 female A/J mice were exposed to CS for six months and treated with the P2Y6 antagonist, MRS2578, for three months. PAH and cardiac remodeling were assessed by echocardiography, Fulton index (FI), right ventricular (RV) morphometry, fibrosis, and gene expression. Lungs were analyzed by histology, and P2Y6, α-smooth muscle actin (α-SMA), and collagen immunofluorescence. Emphysema and pulmonary arterial remodeling were evaluated by histology. Precision-cut lung slices (PCLS) from 48 female A/J mice were exposed to CS extract (CSE) to determine vasoreactivity. Parametric or non-parametric tests were used. CS exposure induced emphysema and echocardiographic features of PAH, including reduced pulmonary artery acceleration time (PAAT), and RV hypertrophy. Perivascular α-SMA and P2Y6 expression were increased and co-expressed despite unchanged arterial wall thickness. MRS2578 prevented PAH-related changes, reduced perivascular α-SMA-positive cells, and inhibited vasoconstrictor responses in CSE-exposed lung slices. This study suggests a role of P2Y6 in PAH and vascular remodeling in CS in vivo exposure, as well as a functional role in the acute vasoconstriction after CSE ex vivo exposure.

Objetivo Identificar barreras en el acceso a control preventivo de la Atención Primaria en padres migrantes de lactantes y preescolares en Santiago, Chile, en el año 2018. Métodos Estudio observacional, descriptivo, transversal, en una muestra no probabilística de 108 padres migrantes de lactantes y preescolares entre 0-4 años, 11 meses, 29 días, que asisten a jardines infantiles de la comuna de Santiago, en quienes se autoaplicó un cuestionario en español y creole, diseñado y validado en contenido y traducción de forma piloto, previa autorización de Comité de Ética, entre julio y octubre de 2018. Se midieron variables de caracterización sociodemográfica, asistencia a control preventivo y barreras. Resultados Un 7,8% de padres manifestó que su hijo no asistía a control, y 48,5% de los padres indicó que tenía dificultades para asistir. Las barreras para asistir a control fueron en un 63% horario y tiempos de espera, en un 39,8% desconocimiento del funcionamiento del sistema y en un 11,1% transporte. Conclusiones Son necesarias estrategias para mejorar el acceso a salud con una mirada desde los determinantes sociales de la salud.