Scielo RSS <![CDATA[Revista médica de Chile]]> http://www.scielo.cl/rss.php?pid=0034-988720070001&lang=es vol. 135 num. 1 lang. es <![CDATA[SciELO Logo]]> http://www.scielo.cl/img/en/fbpelogp.gif http://www.scielo.cl <![CDATA[<b>El aniversario 135 de la Revista Médica de Chile</b>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872007000100001&lng=es&nrm=iso&tlng=es Revista Médica de Chile was founded 135 years ago and it has been published monthly since then, being now the 23rd oldest biomedical journal in the world and the second oldest published in Spanish (Table 1). It is included in the major international data bases and it adheres since their first version to the Uniform Requirements for Manuscripts Submitted to Biomedical Journals (ICMJE) and to the recommendations established by the World Association of Medical Journal Editors (WAME) . The number of articles submitted for publication to the Revista has increased in the last decade, including manuscripts coming from other countries and these are published in English when the authors do not have Spanish as their original language. The rejection rate in 2006 raised to 35% and the time-lag for publication of accepted manuscripts did not differ importantly from other regional or international journals (Table 2). This 135th Anniversary pictures the Revista as a respected medical publication in Chile and in a relevant position among those biomedical journals whose main publication language is not English <![CDATA[<b>Estudio retrospectivo de la endocarditis infecciosa en diferentes grupos de riesgo</b>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872007000100002&lng=es&nrm=iso&tlng=es Background: Due to the increasing number of intravenous drug users, subjects with immune deficiencies or with prosthetic valves, infective endocarditis (IE) continues to be prevalent and to have a high mortality. Aim: To review all cases of infective endocarditis diagnosed in an Internal Medicine Service. Material and methods: Retrospective review of medical records of all patients with infective endocarditis, hospitalized in an Internal Medicine ward, between 1989 and 2003. Dukes criteria were used to define definitive, possible and less probable cases of IE. Results: Eighty seven patients with definite IE were identified (66 males, age range 19-84 years), with a mean incidence of 5.3 per 1000 hospitalizations. IE in intravenous drugs users was usually caused by Staphylococcus aureus and presented high risk of embolism (RR: 3,21). Subjects aged over 70 years had a relative risk of mortality of 5.5. Hospital acquired IE was associated with advanced age and IV catheters appeared as the only predisposing factor. Patients with prosthetic valves were also older, their main complication was abscess formation and their mortality was higher. Conclusions: A closer approach to differential conditions of patients, according to age, intravenous drug use or the presence of prosthetic valves, is necessary <![CDATA[<b>Identificación de asociaciones clínico-patológicas e hipermetilación de genes supresores de tumores en cáncer gástrico difuso a través de análisis de <i>Hierarchical clustering</i></b>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872007000100003&lng=es&nrm=iso&tlng=es Background:Methylation is an inactivation mechanism for tumor suppressor genes, that can have important clinical implications. Aim: To analyze the methylation status of 11 tumor suppressor genes in pathological samples of diffuse gastric cancer. Material and methods: Eighty three patients with diffuse gastric cancer with information about survival and infection with Epstein Barr virus, were studied. DNA was extracted from pathological slides and the methylation status of genes p14, p15, p16, APC, p73, FHIT, E-caderin, SEMA3B, BRCA-1, MINT-2 y MGMT, was studied using sodium bisulphite modification and polymerase chain reaction. Results were grouped according to the methylation index or Hierarchical clustering (TIGR MultiExperiment Viewer). Results: Three genes had a high frequency of methylation (FHIT, BRCA1, APC), four had an intermediate frequency (p15, MGMT, p14, MINT2) and four had a low frequency (p16, p73, E-cadherin, SEMA3B). The methylation index had no association with clinical or pathological features of tumors or patients survival. Hierarchical clustering generated two clusters. One grouped clinical and pathological features with FHIT, BRCA1, and APC and the other grouped the other eight genes and Epstein Barr virus infection. Two significant associations were found, between APC and survival and p16/p14 and Epstein Barr virus infection. Conclusions: Hierarchical clustering is a tool that identifies associations between clinical and pathological features of tumors and methylation of tumor suppressor genes <![CDATA[<b>Incidencia de hipocalcemia pos tiroidectomía total</b>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872007000100004&lng=es&nrm=iso&tlng=es Background: Postoperative hypocalcemia is one of the most common complications of thyroid surgery. It is related to the type of disease (malignant or benign), the number of identified parathyroid glands during the surgical procedure, and the surgeon's experience. Total thyroidectomy is the procedure of choice in our hospital for benign and malignant thyroid disease, but it can increase the incidence of complications. Aim: To evaluate the incidence of postoperative hypocalcemia in patients subjected to a total thyroidectomy. Material and methods: Two studies were performed. A retrospective review of medical records of 448 patients subjected to total thyroidectomy, looking for serum calcium levels of less than 8 mg/dl and clinical signs of hypocalcemia. In a second study, 45 patients were followed with measurements of preoperative and postoperative serum calcium levels. Results: In the retrospective study, only 136 records had reliable information. Clinical signs of hypocalcemia were registered in 14% of patients and a low serum calcium level was detected in 50%. In the prospective study, 42% of patients had a postoperative low serum calcium level and seven patients (15%) had symptoms. Patients were handled with oral calcium and calcitriol in some cases. Ninety nine percent of patients had normal serum calcium levels two moths after surgery. Conclusions: In this series, the rate of postoperative hypocalcemia after total thyroidectomy is similar to internaitonal reports <![CDATA[<b>Fracturas vertebrales, osteoporosis y vitamina D en la posmenopausia</b>: <b>Estudio en 555 mujeres en Chile</b>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872007000100005&lng=es&nrm=iso&tlng=es Background: Approximately one-third of vertebral fractures can be clinically diagnosed. Aim: To study the frequency of vertebral fractures in postmenopausal women. Patients and methods: We recruited 555 postmenopausal women from Santiago, Chile, aged 55-84 years, who manifested interest in their bone health. All were healthy by self-declaration and by general clinical and laboratory tests and had not taken any bone-active therapy. They all underwent a spine and femoral neck (FN) densitometry and a digital lateral spine X-ray from T4 to L4 was obtained. PTH, calcidiol, and other parameters of calcium metabolism were also measured. Results: Overall, 142 of 478 patients with a complete study (29.7%) had at least one vertebral fracture. The proportion of women with fractures increased with age. A T score below -2.5 in the spine and hip was found in 32% and 14% of women, respectively. The proportion of women with spinal opeoporosis doubled between ages 55-70 and remained constant afterwards. In contrast, at the femoral neck, this proportion increased progressively reaching 53.3% at age 80-85. However, 56% of patients with vertebral fractures did not have densitometric osteoporosis in any location. Calcidiol levels were 16.8±6.8 ng/mL. With a cutoff point of 17 ng/mL, 47.5% of the patients had hypovitaminosis D. There was no association between calcidiol levels and vertebral fractures or bone density at the spine or femoral neck. Patients with fractures differed from those without fractures in that they had significantly lower bone density at the spine and hip and were older (p <0.001). However they did not differ in weight, body mass index, or calcidiol levels. Conclusions: Thirty percent of postmenopausal women in this series had a vertebral fractures. Osteoporosis and vitamin D deficiency were also common. Most vertebral fractures were observed in women without osteoporosis by densitometric criteria <![CDATA[<b>Inestabilidad microsatelital en lesiones preneoplásicas y neoplásicas del cuello uterino</b>: <b>Correlación con el genotipo del virus papiloma humano</b>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872007000100006&lng=es&nrm=iso&tlng=es Background: The association between some specific human papilloma virus (HPV) types and cervix cancer is well known. However, the genetic conditions that favor the development of cervical cancer are less well known. Aim: To determine the presence of satellite instability (MSI) in preneoplastic and neoplastic lesions of the cervix and correlate these findings with HPV genotypes. Material and methods: Biopsy samples of cervical lesions were studied. Sixteen had low grade lesions, 22 had high grade lesions and 28 had an epidermoid cancer. Viral types were identified with polymerase chain reaction, dot-blot hybridization and restriction fragment length polymorphism. MSI was determined using a panel of eight highly informative microsatellites. Results: Microsatellite instability in at least one locus was observed in 91, 56 and 69% of low grade lesions, high grade lesions and epidermoid carcinomas, respectively. MSI-High grade, MSI-Low grade instability and microsatellite stability were observed in 5, 60 and 46% of samples, respectively. Two of three samples with high grade instability had HPV 52 genotype. Other viral subtypes had frequencies that ranged from 78% to 100%, with the exception of HPV16 that was present in only 53% of samples with low grade instability. Conclusions: Two thirds of biopsy samples from cervical lesions had MSI, mechanism that can be involved in the first stages of cervical carcinogenesis. The low frequency of high grade instability, its association with HPV52 and the low frequency of HPV16 in samples with low grade instability, suggest different coadjutant mechanisms in cervical carcinogenesis <![CDATA[<b>Consumo de sustancias y conductas de riesgo en consumidores de pasta base de cacaína no consultantes a servicios de rehabilitación</b>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872007000100007&lng=es&nrm=iso&tlng=es Background: In Chile, cocaine base paste (CBP) is the illegal substance that produces the highest rate of addiction. Nonetheless, a marginal number of users receive treatment each year. Aim: To compare the consumption patterns and risk behavior of CBP and cocaine hydrochloride (CH) users who do not attend rehabilitation services. Material and Methods: In a prospective research design, through a study methodology called Privileged Access Interview of hidden populations, 28 surveyors recruited 231 CBP users (group 1) and 236 CH users (group 2). The Risk Behavior Questionnaire was applied in four communities of Metropolitan Santiago, that have the highest prevalence of PBC and CH use. Results: CBP users showed higher schools drop-out and unemployment rates. Subjects of both groups were predominantly polysubstance and polyaddicted users. The severity of addiction to CBP of group 1 was significantly higher than the severity of addiction to CH of group 2 (5.5 versus 5.1: p<0.001). CBP users showed significantly higher rates of sexual risk behaviors, antisocial behavior, self infliction of injuries, suicide attempt and child neglect. Conclusions: A higher vulnerability was shown for users of CBP than those of CH. Attention is drawn to the need for developing community interventions in order to alter substance abuse and the risk behavior of these vulnerable groups <![CDATA[<b>Modelo de asignación de recursos en atención primaria</b>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872007000100008&lng=es&nrm=iso&tlng=es Resource allocation in primary health care is a worldwide issue. In Chile, the state allocates resources to city halls using a mechanism called "per capita". However, each city hall distributes these resources according to the historical expenses of each health center. None of these methods considers the epidemiological and demographic differences in demand. This article proposes a model that allocates resources to health centers in an equitable, efficient and transparent fashion. The model incorporates two types of activities; those that are programmable, whose demand is generated by medical teams and those associated to morbidity, generated by patients. In the first case the health promotion, prevention and control activities are programmed according to the goals proposed by health authorities. In the second case, the utilization rates are calculated for different sociodemographic groups. This model was applied in one of the most populated communities of Metropolitan Santiago and proved to increase efficiency and transparency in resource allocation <![CDATA[<b>Obesidad en preescolares de la Región Metropolitana de Chile</b>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872007000100009&lng=es&nrm=iso&tlng=es Background: In Chile, obesity is currently the main nutritional problem. Since prevention should start early in life, it is important to determine the prevalence of obesity during childhood according to age category. Aim: To determine and compare the evolution of the obesity prevalence and other anthropometric indicators in preschool children between 2002 and 2004. Material and methods: Twice a year, we analyzed the data of children aged 2 to 4 yrs, from day care centers belonging to the National Association of Day Care Centers located in Greater Santiago, from 2002 till 2004 (the number of children included on each point in time fluctuated between 3,500 and 10,000). Cross-sectional and longitudinal analyses were carried out to determine the evolution of obesity prevalence, weight for age (WA) and body mass index (BMI) Z scores (according to the Centers for Disease Control 2000 reference) on preschoolers who were 2 years old in March 2002 and that were followed 3 years, until November 2004. These parameters were compared by age and gender over time. Results: The prevalence of obesity varied between 11 and 13.6% in two-year old children and between 17% and 20% in three and four year olds. The cross-sectional analysis showed that WA and BMI Z scores were significantly lower at 2 years of age, while the longitudinal analysis clearly demonstrated that there was a sharp rise in obesity between 2 and 3 years of age. Conclusions: The prevalence of obesity is high in preschool children, especially among the 3 and 4 year-olds with a significant rise from 2 to 3 years of age <![CDATA[<b>Estado nutricional, consumo de alimentos y actividad física en escolares mujeres de diferente nivel socioeconómico de Santiago de Chile</b>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872007000100010&lng=es&nrm=iso&tlng=es Background: A high prevalence of obesity is the main public health problem in Chilean school children. Aim: To compare the nutritional status, consumption of selected foods and extracurricular physical activity (PA) habits in school children of different socioeconomic levels as a baseline for developing effective educational interventions. Material and methods: Cross-sectional study that determined the body mass index, food consumption and physical activity with previously validated instruments in 202 and 358 girls from 3rd to 8th grade in schools of medium-high and low socioeconomic level (SEL) from Santiago, Chile, respectively. Results: Compared to their counterparts of low socioeconomic level (SEL), the prevalence of obesity was significantly lower in 8-9 year-old girls of medium high SEL (19% and 9%, respectively, p =0.012) and 12-13 year-old (12% and 2.5% respectively, p =0.008). Also median daily intake of dairy products was higher in girls of medium high SEL (250 and 470 ml/day, respectively). The intake of fruits and vegetables was similar (200 g/d); and the intake of bread was lower (230 and 70 g/day, respectively, p <0.01). Consumption of energy-dense foods was lower in 10-13 year-old girls of medium high SEL (80 and 50 g/day, respectively, p <0.01). 45% of 8-9 year-old girls and 35% of 12-13 year-old girls of both SEL engaged in PA four or more times per week (NS). Conclusions: Although the prevalence of obesity in girls of medium-high SEL was not as high as in those from low SEL, it is still high. There is a need for educational interventions to improve their food and PA habits and to promote an environment that enhances healthy behaviors <![CDATA[<b>Madres niñas-adolescentes de 14 años y menos</b>: <b>Un grave problema de salud pública no resuelto en Chile</b>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872007000100011&lng=es&nrm=iso&tlng=es Background: Teenage fecundity rates are an indicator of epidemiological discrimination in developing countries. Aim: To study fertility rates of girls under 14 years of age in Chile from 1993 to 2003. Material and methods: Information of children born alive from mothers aged 10 to 15 years, was obtained from the Chilean National Institute of Statistics. Age segmented population data was obtained from the Ministry of Health. Trends were analyzed by regions and single ages. The rates in communities of the Metropolitan Region were compared. Results: Between 1993 and 2003, there was an increasing trend in fecundity rates, ratios and crude numbers. These rates duplicate from 14 to 15 years of age. In the Metropolitan Region, the fecundity ratios of communities with lower economical incomes is seven times greater than those with higher incomes. During 2003, the fecundity rates in Chile were 100 and 10 higher than those of Holland and Sweden in 1981. Conclusions: In developing countries with very low infant mortality rates such as Chile, the high fecundity rates of young girls is an indicator of a deficient human and social development. Sexual Education and Health Services for adolescents are essential to prevent this public health problem <![CDATA[<b>Cetoacidosisdiabética</b><b> reversible con metotrexato</b>: <b>Resistencia al tratamiento insulínico. Caso clínico</b>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872007000100012&lng=es&nrm=iso&tlng=es We report a 42 year-old woman with a hypothyroidism and a mixed connective tissue disease treated with prednisone and methotrexate. The patient had normal blood glucose levels but when the methotrexate dose was tapered, she presented a diabetic ketoacidosis that required up to 520 units of insulin per day. Due to the intensification of the mixed connective tissue disease symptoms, the doses of methotrexate and prednisone were increased again with a simultaneous normalization of serum glucose levels and glucose tolerance. In the following six months, when the dose of methotrexate was tapered again, the hyperglycemia reappeared and was again controlled increasing the dose. Thirty months after the episode of keotacidosis, the patient was with a weekly dose of methotrexate, asymptomatic and with a normal glucose tolerance. Anti insulin antibodies were not detected and anti islet antibodies were indeterminate, due to interference with antinuclear antibodies. It is possible that the episode of ketoacidosis was unveiled by an autoimmune phenomenon <![CDATA[<b>Tratamiento quirúrgico de la isquemia mesentérica crónica</b>: <b>Caso clínico</b>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872007000100013&lng=es&nrm=iso&tlng=es Although the classic therapy for chronic mesenteric ischemia is surgical revascularization, endovascular therapy is a new therapeutic option. We report a 55 year-old female, with a 2 years history of post prandial abdominal pain, diarrhoea, and weight loss, with occlusion of both mesenteric arteries and critical stenosis of the celiac artery. The initial treatment consisted in angioplasty and celiac artery stent placement in two occasions, with a brief symptomatic relief. Finally, a visceral artery bypass was performed, with good post operative outcome and complete symptomatic resolution at one year follow up. In our opinion endovascular therapy is a good therapeutic option for chronic mesenteric ischemia in high surgical risk patients, specially when dealing with stenotic injuries. It may also be a complement for patients who need to recover their nutritional status prior to revascularization surgery. On the other hand, due to the long term patency and symptomatic relief, surgical treatment is a good option in low risk patients <![CDATA[<b>Trombosis de la arteria renal después de suspender la terapia anticoagulante en una trasplantada renal con trombofilia</b>: <b>Caso Clínico</b>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872007000100014&lng=es&nrm=iso&tlng=es Kidney graft loss because arterial thrombosis is not common and is related to risk factors such as recurrent vascular hemodialysis access thrombosis, collagen-vascular disease, repeated miscarriage, diabetes mellitus and thrombophilia. Patients having this last disorder have an increased risk of repeated thrombosis in successive transplants unless they receive anticoagulation therapy. We report a 51 year-old diabetic woman who had a history of recurrent vascular hemodialysis access thrombosis (both native and prosthetic) while on dialysis and received a cadaveric donor kidney. One month after transplantation she had axillary vein thrombosis complicated with pulmonary embolism and received anticoagulants for six months. Just days after stopping the anticoagulation, she became suddenly anuric due to renal artery thrombosis and complete graft infarction. The coagulation study showed moderate hyperhomocysteinemia and a significant protein C deficiency (39%). Days after nephrectomy she suffered a femoral vein thrombosis and anticoagulation was prescribed for life <![CDATA[<b>Cien años de la enfermedad de Alzheimer</b>: <b>La inmunoterapia ¿una esperanza?</b>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872007000100015&lng=es&nrm=iso&tlng=es In 1906 Alois Alzheimer, described the cerebral lesions characteristic of the disorder that received his name: senile plaques and neurofibrillary tangles. Alzheimer's disease (AD) is now, 100 years after, the most prevalent form of dementia in the world. The longer life expectancy and aging of the population renders it as a serious public health problem of the future. Urgent methods of diagnosis and treatment are required, since the definitive diagnosis of AD continues to be neuropathologic. In the last 30 years several drugs have been approved to retard the progression of the disease; however, there are still no curative or preventive treatments. Although still in experimentation, the visualization of amyloid deposition by positron emission tomography or magnetic resonance imaging will allow in vivo diagnosis of AD. In addition, experiments with the amyloid vaccine are still ongoing, and very recent data suggest that intravenous gammaglobulins may be beneficial and safe for the treatment of AD <![CDATA[<b>Quistes renales, manifestación de diversas patologías</b>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872007000100016&lng=es&nrm=iso&tlng=es Many diseases can be associated with kidney cysts and they may be classified as hereditary and non-hereditary renal cystic disease. The first group can be sub-classified as autosomal recessive cystic disease, such as autosomal recessive polycystic kidney disease and nephronophthisis, as autosomal dominant kidney disease such as autosomal dominant polycystic kidney disease, glomerulocystic disease and tuberous sclerosis, and as cysts associated with syndromes. Cystic dysplasia, multicystic dysplastic kidney, simple cyst, multilocular cysts, Wilm's tumor and acquired cystic kidney disease are classified in the second group. The genetic study of renal cysts is becoming increasingly important, due to the possible therapeutic interventions that could be devised in the future. The aim of this review is to provide a fast and easy clinical approach to renal cystc <![CDATA[<b>Sobre el origen ontogénico del ser humano</b>: <b>La solución científica</b>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872007000100017&lng=es&nrm=iso&tlng=es Every living being is the result of a genome-environment interaction. Neither human oocytes nor spermatozoids have human functional genomes, but the zygote that they constitute may have a human functional genome and other functional genomes such as those of the hydatidiform mole, polyploids, and non-human living beings. When the zygotic human functional genome is integrated and activated, the biotic humanity is acquired. This may occur when the paternal chromatin decondenses; the nuclear environment and envelope of both nuclei are changed to constitute pronuclei; the replacement of sperm protamines by histones; genome imprinting modifications; centriole duplication; and more importantly, the fourfold genome replication. Other propositions on the origin of humans are: embryo implantation [6-7 days post fertilization, (dpf)]; the appearance of the antero-posterior axis; the limit for monozygote twining (13dpf) and the appearance of the neural tissue (16dpf). They are refuted because some mammals do not implant; embryo axes are present in the zygote; some animals regenerate complete individuals from each part in which they are divided; plants do not have neural system; a human whose brain was destroyed by cancer continues to be a human. Alternative propositions coming from philosophies, theologies, perceptive knowledge, beliefs and intuitions and based on conceptualizations like person, anima, soul, organization, socio-cultural relations are ideologically or religiously biased and based on irreducible beliefs such as faith. They lead to disagreement rather than to agreement <![CDATA[<b>Necesidad de prudencia frente a las promesas de la terapia celular </b>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872007000100018&lng=es&nrm=iso&tlng=es Every living being is the result of a genome-environment interaction. Neither human oocytes nor spermatozoids have human functional genomes, but the zygote that they constitute may have a human functional genome and other functional genomes such as those of the hydatidiform mole, polyploids, and non-human living beings. When the zygotic human functional genome is integrated and activated, the biotic humanity is acquired. This may occur when the paternal chromatin decondenses; the nuclear environment and envelope of both nuclei are changed to constitute pronuclei; the replacement of sperm protamines by histones; genome imprinting modifications; centriole duplication; and more importantly, the fourfold genome replication. Other propositions on the origin of humans are: embryo implantation [6-7 days post fertilization, (dpf)]; the appearance of the antero-posterior axis; the limit for monozygote twining (13dpf) and the appearance of the neural tissue (16dpf). They are refuted because some mammals do not implant; embryo axes are present in the zygote; some animals regenerate complete individuals from each part in which they are divided; plants do not have neural system; a human whose brain was destroyed by cancer continues to be a human. Alternative propositions coming from philosophies, theologies, perceptive knowledge, beliefs and intuitions and based on conceptualizations like person, anima, soul, organization, socio-cultural relations are ideologically or religiously biased and based on irreducible beliefs such as faith. They lead to disagreement rather than to agreement <![CDATA[<b>CRÓNICA</b>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872007000100019&lng=es&nrm=iso&tlng=es Every living being is the result of a genome-environment interaction. Neither human oocytes nor spermatozoids have human functional genomes, but the zygote that they constitute may have a human functional genome and other functional genomes such as those of the hydatidiform mole, polyploids, and non-human living beings. When the zygotic human functional genome is integrated and activated, the biotic humanity is acquired. This may occur when the paternal chromatin decondenses; the nuclear environment and envelope of both nuclei are changed to constitute pronuclei; the replacement of sperm protamines by histones; genome imprinting modifications; centriole duplication; and more importantly, the fourfold genome replication. Other propositions on the origin of humans are: embryo implantation [6-7 days post fertilization, (dpf)]; the appearance of the antero-posterior axis; the limit for monozygote twining (13dpf) and the appearance of the neural tissue (16dpf). They are refuted because some mammals do not implant; embryo axes are present in the zygote; some animals regenerate complete individuals from each part in which they are divided; plants do not have neural system; a human whose brain was destroyed by cancer continues to be a human. Alternative propositions coming from philosophies, theologies, perceptive knowledge, beliefs and intuitions and based on conceptualizations like person, anima, soul, organization, socio-cultural relations are ideologically or religiously biased and based on irreducible beliefs such as faith. They lead to disagreement rather than to agreement