Browsing by Author "Rodríguez, Lorena"
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Item Accuracy of a Genetic Test for the Diagnosis of Hypolactasia in Chilean Children: Comparison With the Breath Test.(Philadelphia, PA : Lippincott Williams & Wilkins, 2016) Alliende, Francisco; Vial, Cecilia; Espinoza, Karen; Schnettle, Daniela; Romero, Victoria; Miquel, Isabel; Arancibia, María Eugenia; Ríos, Gloria; Rodríguez, Lorena; Quesada, Soledad; Lucero, Yalda; Repetto, GabrielaBACKGROUND: Lactase nonpersistence (LNP) in humans is a genetically determined trait. This age-dependent decrease of lactase expression is most frequently caused by single nucleotide polymorphisms in the regulatory region of the lactase (LCT) gene. The homozygous LCT-13,910C/C genotype (rs 4988235) predominates in Caucasian adults with LNP, and is useful for its diagnosis in this population. The accuracy of this genetic test (GT) has not been completely established in children or in a Latin-American population. OBJECTIVES: The aim of the study was to determine diagnostic accuracy of GT for LNP in Chilean children using the lactose breath test (BT) as a reference, and to compare diagnostic yield in preschool- (<6 years) and in school-age (≥6 years) children. METHODS: Children referred for BT for diagnosis of lactose malabsorption to the Gastroenterology Laboratory at Clínica Alemana, Santiago, from October 2011 to March 2012 were invited to participate. After informed consent, symptom questionnaires, both historic and post lactose ingestion were completed. H2 and CH4 in expired air and -13,910 C>T single nucleotide polymorphism by polymerase chain reaction, restriction enzyme analysis, and/or Sanger sequencing were determined. GT accuracy was calculated compared to BT as reference method. Diagnostic yield of GT in preschool- and school-age children was compared. RESULTS: Lactose malabsorption was detected by BT in 42 of 60 children (70%). Genotype -13,910C/C was identified in 41 of 60 patients (68%). GT showed 80% sensitivity, 63% specificity, and 74% accuracy for LNP in the preschool population. In school-age children values were higher, 85%, 80%, and 84%, respectively. CONCLUSIONS: GT results were significantly concordant with BT results for hypolactasia detection in Chilean children, particularly in those of age 6 years and older.Item Association of Cow's Milk Protein Allergy Prevalence With Socioeconomic Status in a Cohort of Chilean Infants(2020-09) Arancibia, María; Yalda, Lucero; Miquel, Isabel; Marchant, Pamela; Rodríguez, Lorena; Alliende, Francisco; Ríos, Gloria; Maturana, AndrésObjectives: The aim of the study was to compare the cow's milk protein allergy (CMPA) prevalence in 2 cohorts of children from different socioeconomic strata. Methods: Prospective birth cohort that included patients from 2 hospitals providing care for a low- and high-income population, respectively. Healthy newborns >= 34 gestational weeks were recruited and followed up to 12 months by a monthly telephone survey. If >= 2 predefined symptoms/signs suggestive of CMPA were detected, the patient was evaluated by a pediatric gastroenterologist. Diagnosis was confirmed by exclusion diet followed by open oral food challenge. Results: Overall the prevalence of CMPA was 5.2%, with a 6 times higher prevalence in the high income cohort (9.2%) compared with the low-income group (1.5%; relative risk 6.2; 95% confidence interval 1.8-20.7;P = 0.0005). All the cases were non-immunoglobulin E-mediated with predominantly gastrointestinal symptoms. High-income cohort did have higher frequency of Csection, mother's previous chronic disease, mother's history of atopy/food allergy, older age, and higher educational level of parents. Parent smoking and presence of pets at home were more frequent in the low-income cohort. Multiple logistic regression showed that the high-income cohort did have older age and higher educational level of both parents. Conclusion: In these cohorts the prevalence of CMPA was higher than reported previously in other developing countries and significantly higher in the high-income group. Our findings were associated with sociodemographic characteristics of the parents.Publication Barreras para una alimentación saludable: un análisis cualitativo de las semánticas emergentes en las comunidades escolares de Ciudad Sur(2024) Flores, Andrea; Díaz, Carlos; Palacios, José; Pinheiro Fernandes, Anna; Pizarro, Tito; Rodríguez, Lorena; Sáez, LuisObjetivo: Identificar las percepciones de padres, madres y apoderados, profesionales de establecimientos educacionales, funcionarios municipales, y feriantes pertenecientes a la zona sur de Santiago de Chile, respecto a las barreras y limitaciones de la puesta en práctica de una alimentación saludable en el ambiente alimentario escolar. Método: Se realizaron seis grupos focales agrupando a 50 actores claves vinculados a los establecimientos educacionales de Ciudad Sur utilizando una muestra no probabilística. Se aplicó un análisis de contenido mediante la técnica de codificación temática buscando relevar los universos semánticos emergentes. Resultados: Se identificaron nueve barreras, o semánticas, que caracterizan limitantes a la realización de la alimentación saludable en los entornos escolares desde la perspectiva de los participantes: la familia, kioscos escolares, la salida de los establecimientos escolares, gusto, determinantes socioeconómicos, política pública, falta de conocimiento, publicidad y disponibilidad de productos sin sellos. Conclusiones: Las limitaciones asociadas al ambiente alimentario doméstico tienen una representación significativamente alta (47,9%) y contienen un carácter de responsabilización individual en su enunciación. Esta cultura explicativa es opuesta a la evidencia científica y académica respecto al funcionamiento de la conducta alimentaria, y a la centralidad de los ambientes alimentarios respecto a la facilitación u obstaculización del consumo de alimentos saludables o adecuados.Publication Comparando la percepción de ambientes alimentarios entre barrios de distinto nivel socioeconómico en Santiago, Chile: un estudio transversal(2024) Egaña, Daniel; Gálvez, Patricia; Rodríguez, Lorena; Villegas, Rodrigo; Castillo, Bárbara; Molina, PaulinaEn las últimas décadas, se ha relevado la importancia de actuar en factores contextuales de la obesidad, entre ellos, los ambientes alimentarios. Recientemente, en Chile se validó la Encuesta de Medida del Entorno Nutricional Percibido, NEMS-P-Ch. Sin embargo, no existen investigaciones que hayan evaluado la percepción del grado de obesogenicidad/saludable de estos ambientes y se desconoce si difieren entre hogares de distinto nivel socioeconómico (NSE). El objetivo de este estudio es comparar la percepción sobre los ambientes alimentarios entre hogares de barrios de alto y bajo NSE de Santiago, Chile. Estudio transversal, mediante muestreo aleatorio sistemático de hogares. Se aplicó NEMS-P-Ch a 256 hogares (128 de cada comuna). Su aplicación entrega un puntaje global y puntajes asociados a la percepción de cada ambiente. Personas de la comuna de alto NSE presentan mayor ingreso familiar mensual, mayor proporción de personas con educación superior completa y menor número de habitantes en el hogar, respecto a la comuna de bajo NSE. Al comparar el puntaje global, participantes de la comuna de NSE alto perciben el entorno alimentario más salu dable que habitantes de menor NSE y hay diferencias significativas en tres de cuatro ambientes evaluados (doméstico, abastecimiento y vía pública). Mientras la mayoría de los ambientes se perciben como pantanos alimentarios, el ambiente doméstico se percibe más saludable en ambas comunas, asimilable a la idea de oasis alimentario. Estos resultados deberían movilizar acciones nacionales y locales para mejorar la disponibilidad y acceso a alimentos saludables, especialmente en barrios de menor NSE, que perciben sus ambientes alimentarios más obesogénicos.Item Limpieza intestinal para colonoscopia en niños: efectividad, adherencia y efectos adversos de esquemas diferenciados por edad(Sociedad Chilena de Pediatria, 2017) Miquel, Isabel; Arancibia, María Eugenia; Alliende, Francisco; Ríos, Gloria; Rodríguez, Lorena; Lucero, Yalda; Saelzer, EricIntroduction: Adequate intestinal cleanliness is crucial to achieve optimal colonoscopy performance. Several bowel preparation (BP) schemes have been proposed, but there is still no consensus as regards which is the most suitable in paediatric patients. Objective: To describe the effectiveness, adherence, and adverse effects of BP protocols differentiated by age group in paediatric patients subjected to colonoscopy. Patients and Method: Prospective study that included patients < 18 years subjected to colonoscopy. BP protocols differentiated by age group were indicated as follows: < 6 m (glycerine suppository); 6 m-3y 11 m (poly-ethylene-glycol (PEG 3350 without electrolytes); 4y-9y 11 m (PEG 3350 without electrolytes + bisacodyl); 10 y-18 y (PEG 3350 with electrolytes). Demographic, clinical information, adherence and adverse effects were registered. Effectiveness was determined using a validated scale (Boston modified) during colonoscopy. Results: A total of 159 patients were included, of which 87 (55%) were males, and with a median age of 4 years (range 1 m-17 years). Seventy eight percent of patients achieved successful BP. The higher effectiveness was observed in the groups of < 6 m (96%) and 10-18 y (91%). Constipation was significantly more frequent (29%) in the 4 yo-9 yo 11 m in which lower effectiveness was observed (69%). Good adherence was observed in 87% of patients. Adverse effects were observed in a third of patients, although they were mild and did not lead to the suspension of the BP. Conclusions: Satisfactory results were achieved with the BP schemes used, with a successful BP being obtained in 4 out of 5 patients. Results were different between groups, which is probably related to previous bowel transit and indicated medicationItem Nutrient declaration after the food labeling and advertising law in Chile: A Longitudinal Approach(Facultad de Medicina, Clínica Alemana Universidad del Desarrollo,, 2020) Quintiliano-Scarpelli, Daiana; Pinheiro Fernandes, Anna; Rodríguez, Lorena; Pizarro, TitoChile has implemented several strategies to decrease the burden of obesity and chronic diseases. The Food Labeling and Advertising Law (Law 20.606) requires a front-of-package "high in" warning label when energy and nutrients of concern (ENC) (total sugar, saturated fats, sodium) exceed established limits. This study aims to evaluate the impact of Law 20.606 on the ENC declaration of packaged foods in Chile, before and after the law implementation. We analyzed food nutritional labeling declarations from 70% of the most consumed packaged foods in Chile. Data collection was conducted in 2013 and 2019 in Santiago. Pictures from all sides of the package were taken from 476 products, classified into 16 food groups. All food groups had changes in the ENC declaration during the study period. Total sugar content showed the highest reduction (-15.0%; p = 0.001). Dairy, confitures and similar and sugary beverages had the greatest reduction in energy and total sugar content (p < 0.01). Energy, total sugar and sodium front of package "high in" simulation was significantly reduced in dairy, sugary beverages, flour-based foods, confitures and similar, fish and seafoods, fats and oils, spices, condiments and sauces and sugars (p < 0.05). We observed that companies reformulated products to adapt to the new regulation.Publication 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, PatriciaINTRODUCTION 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 environmentsPublication Prevalence of Cow’s Milk Allergy in Infants from an Urban, Low-Income Population in Chile: A Cohort Study(2025) Cruchet, Sylvia; Arancibia, María Eugenia; Maturana, Andrés; Marchant, Pamela; Rodríguez, Lorena; Lucero, YaldaBackground. Cow’s milk allergy (CMA) is one of the most common food allergies in infancy, with prevalence estimates of 0.5–7.5% in high-income countries. Data from low- and middle-income regions remain limited, and the predominant immune mechanism (IgE or non-IgE mediated) may vary across populations. Objective. We aimed to determine the prevalence and clinical characteristics of CMA in infants from an urban, low-income Chilean population. Methods. A prospective cohort study was conducted at Padre Hurtado Hospital in Santiago, Chile. Healthy term newborns were recruited and followed for up to 12 months. Sociodemographic, perinatal data and parental atopy were recorded. Parents were contacted monthly to screen for CMA symptoms. Infants with ≥two symptoms underwent clinical evaluation, a 4-week cow’s milk protein exclusion diet, and an open oral food challenge (OFC). Diagnosis followed international consensus guidelines. Results. Of 552 enrolled infants (48% male), 27 were diagnosed with CMA, yielding a prevalence of 4.9% (95% CI 3.1–7.0%). All cases exhibited non-IgE-mediated symptoms, including vomiting, dermatitis, colic, and perianal erythema. CMA was diagnosed before 6 months of age in 74% of cases. At 12 months, 40% had developed oral tolerance. Sociodemographic and perinatal characteristics were similar between groups, but some self-reported parental atopic traits were more frequent in CMA cases. Conclusions. CMA prevalence in this Chilean cohort was comparable to that reported in high-income countries, with a predominance of non-IgE-mediated forms. These findings support the need for standardized diagnostic protocols, including OFC, in diverse populations. Future studies should explore long-term outcomes and risk factors in non-IgE-mediated CMA.Item Recomendaciones en enfermedad hepática crónica y trasplante hepático durante COVID-19 en pediatría(2020) Godoy, Marcela; Zuloaga, Natalia; Navarro, Elizabeth; Soriano, Humberto; Vizcaya, Cecilia; Rodríguez, Lorena; Juanet, Juan Ignacio; Faúndez, Rossana; Gana, Juan CristóbalEl brote del virus SARS-CoV-2 que comenzó a fines del año 2019 en China, se ha expandido a Chile y al mundo rápidamente. Hasta la fecha, en Chile, ha afectado a 18.435 personas con una letalidad en adultos de 1,4%. Los pacientes pediátricos con enfermedades hepáticas crónicas son también susceptibles a COVID-19 y podrían tener una peor evolución. El objetivo es entregar recomendaciones sobre el tratamiento médico de pacientes pediátricos con daño hepático crónico (DHC), hepatitis autoinmune (HAI), Enfermedad de hígado graso no alcohólico (EHGNA) y trasplantados hepáticos (TH) en relación a COVID-19. Lo primordial es evitar el contagio y para esto, lo más importante es el lavado de manos, uso de mascarilla en espacios públicos y cerrados, como el distanciamiento social y evitar contacto con personas sintomáticas. Los pacientes con DHC, HAI, EHGNA y TH deben evitar los controles presenciales y favorecer la telemedicina. No existe evidencia que recomiende la modificación del tratamiento basal en estos casos. En pacientes COVID-19 (+) se recomienda medidas de aislamiento, preferir uso de paracetamol como antipirético y analgésico y en el manejo de la inmunosupresión, debe considerarse cada caso de forma individual, según gravedad y con evaluación del especialista. Además, se revisan las actuales terapias específicas para COVID-19 y sus precauciones en pacientes con hepatopatías. Las medidas de prevención del contagio, aislamiento social y diagnóstico precoz son fundamentales en pacientes con enfermedad hepática y el riesgo de infección por SARSCoV-2