Browsing by Author "Quezada, Felipe"

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    Assessing the impact of a single qualitative fecal immunochemical test on colonoscopy prioritization and mortality in risk-stratified patients with suspected colorectal cancer: a retrospective cohort study
    (2025) Quezada, Felipe; Acevedo, Johanna; González, Maite; Tello, Andrea; Castillo, Richard; Morales, Carlos; Manríquez. Erik; Duran, Valentina; Mena, Felipe; Le-Bert, Catherine; Cabreras, Manuel; Fulle, Ángelo; Carvajal, Gonzalo; Briones, Pamela; Nervi, Bruno; Kusanovich, Rodrigo
    Background: Performing fecal immunochemical tests in symptomatic individuals at low-or moderate risk for suspected colorectal cancer could help prioritize candidates for colonoscopies. The objective of this study was to assess the diagnostic accuracy of the fecal immunochemical test (FIT) in symptomatic individuals at low-or moderate risk of colorectal cancer and explore association with survival. Methods: We conducted a retrospective cohort study between December 2016 and July 2024 from a single-center, public hospital in Chile. Adults (≥18 years-old) individuals were included, those with symptoms suggestive of colorectal cancer and set for evaluation via colonoscopy. Symptomatic individuals with suspected colorectal cancer were stratified as high risk or low/moderate risk by a trained nurse according to 2015 NICE guidelines. Subsequently, high risk patients were directly referred for colonoscopies, while low/moderate risk patients underwent a single qualitative FIT and prioritized to colonoscopy based on results. Main outcomes were FIT diagnostic accuracy for colorectal cancer, overall mortality, and colorectal cancer-specific mortality. Findings: A total of 394 out of 1304 participants (30%) were classified as high risk. The remaining 910 (70%) were categorized as low/moderate risk and were referred for FIT. From these, 808 (89%) individuals were tested and had results for FIT. Regarding the diagnostic accuracy of the FIT, sensitivity was 96% and specificity reached 66.8%, with a negative value of 99.8%. Low/moderate risk positive FIT (FIT+) and high-risk participants had higher mortality rates vs. low/moderate risk negative FIT (FIT-) individuals. Time-to-event analysis confirmed a lower cumulative mortality in low/moderate risk FIT- patients. A multivariable Cox regression model showed a consistently lower risk of death in this group, while a non-significant trend towards increased mortality was observed in low/moderate risk FIT+ individuals after 30 months. Interpretation: In symptomatic individuals at low or moderate risk, a single qualitative FIT was associated with high sensitivity and moderate specificity for colorectal cancer detection. FIT may help prioritize colonoscopy in low-resource settings, but further prospective validation is warranted. Funding: This research was partially funded by ANIDFONDAP152220002 (CECAN).
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    Frecuencia de control odontológico en niños con síndrome de down, entre 6 y 12 años, en el año 2018, en el Colegio Andalué
    (Universidad del Desarrollo. Facultad de Medicina. Escuela de Odontología, 2019) Quezada, Felipe; Riveros, Nicolás; Quezada, Felipe; Riveros, Nicolás; González Moya, Lizabeth; González Moya, Lizabeth
    El Síndrome de Down se ha convertido en uno de los Síndromes de más prevalencia en Chile y, por lo tanto, cada vez es más frecuente encontrar niños que presenten esta condición. A partir de esto, el odontólogo ha tenido que tomar un rol más activo en cuanto a su atención. Esta información ha llevado a indagar cuál es la situación de atención odontológica en que se encuentran estos niños/as, para lo cual se realizó una encuesta que registra principalmente su atención odontológica en el año 2018, tomando como muestra a niños/as entre 6 y 12 años de la Escuela especial Andalué, Maipú. Para lograr esto, se encuestó a 37 apoderados de los cuales se logró una muestra de 30 participantes que cumplían con los criterios de inclusión, donde debieron responder un documento impreso tipo encuesta. Como resultado se obtuvo que de un total de 30 participantes, solo un 46,6% tuvo una frecuencia adecuada de asistencia al odontólogo durante el año 2018. Además se registró una baja entrega de información a los padres y/o apoderados en relación a frecuencia de controles odontológicos y notificación del GES a los 6 años, por parte del establecimiento y centros de salud. Se concluyó que existe un bajo porcentaje de niños/as con Síndrome de Down que tuvieron una frecuencia de control odontológico adecuado durante el año 2018

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