Repositorio Institucional
Nuestra plataforma Reúne, conserva y difunde la producción intelectual en formato digital de estudiantes, académicos e investigadores de la Universidad del Desarrollo. Es una plataforma web colaborativa diseñada y administrada por el Sistema de Bibliotecas, en el que participan las unidades académicas como proveedoras de contenido, ejerciendo el rol de editor en su respectiva “comunidad” Leer Más...
¿Qué estás buscando?
Recent Submissions
Propuesta de un modelo de gestión de calidad de una planta de tableros contrachapados, sustentado en metodología Lean Six Sigma
(Universidad del Desarrollo. Facultad de Ingeniería, 2024) Lillo Garrido, Viviana Andrea; Palma Infante, Cristian
Este trabajo presenta una propuesta de modelo de gestión de calidad basada en metodología Lean Six Sigma para la aplicación en el proceso de fabricación de tableros contrachapados. El objetivo de esta investigación es proponer un modelo de gestión de calidad con base en metodología lean six sigma para el logro de los objetivos productivos disminuyendo los rechazos operacionales. Para lograrlo se propone una aproximación cualitativa a las opiniones de subgerentes (2), jefe de áreas (4), supervisores de producción (4), ingenieros de procesos (2) y personal técnico del área de calidad (2), basada en entrevistas semi estructuradas y considerando una muestra por conveniencia, para entender cómo y cuáles son los procesos y variables claves, para mejorar el actual sistema de gestión de calidad. Los datos muestran que las personas entrevistadas no tienen amplio conocimiento de la metodología Six Sigma y los potenciales beneficios en la gestión de calidad del proceso de fabricación de tableros contrachapados. Por otra parte, se tiene que en la actualidad se maneja el control de gran número de variables que no son correctamente analizadas y se desconoce su impacto real en los resultados degastando al equipo en actividades que no agregan valor. Se concluye que la incorporación de un modelo de gestión de calidad basado en la metodología Lean Six Sigma en el proceso de gestión de calidad en fabricación de tableros contrachapados, permitirá: definir, medir, analizar, mejorar y controlar las variables críticas de los procesos, focalizando los esfuerzos y recursos disponibles en aquellas que son de mayor impacto en resultados de calidad, rendimiento y costos.
El litio en Chile. ¿Problemas para su producción?: Percepciones que involucran al recurso estratégico y al bien común
(Universidad del Desarrollo. Facultad de Ingeniería, 2024) Romero Stevens, Camila Grace; Valdés González, Héctor
Este trabajo presenta un análisis de percepciones que provoca la acelerada demanda del litio y su creciente utilización debido a avances tecnológicos, y cómo dicha demanda coloca a las reservas del norte chileno, en los salares, en el centro de debates que involucran formas de explotación y comercialización. El objetivo de esta investigación es analizar las percepciones de profesionales expertos en la producción del litio, para la determinación de las barreras
que han impedido que Chile lidere la producción de dicho mineral. Para lograrlo se propone una aproximación cualitativa bajo un paradigma interpretativo y con base en 10 entrevistas semiestructuradas a profesionales y ejecutivos del ámbito minero para la determinación de cómo y porque se ha retrasado la explotación del litio tan demandado y necesario para el desarrollo tecnológico mundial. Los datos revelan que las diversas posturas predominantes tienden a neutralizarse entre sí. Por un lado, se encuentra el modelo económico extractivista que busca fortalecer y hacer rentable la oportunidad nacional, considerando a la minería
como un recurso estratégico para la industria. Por otro lado, existen enfoques políticos ambientalistas que buscan condicionar el proceso a regulaciones más estrictas o a consultas territoriales enfocadas en el bien común, lo que ralentiza el avance de la extracción en términos políticos. En síntesis, las diferentes concepciones en torno al litio son una representación de modelos ideológicos en pugna, donde el debate económico y el político ambiental no han terminado de definir lo que es bueno para nuestro país, y requieren revisarse para no perder una oportunidad estratégica relevante.
Concesiones Hospitalarias en Chile: Resultados obtenidos en la aplicación de mecanismos de supervisión independientes en el Hospital Regional Leonardo Guzmán y Hospital Félix Bulnes Cerda
(Universidad del Desarrollo. Facultad de Gobierno, 2023) Figueroa Chamorro, Camila Eugenia; Castillo, Carla
La presente investigación busca caracterizar las diferentes herramientas con las que cuenta el Estado para controlar y supervisar el cumplimiento de sus contratos
concesionados para infraestructura hospitalaria en etapa de explotación; y evaluar los resultados obtenidos de la aplicación de estos procedimientos de
revisión a la fecha, con particular énfasis en los procedimientos de revisión o auditorías de gestión independientes.
Modelo de seguimiento y acompañamiento del plan de mejora de programas de estudio desde una perspectiva del aseguramiento de la calidad
(Universidad del Desarrollo. Facultad de Ingeniería, 2024) Valdés Sepúlveda, Daniel Alejandro; Valdés González, Héctor
Este estudio examina las etapas y variables esenciales para un plan de seguimiento de mejoras dentro del contexto de aseguramiento de la calidad universitaria. El acompañamiento en la implementación de mejoras es vital para la retroalimentación curricular, la verificación de la calidad educativa y la coherencia con las normativas de acreditación de una universidad regional. El objetivo de esta investigación es proponer un modelo integral de seguimiento y acompañamiento del plan de mejora en programas de estudios, desde la perspectiva del aseguramiento de la calidad, utilizando un enfoque metodológico mixto para el fortalecimiento de los procesos en universidades regionales según el marco regulatorio vigente. La metodología empleada es mixta, combinando una revisión bibliográfica para analizar los marcos de trabajo existentes en la descripción y modelado de planes de mejora, con entrevistas semi estructuradas a directores de carreras y programas, así como a directivos universitarios. Estas entrevistas, a ocho participantes, buscan entender cómo y por qué se implementan los planes de mejora en la forma y el tiempo correspondiente. Además, se realizó un análisis cuantitativo mediante 38 encuestas con las que se complementa lo establecido en las entrevistas con preguntas específicas relacionada al seguimiento del plan de mejora. Este estudio propone un modelo innovador y sostenible
para el seguimiento de calidad en universidades regionales, combinando estándares nacionales con flexibilidad operativa, descentralización, tecnología accesible y mejora continua. El modelo propuesto como resultado sugiere que este enfoque permite superar limitaciones tradicionales como burocracia y falta de recursos, fortaleciendo tanto la gestión institucional como la experiencia educativa, al tiempo que fomenta un sistema replicable que contribuye al aseguramiento efectivo de la calidad en programas universitarios. El estudio concluye que el modelo propuesto, basado en un plan de mejoras, fortalece el aseguramiento de la calidad universitaria mediante flexibilidad, descentralización, monitoreo continuo y capacitación, garantizando sostenibilidad y excelencia académica alineada con el modelo educativos institucional.
Beneficios de una resolución de droguería, para el Centro de Distribución de la Red UC. Christus
(Universidad del Desarrollo. Facultad de Ingeniería, 2024) Guzmán Puerta, Diego Alejandro; Valdés González, Héctor
Este trabajo presenta un análisis del proceso necesario para la resolución y regulación del funcionamiento del centro logístico de la Clínica San Carlos de Apoquindo, ubicada en la comuna de Las Condes. Este análisis enmarca una estrategia integral destinada a proponer un modelo de importación, distribución y venta regulada de insumos y fármacos, buscando posicionar al centro como una entidad rentable, eficiente y diferenciada frente a la competencia de los centros de salud públicos y privados en Chile.
Este planteamiento se basa en la capacidad de reflejar un sistema que no solo cumpla con las normativas vigentes, sino que también fortalezca la atención centrada en el paciente, asegurando así una mayor accesibilidad y mejora en la calidad del servicio de salud. El objetivo de esta investigación es proponer un modelo de implementación de una droguería regulada según las normas ISP 4160019 e ISP 4160020, que permita la creación de un centro logístico validado, autónomo y rentable para UC. CHRISTUS.
Para lograrlo, se plantea una aproximación mixta. Desde una perspectiva cualitativa, se utilizan tres grupos focales compuestos por ejecutivos y profesionales de la salud para comprender las etapas necesarias en el modelo. Cuantitativamente, se realiza un análisis a través de una encuesta de evaluación que complementa los hallazgos cualitativos y permite medir la percepción de los beneficios, desafíos y necesidades asociadas a la implementación de una droguería regulada en UC. CHRISTUS. En esta encuesta, los participantes deben indicar su nivel de acuerdo con una serie de afirmaciones utilizando una escala de Likert de 1 a 5, donde 1 = Totalmente en desacuerdo, 2 = En desacuerdo, 3 = Neutral, 4 = De acuerdo y 5 = Totalmente de acuerdo. Este estudio propone un modelo de droguería regulada en Chile, integrando las normativas vigentes con sostenibilidad operativa y financiera. Los datos indican que la autorización legal de funcionamiento, junto con el modelo de venta y distribución propuesto, establece una relación financiera sostenible, lo que permite al directorio de UC. CHRISTUS aumentar el margen de contribución mediante la expansión del negocio. Los hallazgos revelan que un 59,6% de los encuestados está totalmente de acuerdo con las afirmaciones presentadas, mientras que un 24% está de acuerdo, lo que indica una percepción positiva hacia el análisis. Sin embargo, un 3,6% se manifiesta neutral, lo cual podría reflejar indecisión o falta de información, y un 12,8% expresa desacuerdo. Estos datos sugieren que, aunque existe una aceptación general, es crucial investigar las razones detrás de la neutralidad y el desacuerdo, lo que podría ofrecer oportunidades para mejorar la
comprensión y aceptación del análisis, así como potenciar la percepción global en futuras evaluaciones. En síntesis, la certificación de la droguería garantiza el cumplimiento normativo, mejora la eficiencia operativa y habilita nuevas líneas de negocio, consolidando así un modelo regulado, eficiente y rentable. El estudio, a través del modelo propuesto, integra tecnología avanzada, optimización logística y estrategias de gestión del cambio, asegurando la sostenibilidad económica y la competitividad del centro. Este modelo refuerza la accesibilidad a productos farmacéuticos y proporciona directrices para superar barreras, como la resistencia al cambio y la inversión en infraestructura, posicionando a la central como un actor clave y diferenciado en el sector salud chileno.
Radiotherapy-induced vitiligo in a patient with breast cancer, a case report
(2024) Villanueva, Francisco; Jara, Natalia; Darlic, Valentina
Vitiligo is a disease characterised by the autoimmune destruction of melanocytes, manifesting as depigmentation of the skin. We present the case of a female patient with a history of breast cancer who developed vitiligo in the area of the treatment field 12 months after the end of radiotherapy. It has been reported in the literature that vitiligo can occur in patients with a history of vitiligo after radiotherapy, attributable to the Koebner phenomenon, where some treatments can induce new vitiligo lesions in the patient.
Deep‐frying impact on food and oil chemical composition: Strategies to reduce oil absorption in the final product
(2024) Valle, Consuelo; Echeverría, Francisca; Chávez, Vilma; Valenzuela, Rodrigo; Bustamante, Andrés
During frying, oils can deteriorate due to autoxidation and hydrolytic alterations, processes influenced by the oil's fatty acid composition (FAC) and antioxidant content. However, there are different techniques to improve fried food quality and reduce oil absorption. This review aims to assess existing literature on the interactions between frying methods, oil selection, and the chemical composition of foods. To achieve this goal, the article examines the impact of oil FAC, antioxidants, pretreatments, and alternative frying technologies. A literature search was conducted from 2016 to 2023. The keywords used were (AND/OR) frying, fried foods, oil, oil absorption, and fatty acids. Oils rich in monounsaturated fatty acids and antioxidants, such as olive oil, are recommended for their nutritional benefits and improved oil stability. The water content and structure of the food also play a significant role in oil absorption. Pretreatments to diminish food moisture content contribute to a lower oil absorption in the fried food while mitigating excessive accumulation of lipid oxidation products. Proper selection of frying oils, incorporation of antioxidants, and the use of pretreatments could help prevent chemical changes and minimize oil absorption during frying. These measures contribute to maintaining the nutritional quality and safety of fried foods while also enhancing their overall sensory appeal.
Fiscalización Estratégica-Preventiva para el Servicio Agrícola y Ganadero de Chile: Una Revisión de Enfoques y Desafíos
(Universidad del Desarrollo. Facultad de Ingeniería, 2024) Pérez Carvajal, Andrés Eduardo; Valdés González, Héctor
Este trabajo presenta un análisis de los desafíos significativos que enfrenta el Servicio Agrícola Ganadero (SAG) de Chile, como un órgano del Ministerio de Agricultura, en la fiscalización estratégica en el ámbito silvoagropecuario. El objetivo de esta investigación es desarrollar un modelo de fiscalización estratégica y preventiva aplicable al SAG, para el fortalecimiento de la gestión fito y zoosanitaria. Para lograrlo se plantea el uso de una aproximación cualitativa basada en 25 entrevistas semi estructuradas a profesionales y técnicos, que permita la comprensión de cómo y porque se aborda la fiscalización con un enfoque punitivo. Este estudio propone un modelo de fiscalización estratégica-preventiva para el SAG, integrando planificación estratégica, análisis predictivo, Objetives and Keys
Results (OKR), herramientas de geomática y ciencia de datos, y enfoque educativo, optimizando recursos y alineando las prácticas con su misión institucional y objetivos preventivos. Los resultados muestran que la forma actual de perspectiva de la fiscalización no es la adecuada, careciendo de una visión estratégica proactiva que aporte en el cómo, porqué y cuando realizar una fiscalización y que fortalezca la vigilancia fito y zoosanitaria.
Este nuevo paradigma propuesto es un aporte en la subsanación de las debilidades del macroproceso de fiscalización con foco en la misión y visión estratégica del Servicio. Se concluye que la incorporación de una perspectiva estratégica preventiva mejora la fiscalización del SAG, optimizando recursos y aportando a su gestión estratégica. Identifica barreras como oposición al cambio y falta de recursos, y oportunidades como tecnologías avanzadas y capacitación. Propone un modelo innovador, alineando la fiscalización con su misión y fomentando un cambio cultural hacia la prevención, contribuyendo a la sostenibilidad del sector silvoagropecuario y su replicabilidad en otras instituciones estatales.
Predictability and functional impact of lateral acromioplasty using preoperative 2D planning on the correction of the critical shoulder angle (CSA) in patients with rotator cuff repair
(2024) Toro, Felipe; De la Paz, Joaquín; De la Maza, Francisca; Ruiz, Francisco; Moraga, Claudio; Mardones, Paula
Background: Rotator cuff tears are highly prevalent, and their association with critical shoulder angle (CSA) has been reported. There is controversy regarding whether the morphology of the acromion influences its incidence, as well as whether acromioplasty would impact the results of a rotator cuff repair. Lateral acromioplasty does not play a decompressive role; rather, it aims to correct the deltoid vector. According to some publications, this would achieve less loading on the repaired rotator cuff, a lower retear rate, and better function. CSA correction with lateral acromioplasty can be planned with radiography (2-dimensional [2D]), but its predictability has not been fully studied. The primary objective of this study is to evaluate the predictability of 2D planning with radiography in CSA correction in patients with rotator cuff repair. The secondary objective is to analyze the association between the correction of the CSA and the functional outcomes.
Methods: This single-center, prospective, observational, analytical study included candidates for arthroscopic repair of a rotator cuff tear with a CSA > 35°. Lateral acromioplasty was performed as planned with preoperative radiography (2D) to achieve a CSA of 35°. The degrees to be corrected were calculated. CSA was recalculated with a postoperative radiography; and the error in the planned grades to be corrected was calculated. At the end of follow-up, Visual Analog Scale, Subjective Shoulder Value (SSV), and Quick-Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) scores were evaluated.
Results: Forty one cases were included, 43.9% were men, and the mean age was 55.5 ± 8.6 years. The mean preoperative and postoperative CSA were 39.6° ± 1.9° and 35.7° ± 2.3°, respectively; 41.5% achieved a postoperative CSA ≤ 35°. The mean CSA planned correction error was 45.7 ± 28.8%. At the end of the follow-up, 33 (78.6%) had a functional evaluation, with an average follow-up of 41 ± 6.8 months. The mean Visual Analog Scale, Quick-DASH, and SSV were 0.9 ± 1.6, 5.3 ± 7.5, and 92.7 ± 10.6, respectively. There was a significant difference in Quick-DASH (P = .01) and SSV (P = .02) according to whether a postoperative CSA ≤ 35° was achieved.
Conclusion: In lateral acromioplasty, planning of CSA correction with radiography (2D) is imprecise. Reaching a CSA ≤ 35° positively influences functional results.
Effects of school closure on lifestyle behaviours and health outcomes in children during the COVID-19 pandemic in Chile: A time-matched analysis
(2024) Suárez, Mónica; Fernández, Rodrigo; Quintiliano Scarpelli Dourado, Daiana; Pinheiro Fernandes, Anna Christina; Pizarro, Tito
Background: The COVID-19 pandemic led to school closures, potentially impairing children's behaviours and health. We aimed to explore the effects of school closure on lifestyle behaviours (dietary habits, physical activity) and health outcomes (adiposity, fitness, self-esteem, self-concept) in children.
Methods: We measured 247 children before school closure (October-November 2019) and after school reopening (October-November 2021) (COVID-19 group). To distinguish the changes due to school closure from changes due to growth, we included 655 age-matched children with cross-sectional measurements in October-November 2019 (control group). The response of this group (i.e., differences between children with 2 years of difference) was considered the expected response to growth. Two-way ANOVA was used to test age-by-group interactions, indicating an effect of school closure.
Results: In 7-to-9-year-old children, the COVID-19 group had larger-than-expected decreases in physical activity (by 0.4 points), resulting in higher physical inactivity prevalence (by 19 percent points) at 9 years. This was accompanied by larger-than-expected increases in fat percentage (by 6.1 percent point). In 8-to-10-year-old children, the COVID-19 group had higher physical inactivity prevalence at 10 years (by 20 percent points). This was accompanied by larger-than-expected increases in fat percentage (by 8.3 percent points), z-score BMI (by 0.90 units), and waist circumference (by 6.1 cm). In 9-to-11-year-old children, the COVID-19 group had larger-than-expected decreases in physical activity (by 0.3 points) and increases in self-concept (by 0.2 points). The response in dietary habits, fitness, or self-esteem was not different between groups.
Conclusion: Overall, school closure negatively impacted physical activity and adiposity, particularly in the youngest children.
Criteria and Indicators for Centers of Clinical Excellence in Stroke Recovery and Rehabilitation: A Global Consensus Facilitated by ISRRA
(2024) Stockley, Rachel; Walker, Marion; Murphy, Margit; Abd Aziz, Noor Azah; Amooba, Philemon; Churliov, Leonid; Farrin, Amanda; Fini, Natalie; Ghaziani, Emma; Godecke, Erin; Gutierrez, Tania; Jia, Jie; Kandasamy, Thoshenthri; Lindsay, Patrice; Solomon, John; Thijs, Vincent; Tindall, Tierney; Tippett, Donna; Watkins, Caroline; Lynch, Elizabeth
Background: The aim of the International Stroke Recovery and Rehabilitation Alliance is to create a world where worldwide collaboration brings major breakthroughs for the millions of people living with stroke. A key pillar of this work is to define globally relevant criteria for centers that aspire to deliver excellent clinical rehabilitation and generate exceptional outcomes for patients.
Objectives: This paper presents consensus work conducted with an international group of expert stroke recovery and rehabilitation researchers, clinicians, and people living with stroke to identify and define criteria and measurable indicators for Centers of Clinical Excellence (CoCE) in stroke recovery and rehabilitation. These were intentionally developed to be ambitious and internationally relevant, regardless of a country's development or income status, to drive global improvement in stroke services.
Methods: Criteria and specific measurable indicators for CoCE were collaboratively developed by an international panel of stroke recovery and rehabilitation experts from 10 countries and consumer groups from 5 countries.
Results: The criteria and associated indicators, ranked in order of importance, focused upon (i) optimal outcome, (ii) research culture, (iii) working collaboratively with people living with stroke, (iv) knowledge exchange, (v) leadership, (vi) education, and (vii) advocacy. Work is currently underway to user-test the criteria and indicators in 14 rehabilitation centers in 10 different countries.
Conclusions: We anticipate that use of the criteria and indicators could support individual organizations to further develop their services and, more widely, provide a mechanism by which clinical excellence can be articulated and shared to generate global improvements in stroke care.
Linfangioma Oral en Paciente con Síndrome Koolen de Vries: Presentación de Caso y Revisión de Literatura
(2024) Stierling, María; Ramírez, Diego; Sebastián Lazo
Los linfangiomas son tumores benignos hamartomatosos de los vasos linfáticos, originadas de un secuestro del saco linfático y agrandados por un inadecuado drenaje a la falta de comunicación con los canales linfáticos centrales o a la secreción excesiva de células de revestimiento. La incidencia de estos tumores en el sistema linfático es baja con una frecuencia de 1,2 a 2,8/1.000 en niños, sin predilección por sexo. En el territorio maxilofacial se pueden distinguir tres tipos de linfangioma: linfangioma simple, linfangioma cavernoso e higroma quístico o linfangioma quístico. Clínicamente estas lesiones se presentan como masas de tejido blando indoloras y de crecimiento lento. Su aspecto clínico depende de la extensión de la lesión. Diversos métodos de tratamiento para el linfangioma han sido reportados en la literatura, siendo la escisión quirúrgica la indicada, principalmente cuando estructuras vitales no están involucradas en la lesión. En este artículo se presenta un caso de una paciente femenina de 13 años con un aumento de volumen en el bermellón del labio superior, con antecedente de síndrome Koolen De Vries, a la cual se le realizó la exéresis de la lesión.
Lymphangiomas are benign hamartomatous tumors of the lymphatic vessels, originating from a sequestration of the lymphatic sac and enlarged by inadequate drainage, lack of communication with the central lymphatic channels or excessive secretion of lining cells. The incidence of these tumors in the lymphatic system is low, with a frequency of 1.2 to 2.8/1000 in children, with no predilection for sex. Three types of lymphangioma can be distinguished in the maxillofacial territory: simple lymphangioma, cavernous lymphangioma, and cystic hygroma or cystic lymphangioma. Clinically, these lesions present as painless, slow-growing soft tissue masses. Their clinical appearance depends on the extent of the lesion. Various treatment methods for lymphangioma have been reported in the literature, with surgical excision being indicated mainly when vital structures are not involved in the lesion. This article presents a case of a 13-year-old female patient with an increase in volume in the vermilion of the upper lip, with a history of Koolen De Vries syndrome, in which the excision of the lesion was performed.
Oxidative Stress in Polycystic Ovary Syndrome: Impact of Combined Oral Contraceptives
(2024) Santander, Nicolás; Figueroa, Esteban; González, Alejandro; Maliqueo, Manuel; Echiburú, Bárbara; Crisosto, Nicolás; Salas, Francisca
Polycystic Ovary Syndrome (PCOS) is a complex hormonal disorder that is associated with heightened metabolic risks. While oxidative stress (OS) is known to play a role in PCOS, the precise nature of the relationship between PCOS and increased OS remains not entirely understood. Combined oral contraceptives (COCs) are the first-line treatment to regulate menstrual cycles and androgen levels, but their impact on oxidative stress requires further study. We conducted a transcriptomic analysis using RNAseq and assessed the levels of various oxidative stress (OS) markers in serum samples from women with PCOS and controls and whether they were using combined oral contraceptives (COCs), including enzymatic activities, FRAP, and 8-isoprostane (8-iso). A total of 359 genes were differentially expressed in women with PCOS compared to control women. Genes differentially expressed were enriched in functions related to inflammation and, interestingly, oxidative stress response. In controls, 8-iso levels were increased in women using COCs, whereas in women with PCOS, 8-iso levels were reduced in those using oral contraceptives (191.1 ± 97 vs. 26.4 ± 21 pg/mL, p: <0.0001). Correlation analyses showed a trend for a negative correlation between 8-iso and Ferriman score in women with PCOS consuming COCs (r = -0.86, p = 0.06) and a negative correlation between GSH and hyperandrogenism in women with PCOS (r = -0.89, p = 0.01). These results reveal the presence of lipid peroxidation in women with PCOS, which was modified by the use of COCs, providing new insights into the pathophysiology of PCOS in the Chilean population.
Formación del cardiólogo en Chile y contribuciones desde la Sociedad Chilena de Cardiología y Cirugía Cardiovascular
(2024) Rossel, Víctor; Gajardo, Jorge; Miranda, Rodrigo; Nauhm, Yalile; Larrea, Ricardo; Greig, Douglas; Fernández, Flor; Bittner, Alex; Aguayo, Rubén; Varleta, Paola; Sanhueza, Gonzalo; Bugueño, Claudio; Quiñiñir, Luis; Llancaqueo, Marcelo; Pedemonte, Oneglio; Julio, Patricio; Sepúlveda, Luis; Oyonarte, Miguel; Sociedad Chilena de Cardiología y Cirugía Cardiovascular
La Sociedad Chilena de Cardiología y Cirugía Cardiovascular (SOCHICAR) es una entidad científica cuya misión es mejorar la salud cardiovascular del país y entre sus objetivos principales está el debatir los problemas de la especialidad y realizar diferentes actividades que tiendan a fomentar su progreso. Para cumplir con ellos se realizan diversas actividades de educación dirigidas a profesionales de la salud, entre los cuales se encuentran los médicos en programas de formación de cardiología. La formación de especialistas en Chile es responsabilidad de las Universidades, quienes diseñan la malla curricular y planifican las distintas actividades del programa de acuerdo con el perfil de egreso. La SOCHICAR busca integrar a estas nuevas generaciones de cardiólogos, implementando una serie de actividades dirigidas a ellos que contribuyan en su período de formación. Nos pareció relevante entregar nuestra posición como Sociedad Científica en importantes aspectos relacionados con este proceso: el perfil de egreso del cardiólogo clínico, las competencias necesarias para su desempeño en el país, la identificación de áreas deficitarias en su etapa formativa y las contribuciones desde la Sociedad a este proceso dependiente de las universidades. Se convocó a cardiólogos de SOCHICAR, en distintas etapas de desarrollo profesional, diferentes áreas geográficas y ámbitos de desempeño y funciones, en total, 15 cardiólogos (as), distribuidos en tres grupos de trabajo. Esta declaración de posición de la SOCHICAR puede ser de utilidad y una fuente de información importante a considerar por autoridades, entidades acreditadoras, centros formadores y la Sociedad Chilena de Cardiología.
The Chilean Society of Cardiology and Cardiovascular Surgery (SOCHICAR) is a scientific society whose mission is to improve the nation's cardiovascular health. Its primary goals include discussing issues affecting the specialty and engaging in various activities that support its advancement. To achieve these goals, numerous educational initiatives are undertaken for health professionals, including physicians in cardiology training programs. Training specialists in Chile is the responsibility of the universities, which design the curriculum and plan the program according to the graduate profile. SOCHICAR seeks to integrate these new generations of cardiologists, setting up tasks that contribute to their training. It seemed relevant to us to state our position as a Scientific Society in importants aspects related to this process: the graduate profile of the clinical cardiologist, the necessary competencies for their performance nationally, the identification of deficient areas in their training period, and the Society's contributions to this university-dependent process. A total of 15 cardiologists from SOCHICAR, at different stages of professional development, various geographic areas, and areas of performance and functions, were invited to participate in three working groups. This SOCHICAR position statement may be useful and an important source of information to be considered by authorities, accrediting entities, training centers, and the Chilean Society of Cardiology.
Obesogenicity perception of food environments in adults: A cross-sectional study in urban areas of Santiago, Chile
(2024) Rodríguez, Lorena; Egaña, Daniel; Molina, Paulina; Villegas, Rodrigo; Castillo, Barbara; Gálvez, Patricia
INTRODUCTION In Chile, there is a high prevalence of obesity, and most people have an inadequate quality of food. Food environments can constitute barriers that prevent healthy food choices and lead to overweight and obesity, as well as diet-related non-communicable diseases. There are international instruments that allow the characterization of food environments. In Chile, there are no studies on the perception of food environments. This study aimed to characterize the perception of obesogenicity of food environments in the urban Chilean population using an instrument previously validated in Chile.
METHODS This is a cross-sectional study with probabilistic sampling. The "Perceived Nutrition Environment Measures Survey", based on the Chilean model of food environments, was applied to 256 participants from two urban communities of the Metropolitan Region. Scores were calculated for the instrument items, which allowed calculating scores by environments included in the Chilean model of Food Environments. Negative scores were related to a higher obesogenic level.
RESULTS The results show that the domestic food environment is perceived as less obesogenic (median of 15.8 points), with more than 90% of households having fruits, vegetables, and legumes, even though the supply food environment was negative (median-0.19 points). However, about 50% of households had ultra-processed foods. The street food environment was perceived as the most obesogenic (median -1.91 points), with more than 60% of the participants indicating difficulty finding healthy options.
CONCLUSIONS According to the level of obesogenicity of the environments studied, it is necessary to have public policies that improve them and ensure the availability and physical and economic access to healthy food, particularly in the food supply and public road environments
Long-term quality of life in patients with bariatric surgery evaluated with BAROS
(2024) Palacio Agüero, Ana; Díaz-Torrente, Ximena; Zancheta, Camila; Reyes, Alejandra; Cosentino, Marcela; Almada, María José
Quality of life (QoL) significantly improves in the short term after bariatric surgery (BS). However, evidence on the long-term QoL of patients with BS is limited. Aim: To analyze the long-term QoL of patients who underwent Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG). Methods: We evaluated 257 patients from three private clinics in Santiago, Chile, with ~10-y since surgery. The Bariatric Analysis and Reporting Outcome System (BAROS) was used.
Results: Median values for the BAROS score indicated good results of treatment:4.3 (2.3-6.0) and 4.1 (2.1-6.4) for RYGB and SG patients, respectively. The Moorehead-Ardelt Quality of Life (MAQoL) score was higher in patients with SG compared to RYGB (1.5 vs. 1.3, p = 0.047). A moderate, positive, and significant correlation was observed between the percentage excess weight loss and MAQoL score (rho= 0.48, p<0.001). Conclusions: Patients undergoing BS showed a good QoL even in the long term (~10 y).
Gaps in biomedical research in frontotemporal dementia: A call for diversity and disparities focused research
(2024) Nuytemans, Karen; Franzen, Sanne; Broce, Iris J.; Caramelli, Paulo; Ellajosyula, Ratnavalli; Finger, Elizabeth; Gupta, Veer; Gupta, Vivek; Illán-Gala, Ignacio; Loi, Samantha M.; Morhardt, Darby; Pijnenburg, Yolande; Rascovsky, Katya; Williams, Monique M.; Yokoyama, Jennifer S.; Acosta-Uribe, Juliana; Akinyemi, Rufus; Alladi, Suvarna; Ayele, Biniyam A.; Ayhan, Yavuz; Bourdage, Renelle; Castro-Suarez, Sheila; Cruz de Souza, Leonardo; Dacks, Penny; Boer, Sterre C. M. de; Leon, Jessica de; Dodge, Shana; Grasso, Stephanie; Ghoshal, Nupur; Kamath, Vidyulata; Kumfor, Fiona; Matias-Guiu, Jordi A.; Narme, Pauline; Nielsen, T. Rune; Okhuevbie, Daniel; Piña-Escudero, Stefanie; Ruiz-Garcia, Ramiro; Ryan, Brigid; Scarioni, Marta; Slachevsky Chonchol, Andrea; Suarez-Gonzalez, Aida; Lead Tee, Boon; Tsoy , Elena; Ulugut, Hulya; Chiadi U Onyike, Chiadi U.; Babulal, Ganesh M.; ISTAART Frontotemporal Dementia and Related Disorders PIA; ISTAART Diversity and Disparities PIA
Frontotemporal dementia (FTD) is one of the leading causes of young-onset dementia before age 65, typically manifesting as abnormal behavior (in behavioral variant FTD) or language impairment (in primary progressive aphasia). Although FTD affects all populations across the globe, knowledge regarding the pathophysiology and genetics derives primarily from studies conducted in North America and Western Europe. Globally, biomedical research for FTD is hindered by variable access to diagnosis, discussed in this group's earlier article, and by reduced access to expertise, funding, and infrastructure. This perspective paper was produced by two professional interest areas of the Alzheimer's Association International Society to Advance Alzheimer's Research and Treatment (ISTAART) and discusses the field's current status on the cross-cultural aspects of basic and translational research in FTD (including that focused on epidemiology, genetics, biomarkers, and treatment). It subsequently provides a summary of gaps and needs to address the disparities and advance global FTD biomedical research.
Food insecurity and sociodemographic factors in Latin America during the COVID-19 pandemic
(2024) Novoa-Sanzana, Stephanie; Moya-Osorio, José; Morejón Terán, Yadira; Ríos-Castillo, Israel; Becerra Granados, Luis Miguel; Prada Gómez, Gloria; Ramos de Ixtacuy, Mónica; Fernández Condori, Roxana Carla; Nessier, María Celeste; Guerrero Gómez, Ana; González-Céspedes, Laura; Nava-González, Edna J.; Pérez Ocampo, Luisa; Castillo-Albarracín, Adriana Nathaly; Durán-Agüero, Samuel
Objective. To understand the association of food insecurity with sociodemographic factors in a sample population in Latin America during the COVID-19 pandemic.
Methods. This was a multicenter cross-sectional study conducted in 10 countries in Latin America using an online survey through various digital platforms from October 14, 2020 to February 15, 2021. Statistical analysis of data was performed by applying descriptive statistics, chi-square test, and logistic regression analysis.
Results. Of a total of 6 357 surveys, 58.2% of respondents experienced food security, 29.3% were slightly food insecure, 9.2% were moderately food insecure, and 3.3% were severely food insecure. Concerning the association food insecurity and sociodemographic variables, there is a significant association in the variables studied, including area of residence, education level, occupation, number of persons in the household, house hold with children younger than 10 years of age, and socioeconomic level.
Conclusions. These findings indicate that sociodemographic factors associated with food insecurity during the COVID-19 pandemic in Latin America were rural residence; complete and incomplete basic and secondary schooling; occupation (homemaker, unemployed, and self-employed); low, medium-low, and medium socioeconomic level; household with more than four persons; and household with children younger than 10 years of age.
International Society on Thrombosis and Haemostasis clinical practice guideline for treatment of congenital hemophilia A and B based on the Grading of Recommendations Assessment, Development, and Evaluation methodology
(2024) Rezende, Suely; Neumann, Ignacio; Angchaisuksiri, Pantep; Awodu, Omolade; Boban, Ana; Cuker, Adam; Curtin, Julie; Fijnvandraat, Karin; Gouw, Samantha; Gualtierotti, Roberta; Makris, Michael; Nahuelhual, Paula; O'Connell, Niamh; Saxena, Renu; Shima, Midori; Wu, Runhui; Rosendaal, Frits
Background: Hemophilia is a rare congenital bleeding disorder that results from complete or partial deficiency of blood coagulation factor (F)VIII (hemophilia A) or FIX (hemophilia B) due to pathogenic variants in their coding genes. Hemophilia requires complex management. To date, there is no evidence-based clinical practice guideline on hemophilia treatment based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.
Objectives: This evidence-based clinical practice guideline from the International Society on Thrombosis and Haemostasis aims to provide an overview of evidence and support patients, caregivers, hematologists, pediatricians, other clinicians, researchers, and stakeholders in treatment decisions about congenital hemophilia A and B.
Methods: The International Society on Thrombosis and Haemostasis formed a multidisciplinary guideline panel of physicians and patients with global representation, balanced to minimize potential bias from conflicts of interest. The panel prioritized a set of clinical questions and outcomes according to their importance for clinicians and patients. A methodological team supported the guideline development process, including searching for evidence and performing systematic reviews. The GRADE approach was used, including GRADE Evidence to Decision frameworks. The recommendations were subject to public comment.
Results: The panel selected 13 questions, of which 11 addressed the treatment of hemophilia A and 2 the treatment of hemophilia B. Specifically, the panel addressed questions on prophylactic and episodic treatment with FVIII concentrates, bypassing agents, and nonfactor therapy (emicizumab) for hemophilia A (with and without inhibitors) as well as immune tolerance induction for hemophilia A. For hemophilia B, the panel addressed questions on prophylactic and episodic treatment of bleeding events with FIX concentrates. Agreement was reached for all 13 recommendations, of which 7 (54%) were based on evidence from randomized clinical trials, 3 (23%) on observational studies, and 3 (23%) on indirect comparisons.
Conclusion: Strong recommendations were issued for prophylactic over episodic treatment for severe and moderately severe hemophilia A and B. Only conditional recommendations were issued for the remaining questions. Future research should focus on direct treatment comparisons and the treatment of hemophilia B with and without inhibitors. Future updates of this guideline will provide an updated evidence synthesis on the current questions and focus on new FVIII and FIX concentrates, novel nonfactor therapies, and gene therapy for severe and nonsevere hemophilia A and B.
Effectiveness and safety of the tetravalent TAK-003 dengue vaccine: a systematic review
(2024) Bengolea, AgustIn; Scigliano, Clara; Ramos, Jose; Rada, Gabriel; Catalano, Hugo; Izcovich, Ariel
In Argentina, the dengue virus has experienced an increase in recent years. This study aims to conduct a systematic review to evaluate the effectiveness and safety of the TAK-003 tetravalent dengue vaccine in this context. A systematic review of randomized controlled trials comparing the effectiveness and safety of the vaccine with placebo in the general population was conducted. The search was carried out in Epistemonikos, and two researchers independently assessed the studies. Risk of bias was evaluated using the Cochrane Rob 2 tool. A meta-analysis of the results was performed, and the certainty of evidence was assessed using the GRADE methodology. We concluded, with high certainty of evidence, that the tetravalent dengue vaccine reduces severe infections (RR 0.17, 95% CI 0.12 to 0.24) and infections by the dengue virus (RR 0.40, 95% CI 0.36 to 0.45) in a population ≤17 years. The vaccine may not increase the risk of serious adverse events, although it is important to note the low certainty of evidence (RR 1.04, 95% CI: 0.69-1.55). The use of the tetravalent dengue vaccine decreases the risk of severe and non-severe dengue infections in this population. However, there is low certainty of evidence regarding the vaccine's safety. The decision to vaccinate should consider the magnitude of benefits relative to the risk of infection.