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Artículos, documentos de trabajo y otros documentos de investigación / Articles, working papers and other research papers

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24/7 Physical Therapy Intervention With Adult Patients in a Chilean Intensive Care Unit: A Cost-Benefit Analysis in a Developing Country
(2020) Merino, Catalina; Velásquez, Mónica; Marmolejo, José Ignacio; Fu, Carolina
Objectives: Physiotherapy in an adult intensive care unit (ICU) affects health outcome. To justify the investment in ICU physical therapy, the cost savings associated with its benefits need to be established. The main objective of this study is to evaluate the potential cost savings of implementing 24-hour, 7-days-per-week physiotherapist (24/7-PT) in a Chilean public high-complex specialized ICU. Methods: Using clinical data from a literature review and a micro-costing technique, we conducted a cost-benefit analysis in the National Institute of Thorax in Chile. Our example scenario involves 697 theoretical admissions of adult patients with cardiovascular or respiratory diseases, and the costs and benefits by reduction of length of stay in ICU, days of mechanical ventilation, and days with respiratory infections during the first year and 5 years of admissions. A sensitivity analysis was considered according to the variability in total costs, production income, and clinical benefits. Results: Net cost savings generated in our example scenario demonstrate that the implementation of 24/7-PT produces a minimum saving for the institution of $16 242 during the first year and $69 351 over a 5-year interval considering individual income production. Out of the 30 scenarios included in the sensitivity analyses, 26 (87%) demonstrated net savings. Conclusions: A financial model, based on literature review and actual cost data, projects that 24/7-PT intervention is a costbenefit alternative in adult ICU patients with cardiovascular or respiratory diseases in Chile. It is necessary a scenario of at least 3 sessions per day with insurance payment for individual treatments to support the long-term implementation of a 24/7-PT program.
3D-printed hand prostheses function in adolescents with congenital hand amputation: a case series
(2020) Dote, Jacqueline; Nahuelhual, Paula; Cubillos, Rodrigo; Fuentes, Gabriel; Zuniga, Jorge
Objective: To describe the effect of the 3D-printed Cyborg Beast prosthesis on upper limbs function in adolescents with congenital hand amputation. Clinical Cases: Five patients aged between 12 and 17 years, with congenital hand amputation were selected. All patients were from the Teletón Institute in Santiago, Chile. The patients were trained for prosthesis use in four sessions. Hand function was evaluated without prosthesis, at 1 and 4 months of use with the modified Bilan 400 points scale, and upper limb function perception was evaluated with the ’Upper Extremity Functional Index (UEFI)’. At 1 month and 4 months of use, the percentage change for hand functionality for the unaffected limbs was between -11% and -4%; and -9% and -2% for the affected limb. The percentage change for the upper limbs perceived function was -62%. Conclusions: The use of the 3D-printed Cyborg Beast prosthesis was not a functional solution for the 5 patients included in this study. Future research is needed to improve the functionality of these types of 3D-printed hand prostheses.
4-Hydroxynonenal induces Cx46 hemichannel inhibition through its carbonylation
(2020) Retamal, Mauricio; Fiori, Mariana C.; Fernández-Olivares, Ainoa; Linsambarth, Sergio; Peña, Francisca; Quintana, Daisy; Stehberg, Jimmy; Altenberg, Guillermo A.
Hemichannels formed by connexins mediate the exchange of ions and signaling molecules between the cytoplasm and the extracellular milieu. Under physiological conditions hemichannels have a low open probability, but in certain pathologies their open probability increases, which can result in cell damage. Pathological conditions are characterized by the production of a number of proinflammatory molecules, including 4-hydroxynonenal (4-HNE), one of the most common lipid peroxides produced in response to inflammation and oxidative stress. The aim of this work was to evaluate whether 4-HNE modulates the activity of Cx46 hemichannels. We found that 4-HNE (100 μM) reduced the rate of 4′,6-diamino-2-fenilindol (DAPI) uptake through hemichannels formed by recombinant human Cx46 fused to green fluorescent protein, an inhibition that was reversed partially by 10 mM dithiothreitol. Immunoblot analysis showed that the recombinant Cx46 expressed in HeLa cells becomes carbonylated after exposure to 4-HNE, and that 10 mM dithiothreitol reduced its carbonylation. We also found that Cx46 was carbonylated by 4-HNE in the lens of a selenite-induced cataract animal model. The exposure to 100 μM 4-HNE decreased hemichannel currents formed by recombinant rat Cx46 in Xenopus laevis oocytes. This inhibition also occurred in a mutant expressing only the extracellular loop cysteines, suggesting that other Cys are not responsible for the hemichannel inhibition by carbonylation. This work demonstrates for the first time that Cx46 is post-translationally modified by a lipid peroxide and that this modification reduces Cx46 hemichannel activity.
5,926 hysterectomies: complications described by Clavien–Dindo classification
(2021) Alliende, Rodrigo; Carrasco, Álvaro; Levancini, Marco; Kovoor, Elias; Guzmán Rojas, Rodrigo; Miranda, Ignacio
Hysterectomy is the most common major gynaecological surgery. Due to its high volume, the analysis of its results is relevant. The objective of this study was to describe intraoperative complications and reoperations, for both benign and malignant causes, using the Clavien–Dindo classification (approved by local ethics committee, number 100220). Between 2000 and 2019, 5926 elective hysterectomies were performed, of which 90.2% were for benign aetiology and 9.8% for malignant causes. The abdominal route was 52.7%, vaginal 40.1% and laparoscopic 7.2%. Intraoperative complications and reoperations (grade III Clavien–Dindo) were 4% and 2.1%, respectively. Oncological surgery had significantly more intraoperative complications (10% vs. 3.4%) and reoperations (3.6% vs. 1.9%) than benign procedures. Noteworthy, intraoperative complications required a new operation in only 3.4% for malignant and 2.8% for benign surgery. Our data showed the relevance of detecting and rectifying intraoperative complications during surgery, which consequently leads to a lower reoperation rate, minimising postoperative morbidity and mortality for patients.
A 10-gene classifier for indeterminate thyroid nodules: development and multicenter accuracy study
(American Thyroid Association, 2017) González, Hernán; Martínez, José R.; Vargas, Sergio; Solar, Antonieta; Veliz, Loreto; Cruz, Francisco; Arias, Tatiana; Loyola, Soledad; Horvath, Eleonora; Tala, Hernán; Traipe, Eufrosina; Meneses, Manuel; Marín, Luis; Wohllk, Nelson; Diaz, René; Véliz, Jesús; Pineda, Pedro; Arroyo, Patricia; Mena, Natalia; Bracamonte, Milagros; Miranda, Giovanna; Bruce, Elsa; Urra, Soledad
BACKGROUND: In most of the world, diagnostic surgery remains the most frequent approach for indeterminate thyroid cytology. Although several molecular tests are available for testing in centralized commercial laboratories in the United States, there are no available kits for local laboratory testing. The aim of this study was to develop a prototype in vitro diagnostic (IVD) gene classifier for the further characterization of nodules with an indeterminate thyroid cytology. METHODS: In a first stage, the expression of 18 genes was determined by quantitative polymerase chain reaction (qPCR) in a broad histopathological spectrum of 114 fresh-tissue biopsies. Expression data were used to train several classifiers by supervised machine learning approaches. Classifiers were tested in an independent set of 139 samples. In a second stage, the best classifier was chosen as a model to develop a multiplexed-qPCR IVD prototype assay, which was tested in a prospective multicenter cohort of fine-needle aspiration biopsies. RESULTS: In tissue biopsies, the best classifier, using only 10 genes, reached an optimal and consistent performance in the ninefold cross-validated testing set (sensitivity 93% and specificity 81%). In the multicenter cohort of fine-needle aspiration biopsy samples, the 10-gene signature, built into a multiplexed-qPCR IVD prototype, showed an area under the curve of 0.97, a positive predictive value of 78%, and a negative predictive value of 98%. By Bayes' theorem, the IVD prototype is expected to achieve a positive predictive value of 64-82% and a negative predictive value of 97-99% in patients with a cancer prevalence range of 20-40%. CONCLUSIONS: A new multiplexed-qPCR IVD prototype is reported that accurately classifies thyroid nodules and may provide a future solution suitable for local reference laboratory testing.
A 12-month prospective study on the time to hospitalization and clinical management of a cohort of bipolar type I and schizoaffective bipolar patients
(Elsevier Masson SAS, 2019-09) Murru, Andrea; Verdolini, Norma; Anmella, Gerard; Pacchiarotti, Isabella; Samalin, Ludovic; Aedo, Alberto; Undurraga, Juan; Goikolea, José; Benedikt, Amann; Carvalho, Andre; Vieta, Eduard
Background: Schizoaffective disorder, bipolar type (SAD) and bipolar disorder I (BD) present a large clinical overlap. In a 1-year follow-up, we aimed to evaluate days to hospitalization (DTH) and predictors of relapse in a SAD-BD cohort of patients. Methods: A 1-year, prospective, naturalistic cohort study considering DTH as primary outcome and incidence of direct and indirect measures of psychopathological compensation as secondary outcomes. Kaplan-Meyer survival analysis with Log-rank Mantel-Cox test compared BD/SAD subgroups as to DTH. After bivariate analyses, Cox regression was performed to assess covariates possibly associated with DTH in diagnostic subgroups. Results: Of 836 screened patients, 437 were finally included (SAD = 105; BD = 332). Relapse rates in the SAD sample was n = 26 (24.8%) vs. n = 41 (12.3%) in the BD sample (p = 0.002). Mean ± SD DTH were 312.16 ± 10.6 (SAD) vs. 337.62 ± 4.4 (BD) days (p = 0.002). Patients with relapses showed more frequent suicide acts, violent behaviors, and changes in pharmacological treatments (all p < 0.0005) in comparison to patients without relapse. Patients without relapses had significantly higher mean number of treatments at T0 (p = 0.010). Cox regression model relating the association between diagnosis and DTH revealed that BD had higher rates of suicide attempts (HR = 13.0, 95%CI = 4.0-42.0, p < 0.0005), whereas SAD had higher rates of violent behavior during psychotic episodes (HR = 12.0, 95%CI = .3.3-43.5, p > 0.0005). Conclusions: SAD patients relapse earlier with higher hospitalization rates and violent behavior during psychotic episodes whereas bipolar patients have more suicide attempts. Psychiatric/psychological follow-up visits may delay hospitalizations by closely monitoring symptoms of self- and hetero-aggression.
A 19 Year Analysis of Small Mammals Associated with Human Hantavirus Cases in Chile
(2019) Torrez-Pérez, Fernando; Palma, Eduardo; Boric-Bargetto, Dusan; Vial, Cecilia; Ferrés, Marcela; Vial, Pablo; Martínez-Valdebenito, Constanza; Pavletic, Carlos; Parra, Alonso; Marquet, Pablo; Mertz, Gregory
Small mammals present in areas where hantavirus cardiopulmonary syndrome (HCPS) cases had occurred in central and southern Chile were captured and analyzed to evaluate theabundance of rodents and seroprevalence rates of antibodies to Andes orthohantavirus (ANDV). Sampling areas ranged from the Coquimbo to Aysén regions (30–45° S approx.) regions. Ninetytwo sites in peridomestic and countryside areas were evaluated in 19 years of sampling. An antibody against ANDV was detected by strip immunoassay in 58 of 1847 specimens captured using Sherman traps. Of the eleven species of rodents sampled, Abrothrix olivacea, Oligoryzomys longicaudatus and Abrothrix hirta were the most frequently trapped. O. longicaudatus had the highest seropositivity rate, and by logistic regression analysis, O. longicaudatus of at least 60 g had 80% or higher probability to be seropositive. Sex, age and wounds were significantly related to seropositivity only for O. longicaudatus. Across administrative regions, the highest seropositivity was found in the El Maule region (34.8–36.2° S), and the highest number of HCPS cases was registered in the Aysén region. Our results highlight the importance of long term and geographically extended studies, particularly for highly fluctuating pathogens and their reservoirs, to understand the implications of the dynamics and transmission of zoonotic diseases in human populations.
A 37-year-old woman with dyspnea and stridor
(American Thoracic Society, 2016) Gando, Sebastian; Garcia, Ana; Labarca, Gonzalo; Fernández-Bussy, Sebastián
A woman with morbid obesity and a diagnosis of asthma since childhood sought medical attention because of unrelenting dyspnea and nocturnal stridor. Spirometry revealed a restrictive pattern with amputation of inspiratory and expiratory maximum flow rates. She was referred for further diagnostic evaluation.
A Bayesian quantile binary regression approach to estimate payments for environmental services
(2017) Vásquez Lavín, Felipe; Flores, Ricardo; Ibarnegaray, Verónica
Stated preference approaches, such as contingent valuation, focus mainly on the estimation of the mean or median willingness to pay (WTP) for an environmental good. Nevertheless, these two welfare measures may not be appropriate when there are social and political concerns associated with implementing a payment for environmental services (PES) scheme. In this paper the authors used a Bayesian estimation approach to estimate a quantile binary regression and the WTP distribution in the context of a contingent valuation PES application. Our results show that the use of other quantiles framed in the supermajority concept provides a reasonable interpretation of the technical nonmarket valuation studies in the PES area. We found that the values of the mean WTP are 10-37 times higher than the value that would support a supermajority of 70 per cent of the population.
A biomimetic smart kirigami soft metamaterial with multimodal remote locomotion mechanisms
(2023) Silva, Benjamín; Govan, Joseph; Zagal, Juan Cristóbal; Grossi, Bruno; Roldan, Alejandro; Nunez, Alvaro S.; Acuña, Daniel; Palza, Humberto
Several efforts have been made to develop walking smart soft robots through different strategies such as the use of complex aligned magneto-active materials. Here, we show a simple approach for the design of a smart soft robot using an elastomer film with randomly distributed ferrimagnetic nanoparticles able to be remotely controlled by a magnetic field. The magneto-active robot has a rotating-square kirigami geometry resulting in a flexible smart auxetic metamaterial (i.e., a negative Poisson-ratio structure). Alongside the standard translational locomotion on a smooth-surface under a steady magnetic force, the auxetic kirigami structure mimics the crawling-locomotion of worms over a high-roughness surface under an oscillatory horizontal field, even climbing vertical-obstacles. A theoretical understanding for this new locomotion mechanism stresses the relevance of the kirigami metamaterial design and the ferrimagnetic response of the particles. The soft robot can also transport a payload having weights higher than the weight of the smart elastomeric film. The smart auxetic structure further presents a rolling locomotion by properly orienting the magnetic field, meaning multiple remote locomotion mechanisms.
A Business Case for Marine Protected Areas: Economic Valuation of the Reef Attributes of Cozumel Island
(2021) Lara-Pulido, José Alberto; Mojica, Ángela; Bruner, Aaron; Guevara-Sanginés, Alejandro; Simon, Cecilia; Vásquez Lavín, Felipe; González-Baca, Cristopher; Infanzón, María José
Tourism to Cozumel Island generates USD 762 million annually in local economic activity, and 111 visitors stay in local hotels for each inhabitant. The island’s coast is its principal attraction, yet water quality and reef health are threatened. This paper studies the link between the local economy and management of Arrecifes de Cozumel National Park, using a choice experiment to assess the economic value visitors assign to underwater visibility, biodiversity, and visitor congestion in reef areas. We found that, on average, tourists are willing to pay USD 190 per visit to avoid a projected decrease in biodiversity, USD 120 per visit to prevent a projected decline in visibility, and USD 98 to avoid high congestion during reef visits. We find high heterogeneity in willingness to pay estimates, which may be useful for targeting both conservation and marketing efforts. On the other hand, increasing the reef access fee from USD 2 to USD 6 could fully fund effective protected area management, with no substantial effect on visitors’ consumer surplus. Results suggest that a conservation surcharge could be added to all tours, with little impact on visitation, and that significantly increasing private sector collaboration and government spending on conservation would be good economic choices.
A Case of Interstitial Lung Disease With Apical Pleural Thickening: Idiopathic Pleuroparenchymal Fibroelastosis
(Sociedad Española de Neumología y Cirugia Torácica, 2014) Labarca, Gonzalo; Cabello, Hernán; Fernández‐Bussy, Sebastián; Cabello, Francisca; Díaz, Juan
Idiopathic pleuroparenchymal fibroelastosis (IPPFE) is a very rare, recently described condition, characterised by fibrotic thickening of the pleural and subpleural parenchyma, predominantly in the upper lobes.1 Clinical manifestations and lung function tests are similar to those observed in restrictive interstitial pneumonias, and in some of the cases described, there was a history of recurrent infections, such as allergic bronchopulmonary aspergillosis or cystic fibrosis.2,3 Radiological findings include intense pleural thickening associated with signs of fibrosis, particularly in the upper lobes, with loss of volume and structural distortion, as observed in the case presented here.
A case report of a primary synovial chondromatosis of temporomandibular joint, producing medial displacement of the articular disc
(2014) Droguett, C.; Fumeaux, J.E.; Skármeta, N.P.
Synovial chondromatosis in the temporomandibular joint (TMJ) is a rare benign cartilaginous metaplasia characterized by the formation of loose bodies within the synovial joint space. This condition presents a specific triad of semiological characteristics featuring pain, swelling, and limitation of function. We will present a clinical case of a 49 years-old female patient who presented to the clinica Davila’s maxillofacial service with severe functional alterations in her right TMJ. Clinically, the patient had a maximum aperture of 15 mm wide, alteration of mandibular dynamics and preauricular pain. Posterior conducting a complete clinical examination and conclusive magnetic resonance imaging (MRI) findings it was decided to perform surgery on the joint. Articular cavity was exposed through a preauriclar approach, where the joint capsule presented no evident alteration. After opening the capsule, we were able to identify and extract multiple cartilaginous bodies both above and below the disc space. The articular surfaces were in good condition, while the articular disc was shifted to the medial portion of the cavity. The removal of the loose bodies was held the meniscopexy of the articular disc with a small joint anchor. The immediate post-operative period was uneventful, and the patient did not present any alteration with respect to motor function of facial expression. At the 6-week control, we recorded an increase in maximum mouth opening of 30 mm and a reduction of the pain. Six months later, we recorded an even wider mouth opening with no signs or evidence of recurrence
A case report of granuloma faciale, an uncommon cutaneous vasculitis
(2019) Arellano, Javier; Vargas, Pablo; Pulgar, Constanza; Neely, Gabriel; Corredoira, Yamile
Granuloma faciale is an uncommon benign dermatosis, with unknown etiology, usually asymptomatic, characterized by chronic inflammation localized in sun-exposed areas of the face with a characteristic histological pattern. Although response to treatment is variable, there are multiple therapeutic alternatives that have been reported to be effective in some patients, including systemic treatments with steroids and dapsone or also topical treatments like intralesional corticosteroid, cryotherapy and calcineurin inhibitors, such as tacrolimus. We present the case of an adult patient with an asymptomatic erythematous-violet plaque on the right cheek, with progressive slow growth over two years, clinically and histologically and pathologically compatible with a facial granuloma. The patient responded well to intralesional corticosteroids.
A case-control study of a combination of single nucleotide polymorphisms and clinical parameters to predict clinically relevant toxicity associated with fluoropyrimidine and platinum-based chemotherapy in gastric cancer
(2021) Cordova-Delgado, Miguel; Bravo, María Loreto; Cumsille, Elisa; Hill, Charlotte N.; Muñoz-Medel, Matías; Pinto, Mauricio P.; Retamal, Ignacio N.; Lavanderos, María A.; Miquel, Juan Francisco; Rodriguez-Fernandez, Maria; Liao, Yuwei; Li, Zhiguang; Corvalán, Alejandro H.; Armisén, Ricardo; Garrido, Marcelo; Quiñones, Luis A.; Owen, Gareth I.
Background: Fluoropyrimidine plus platinum chemotherapy remains the standard first line treatment for gastric cancer (GC). Guidelines exist for the clinical interpretation of four DPYD genotypes related to severe fluoropyrimidine toxicity within European populations. However, the frequency of these single nucleotide polymorphisms (SNPs) in the Latin American population is low (< 0.7%). No guidelines have been development for platinum. Herein, we present association between clinical factors and common SNPs in the development of grade 3–4 toxicity. Methods: Retrospectively, 224 clinical records of GC patient were screened, of which 93 patients were incorporated into the study. Eleven SNPs with minor allelic frequency above 5% in GSTP1, ERCC2, ERCC1, TP53, UMPS, SHMT1, MTHFR, ABCC2 and DPYD were assessed. Association between patient clinical characteristics and toxicity was estimated using logistic regression models and classification algorithms. Results: Reported grade ≤ 2 and 3–4 toxicities were 64.6% (61/93) and 34.4% (32/93) respectively. Selected DPYD SNPs were associated with higher toxicity (rs1801265; OR = 4.20; 95% CI = 1.70–10.95, p = 0.002), while others displayed a trend towards lower toxicity (rs1801159; OR = 0.45; 95% CI = 0.19–1.08; p = 0.071). Combination of paired SNPs demonstrated significant associations in DPYD (rs1801265), UMPS (rs1801019), ABCC2 (rs717620) and SHMT1 (rs1979277). Using multivariate logistic regression that combined age, sex, peri-operative chemotherapy, 5-FU regimen, the binary combination of the SNPs DPYD (rs1801265) + ABCC2 (rs717620), and DPYD (rs1801159) displayed the best predictive performance. A nomogram was constructed to assess the risk of developing overall toxicity. Conclusion: Pending further validation, this model could predict chemotherapy associated toxicity and improve GC patient quality of life.
A Chair-based Abbreviated Repositioning Maneuver (ChARM) for fast treatment of posterior BPPV
(2019) Michael, Pia; Muñoz, Daniel; Tuma, Anton; Gárate, Matías; Barraza, Cristian; Nuñez, Marcia; Breinbauer, Hayo
Purpose: To assess the effectiveness of a variation of the Epley maneuver, which we have titled "Chair-based Abbreviated Repositioning maneuver (ChARM)", in solving cases of benign positional paroxysmal vertigo (BPPV) of the posterior canal. ChARM addresses multiple issues of highly overloaded medical centers that delay its due and timely resolution. For example it does not necessitate an examination bed/table and requires only a backed chair, and less than 3 min to be performed. In combination with a recently published abbreviated diagnostic maneuver it can solve BPPV cases within few minutes of single medical visit. Methods: Patients being diagnosed with posterior BPPV by means of an abbreviated diagnostic maneuver were recruited. Immediately after diagnosis, a single attempt of ChARM was conducted. The patient was followed for 48 h and at 1 month after these procedures to assess the persistence of symptomatology. Results: 124 patients were treated with ChARM immediately after diagnosis during their very first medical visit. 92 patients (74.2%) solved their symptomatology completely after a single attempt of ChARM. The absence of symptoms persisted during the 30 days of follow-up. Discussion: ChARM showed high success rates in solving posterior BPPV. The entire diagnostic-treatment procedure takes less than 5 min to perform and may allow direct treatment of patients, thereby avoiding unnecessary referrals or full vestibular testing. These abbreviated tools may be particularly useful in primary care settings or heavily overloaded otolaryngology or neurology departments.
A changing etiologic scenario in liver transplantation for hepatocellular carcinoma in a multicenter cohort study from Latin America
(2018) Pinero, Federico; Costa, Paulo; Longatto Boteon, Yuri; Hoyos Duque, Sergio; Marciano, Sebastián; Anders, Margarita; Varóng, Adriana; Zerega, Alina; Poniachik, Jaime; Soza, Alejandro; Padilla Machaca, Martín; Menéndez, Josemaría; Zapata, Rodrigo; Vilatoba, Mario; Muñoz, Linda; Maraschio, Martín; Podestá, Luis G.; McCormack, Lucas; Gadano, Adrian; Boinc, Ilka S.F. Fatima; García, Parente; Silva, Marcelo; On behalf of the Latin American Liver Research, Education, Awareness Network (LALREAN)
Background and aim: Non-alcoholic fatty liver disease (NAFLD) is an increasing cause of hepatocellular carcinoma (HCC) and liver transplantation (LT). Our study focused on changing trendsof liver related HCC etiologies during the last years in Latin America. Methods: From a cohort of 2761 consecutive adult LT patients between 2005 and 2012 in 17 different centers, 435 with HCC were included. Different periods including years 2005—2006, 2007—2008, 2009—2010 and 2011—2012 were considered. Etiology of liver disease was confirmed in the explant. Results: Participating LT centers per country included 2 from Brazil (n = 191), 5 transplant programs from Argentina (n = 98), 2 from Colombia (n = 65), 4 from Chile (n = 49), 2 from Mexico (n = 12), and 1 from Peru (n = 11) and Uruguay (n = 9). Chronic hepatitis C infection was the leading cause of HCC in the overall cohort (37%), followed by HBV (25%) and alcoholic liver disease (17%). NAFLD and cryptogenic cirrhosis accounted for 6% and 7%, respectively. While HCV decreased from 48% in 2005—06 to 26% in 2011—12, NAFLD increased from 1.8% to 12.8% during the same period, accounting for the third cause of HCC. This represented a 6-fold increase in NAFLD-HCC, whereas HCV had a 2-fold decrease. Patients with NAFLD were older, had lower pre-LT serum AFP values and similar 5-year survival and recurrence rates than non-NAFLD. Conclusion: There might be a global changing figure regarding etiologies of HCC in Latin America. This epidemiological change on the incidence of HCC in the world, although it has been reported, should still be confirmed in prospective studies.
A Chilean Experience of Telestroke in a COVID-19 Pandemic Year
(2022) Delfino, Carlos; Mazzon, Enrico; Cavada, Gabriel; Muñoz Venturelli, Paula; Brunser, Alejandro; Jurado, Felipe; Lara, Lorena; Rocha, Diego; Arévalo, Mirya; Rojas, Diego; Mansilla, Eloy
Background and purpose: Telemedicine for stroke patients' care (telestroke [TS]) has grown notably in recent decades and may offer advantages during health crisis. Hospital admissions related to stroke have decreased globally during the COVID-19 pandemic, but scarce information is available regarding the effect of COVID-19 in TS. Using a population-based TS registry, we investigated the impact of the first year of the COVID-19 pandemic throughout our TS network in Santiago, Chile. Methods: Stroke codes evaluated after the onset of COVID-19 restrictions in Chile (defined as March 15, 2020) were compared with those evaluated in 2019. We analyzed differences between number of stroke codes, thrombolysis rate, stroke severity, and time from the stroke onset to hospital admission. Results: We observed that the number of stroke codes and the number of patients undergoing reperfusion therapy did not change significantly (p = 0.669 and 0.415, respectively). No differences were found with respect to the median time from the stroke onset to admission (p = 0.581) or in National Institutes of Health Stroke Scale (NIHSS) scores (p = 0.055). The decision-making-to-needle time was significantly shorter in the COVID-19 period (median 5 min [IQR 3-8], p < 0.016), but no significant changes were found at the other times. Conclusions: This study demonstrates the potential of adapting TS to extreme situations such as the COVID-19 pandemic, as well as the importance of establishing networks that facilitate patient access to quality treatments.
A Chip Off the Old Block: Do Reading-Motivated Parents Raise Reading-Motivated Children?
(2023) Cubillos, Montserrat
The aim of this study was to investigate the relationship between parents’ reading motivation and leisure reading frequency and their children’s reading motivation. Secondary data analysis was used to examine a sample of almost 330,000 Chilean adolescents. The results of multilevel regression models revealed that parents’ reading motivation and frequency were significantly and positively associated with adolescents’ reading motivation, even after controlling for their classmates’ and their own previous reading achievement. Furthermore, the negative and significant association found between students’ reading motivation and their socioeconomic status was smaller in effect size than that of parents’ reading motivation and frequency combined. The implications and limitations of these findings are also discussed.
A cien años de la Bauhaus : conexiones, ideales y materialización de un proyecto utópico
(2022) Frindt Garretón,María Valeria
En el presente artículo se exponen algunas ideas resultantes de las reflexiones en torno a la Bauhaus en cursos de Historia del Diseño realizados durante los últimos años. El diseño, como disciplina, es relativamente nuevo, propio del contexto Moderno posterior a la Revolución Industrial. En su corta trayectoria ha permitido que muchas personas mejoren su calidad de vida, gracias a innovaciones que ha incorporado y a la masificación de objetos bien hechos. A pesar de que muchos la ven como una profesión vanidosa, sus orígenes permitieron nuestra subsistencia y, actualmente, una vez cubiertas las necesidades básicas, se ha convertido en una potente herramienta de desarrollo social.

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