Browsing by Author "Hernandez Rocha, Cristian"

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    Clostridium difficile associated infections: an updated view
    (SOC CHILENA INFECTOLOGIA, 2012) Hernandez Rocha, Cristian; Naour, Sebastian; Alvarez Lobos, Manuel; Paredes Sabja, Daniel
    Clostridium difficile is an emerging anaerobic, spore forming pathogen, recognized as the etiological agent of similar to 30% of antibiotic associated diarrheas. Clinical symptoms can fluctuate from mild to moderate diarrhea, pseudomembranous colitis and toxic megacolon. The incidence of C. difficile associated infections (CDAI) is similar to 1% of total hospitalized patients. CDAI has a mortality rate of similar to 1 to 5%, and a relapse rate of similar to 20%. The appearance of severe outbreaks of CDAI could be attributed to changes in the production of the two major virulence factors, the enterotoxins TcdA and TcdB, which produce massive epithelial damage. C. difficile spores play an essential role in transmission, initiation and persistence of CDAI. Recent advances in detection methods, development of novel therapies and prevention methods could allow a reduction on the frequency of CDAI. The objective of this review is to provide an updated view on the mechanisms of pathogenesis, epidemiology, risk factors, detection methods, treatment and prevention of CDAI.
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    Diagnóstico y manejo de colitis ulcerosa grave. Una mirada actualizada
    (2017) Hernandez Rocha, Cristian; Ibanez, Patricio; Elena Molina, Maria; Klaassen, Julieta; Valenzuela, Andrea; Candia, Roberto; Bellolio, Felipe; Zuniga, Alvaro; Miguieles, Rodrigo; Francisco Miquel, Juan; Chianale, Jose; Alvarez Lobos, Manuel
    Ulcerative Colitis (UC) is a chronic inflammatory disease involving the colon, with alternating periods of remission and activity. Exacerbations can be severe and associated with complications and mortality. Diagnosis of severe UC is based on clinical, biochemical and endoscopic variables. Patients with severe UC must be hospitalized. First line therapy is the use of intravenous corticoids which achieve clinical remission in most patients. However, 25% of patients will be refractory to corticoids, situation that should be evaluated at the third day of therapy. In patients without response, cytomegalovirus infection must be quickly ruled out to escalate to second line therapy with biological drugs or cyclosporine. Total colectomy must not be delayed if there is no response to second line therapy, if there is a contraindication for second line therapies or there are complications such as: megacolon, perforation or massive bleeding. An active management with quick escalation on therapy allows to decrease the prolonged exposure to corticoids, reduce colectomy rates and its perioperative complications.
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    Experience of continuing online education in gastroenterology for non specialist medical doctors
    (SOC MEDICA SANTIAGO, 2019) Isbej, Lorena; Uribe, Javier; Carrasco, Olga; Villarroel, Isaac; Pizarro, Margarita; Isabel Jiron, Maria; Sanhueza, Edgar; Alvarez Lobos, Manuel; Hernandez Rocha, Cristian; Rollan, Antonio; Monsalve, Ximena; Antonio Diaz, Luis; Alejandra Cerda, Maria; Kramer, Tomas; Munizaga, Fernando; Riquelme, Arnoldo
    Background: Continuing education is essential for health professions and online courses can be a good way for professional development. Aim: To describe the experience with online courses for continuing education in hepatology and gastroenterology and to analyze their educational impact. Material and Methods: A three years' experience in courses on liver diseases and digestive tract is described. Their curricular design, methodology, and the educational impact was analyzed using the four levels of the Kirkpatrick's model. Results: On average, there were 321 students per course (2015-2017). 94% were Chilean and 6% from abroad (20 countries). In the educational impact analysis, in level 1 "reaction": 93% said that the course fulfilled their expectations and 92% would recommend it. In level 2 "learning": 42% approved the courses. Level 3 "behavior" was not evaluated and level 4 "organizational change" highlighted that the traditional face-to-face continuing education model of Chilean Gastroenterology Society (SChG) changed to full distance model in these three courses, with 1284 students from South America, Asia and Europe, in a 3-years-period. Additionally, these programs were included in the Medical Society of Santiago (SMS) continuing education agenda. Conclusions: The alliance between the SMS and the SChG generated on line courses that meet the educational needs of physicians and medical students, with excellent results and student perception.