Person: Munoz Venturelli, Paula
Loading...
Email Address
Birth Date
Research Projects
Organizational Units
Job Title
Last Name
Munoz Venturelli
First Name
Paula
Name
3 results
¿Qué estás buscando?
Search Results
Now showing 1 - 3 of 3
Publication Disparities in Stroke Incidence Over Time by Sex and Age in Latin America and the Caribbean Region 1997 to 2021: A Systematic Review and Meta-Analysis(2023) Nuñez, Marilaura; Delfino, Carlos; Asenjo, Claudia; Schilling, Andrea; Lavados, Pablo; Anderson, Craig; Munoz Venturelli, PaulaBackground High-income country studies show unfavorable trends in stroke incidence (SI) in younger populations. We aimed to estimate temporal change in SI disaggregated by age and sex in Latin America and the Caribbean region. Methods and Results A search strategy was used in MEDLINE, WOS, and LILACS databases from 1997 to 2021, including prospective population-based observational studies with first-ever stroke incidence in Latin America. Reports without data broken down by age and sex were excluded. Risk of bias was assessed with The Joanna Briggs Institute's guide. The main outcomes were incidence rate ratio and relative temporal trend ratio of SI, comparing time periods before 2010 with after 2010. Pooled relative temporal trend ratios considering only studies with 2 periods in the same population were calculated by random-effects meta-analysis. Meta-regression analysis was used to evaluate incidence rate determinants. From 9242 records identified, 6 studies were selected including 4483 first-ever stroke in 4 101 084 individuals. Crude incidence rate ratio in younger subjects (<55 years) comparing before 2010:after 2010 periods showed an increase in SI in the past decade (incidence rate ratio, 1.37 [95% CI, 1.23-1.50]), in contrast to a decrease in older people during the same period (incidence rate ratio, 0.83 [95% CI, 0.76-0.89]). Overall relative temporal trend ratio (<55:≥55 years) was 1.65 (95 CI%, 1.50-1.80), with higher increase in young women (pooled relative temporal trend ratio, 3.08 [95% CI, 1.18-4.97]; P for heterogeneity <0.001). Conclusions An unfavorable change in SI in young people, especially in women, was detected in population-based studies in the past decade in Latin America and the Caribbean. Further investigation of the explanatory variables is required to ameliorate stroke prevention and inform local decision-makers. Registration URL: https://www.crd.york.ac.uk/prospero/ Identifier: CRD42022332563.Publication Sex Differences in Profile and In-Hospital Death for Acute Stroke in Chile: Data From a Nationwide Hospital Registry(2024) Nuñez, Marilaura; Allende, María; González, Francisca; Cavada, Gabriel; Anderson, Craig; Munoz Venturelli, PaulaBackground: Knowledge of local contextual sex differences in the profile and outcome for stroke can improve service delivery. We aimed to determine sex differences in the profile of patients with acute stroke and their associations with in-hospital death in the national hospital database of Chile. Methods and results: We present a retrospective cohort based on the analysis of the 2019 Chilean database of Diagnosis-Related Groups, which represents 70% of the operational expenditure of the public health system. Random-effects multiple logistic regression models were used to determine independent associations of acute stroke (defined by main diagnosis International Classification of Diseases, Tenth Revision [ICD-10] codes) and in-hospital death, and reported with odds ratios (ORs) and 95% CIs. Of 1 048 575 hospital discharges, 15 535 were for patients with acute stroke (7074 [45.5%] in women), and 2438 (15.6%) of them died during hospitalization. Differences by sex in sociodemographic and clinical characteristics were identified for stroke and main subtypes. After fully adjusted model, women with ischemic stroke had lower in-hospital death (OR, 0.79 [95% CI, 0.69-0.91]) compared with men; other independent predictors included age per year increase (OR, 1.03 [95% CI, 1.03-1.04]), chronic kidney disease (OR, 1.47 [95% CI, 1.20-1.80]), atrial fibrillation (OR, 1.50 [95% CI, 1.26-1.80]), and other risk factors. Conversely, for intracerebral hemorrhage, women had a higher in-hospital mortality rate than men (OR, 1.19 [95% CI, 1.02-1.40]); other independent predictors included age per year increase (OR, 1.009 [95% CI, 1.003-1.01]), chronic kidney disease (OR, 1.55 [95% CI, 1.23-1.97]), oral anticoagulant use (OR, 1.88 [95% CI, 1.37-2.58]), and other risk factors. Conclusions: Sex differences in characteristics and in-hospital death of hospitalized patients exist for acute stroke in Chile. In-hospital death is higher for acute ischemic stroke in men and higher for intracerebral hemorrhage in women. Future research is needed to better identify contributing factors.Publication Desigualdades en salud en Chile post COVID-19: adscripción y acceso efectivo según sexo y condición migrante(2025) Nuñez, Marilaura; Delgado, Iris; Matute, María Isabel; Cabieses, Báltica; Munoz Venturelli, PaulaIntroducción: En 2022, tras la pandemia de COVID-19, aproximadamente el 93% de los países de la Región de las Américas continuaron reportando interrupciones en los servicios esenciales de salud, con peores resultados en los grupos sociales vulnerables. El presente estudio busca describir las barreras de acceso a la atención médica en Chile, desagregadas por sexo y condición de migrante internacional. Métodos: Estudio transversal que analizó los resultados de la encuesta CASEN 2022 a personas ≥18 años. Se calculó la adscripción, el acceso efectivo y las barreras de salud según la condición de migrante internacional y el sexo. Se realizaron modelos de regresión logística múltiple ajustando por edad, ruralidad, nivel educativo, ocupación y quintil de ingresos. El modelo se expresó como Odds Ratio ajustado (ORadj) con un intervalo de confianza del 95% en STATA v.18.5. Resultados: En Chile, en el año 2022, un total de 14.767.688 personas participaron en este estudio, con una edad media de 45,4 años (DE: 17,8), de las cuales el 51,2% eran mujeres y el 9,27% migrantes. En cuanto al seguro de salud, el 3,11% de la población no estaba afiliada al sistema de salud, siendo los hombres (ORadj: 0,6; IC 95%: 0,54-0,68) y los inmigrantes (ORadj: 10,3; 8,78-12,15) los grupos más afectados. En cuanto al acceso efectivo, el 17,4% tenía necesidades de salud, con predominio del sexo femenino (ORadj: 1,3; IC 95%: 1,21-1,32). Sin embargo, de quienes tenían necesidades y las expresaron, el 39,2% expresó necesidades no satisfechas, con mayor probabilidad de mostrarlo en mujeres (ORadj: 1,2; IC 95%: 1,10-1,27). Conclusiones: En Chile, la cobertura del sistema de salud sigue siendo un desafío para los hombres y la población migrante. Observamos con preocupación los altos porcentajes de necesidades de salud insatisfechas, especialmente entre las mujeres. La intersección del sexo y la migración internacional revela una doble vulnerabilidad en el acceso a la atención médica que justifica un estudio más profundo.