Browsing by Author "Eduardo Fuentes-López"

Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    Active alcohol consumption is associated with acute-on-chronic liver failure in Hispanic patients
    (2023) Francisco Idalsoaga; Luis Antonio Díaz; Eduardo Fuentes-López; Gustavo Ayares; Francisco Valenzuela; Victor Meza; Franco Manzur; Joaquín Sotomayor; Hernán Rodriguez; Franco Chianale; Sofía Villagrán; Maximiliano Schalper; Pablo Villafranca; Maria Jesus Veliz; Paz Uribe; Maximiliano Puebla; Pablo Bustamante; Herman Aguirre; Javiera Busquets; Juan Pablo Roblero; Gabriel Mezzano; Maria Hernandez-Tejero; Marco Arrese; Juan Pablo Arab
    Background Acute-on-chronic liver failure (ACLF) is a severe clinical entity associated with elevated short-term mortality. We aimed to characterize patients with decompensated cirrhosis according to presence of ACLF, their association with active alcohol intake, and long-term survival in Latin America. Methods Retrospective cohort study of decompensated cirrhotic in three Chilean university centers (2017-2019). ACLF was diagnosed according EASL-CLIF criteria. We assessed survival using competing-risk and time-to-event analyses. We evaluated the time to death using accelerated failure time (AFT) models. Results We included 320 patients, median age of 65.3 ± 11.7 years old, and 48.4% were women. 92 (28.7%) patients met ACLF criteria (ACLF-1: 29.3%, ACLF-2: 27.1%, and ACLF-3: 43.4%). The most common precipitants were infections (39.1%), and the leading organ failure was kidney (59.8%). Active alcohol consumption was frequent (27.7%), even in patients with a prior diagnosis of non-alcoholic fatty liver disease (NAFLD) (16.2%). Ninety-two (28.7%) patients had ACLF (ACLF-1: 8.4%, ACLF-2: 7.8%, and ACLF-3: 12.5%). ACLF patients had a higher MELD-Na score at admission (27 [22-31] versus 16 [12-21], p < 0.0001), a higher frequency of alcohol-associated liver disease (36.7% versus 24.9%, p = 0.039), and a more frequent active alcohol intake (37.2% versus 23.8%, p = 0.019). In a multivariate model, ACLF was associated with higher mortality (subdistribution hazard ratio 1.735, 95%CI: 1.153-2.609; p < 0.008). In the AFT models, the presence of ACLF during hospitalization correlated with a shorter time to death: ACLF-1 shortens the time to death by 4.7 times (time ratio [TR] 0.214, 95%CI: 0.075-0.615; p < 0.004), ACLF-2 by 4.4 times (TR 0.224, 95%CI: 0.070-0.713; p < 0.011), and ACLF-3 by 37 times (TR 0.027, 95%CI: 0.006-0.129; p < 0.001). Conclusions Patients with decompensated cirrhosis and ACLF exhibited a high frequency ofactive alcohol consumption. Patients with ACLF showed higher mortality and shorter time todeath than those without ACLF.
  • No Thumbnail Available
    Item
    Adaptation of the “active communication education” programme into Spanish for older adults with hearing loss
    (2020) Sebastián Rivera; Anthony Marcotti; Adrian Fuente; Eduardo Fuentes-López; Louise Hickson
    Objective: To adapt the Active Communication Education (ACE) programme into Spanish. In addition, this study aimed at determining the effects of the adapted ACE programme on the social/emotional impacts of hearing loss and hearing functioning in a group of older adults with hearing loss who do not wear hearing aids. Design: This was an exploratory cohort study. Study group participants received the newly adapted ACE programme and control group participants received a cognitive stimulation programme. The Shortened Hearing Handicap Inventory for the Elderly in Spanish (HHIE-S) and the Spanish version of the Amsterdam Inventory for Auditory Disability and Handicap (S-AIADH) were carried out before and after each programme. Study sample: Sixty-six older adults with hearing loss and who did not wear hearing aids were randomly assigned to either an ACE group (n = 30) or a cognitive stimulation group (n = 36). Results: Participants who received the ACE programme showed a significantly larger improvement for the S-AIADH than did the cognitive stimulation group participants. Conclusions: The ACE programme has been adapted into Spanish for use with Chilean older adults with hearing loss. The results show that older adults report better functioning in listening situations after attending the sessions of the adapted ACE programme.
  • Thumbnail Image
    Item
    Sensibilidad y especificidad del Test ScreeLing en usuarios afásicos en etapa aguda: un análisis preliminar
    (2020) Valentina Mora-Castelletto; Camila Hermosilla-Gotschlich; Constanza Márquez-Espinoza; Sofía Puelma-Pistelli; Paulina Valdés-Flatow; Josette Sáez-Martínez; Bernardita Letelier-Vera; Eduardo Fuentes-López; Carolina Méndez-Orellana
    En Chile, entre un 20% y un 38% de los usuarios que sufren un ataque cerebro-vascular (ACV) presentan afasia. Pese a su alta prevalencia no existen herramientas validadas que permitan realizar una caracterización lingüística temprana de la afasia. Por lo anterior, el objetivo del presente trabajo es analizar la sensibilidad y especificidad de la versión en español del ScreeLing en una muestra de usuarios afásicos después de producido un ACV. Se trata de un estudio transversal analítico en el cual se aplicó el test ScreeLing a 13 usuarios afásicos tras primer evento de ACV en etapa aguda (< 6 semanas tras ACV) y a 56 adultos neurológicamente sanos. Adicionalmente, se evaluó el nivel comprensivo y el lenguaje espontáneo de usuarios con afasia, con la versión abreviada del Token Test y Escala de Severidad de la Afasia (ASRS). Se construyeron modelos mediante regresiones logísticas, obteniendo sus respectivas áreas bajo la curva ROC. Los resultados muestran que el equilibrio entre sensibilidad y especificidad para el puntaje global del test ScreeLing se estableció en 67 puntos, obteniendo una sensibilidad del 94,6% y especificidad del 100%. El área bajo la curva ROC alcanzó 0,99 (IC 95%: 0,97-1,00). En las subpruebas sintáctica y fonológica se alcanzó un puntaje de corte de 21 puntos, mientras que en la subprueba semántica se lograron 22 puntos. Se concluye que el ScreeLing en español posee una alta sensibilidad y especificidad para la detección de déficits lingüísticos post ACV similar a los resultados encontrados en la versión original del test en holandés. Esfuerzos futuros deben concentrarse en ampliar la muestra de usuarios afásicos con distintos perfiles de severidad.