Browsing by Author "Mardones, Francisco"

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    A weight gain chart for pregnant women designed in Chile
    (WILEY, 2005) Mardones, Francisco; Rosso, Pedro
    The weight gain chart for pregnant women, developed by Rosso and Mardones (RM chart, 1997), is analysed and compared with other charts in terms of its usefulness for targeting nutritional interventions aimed at preventing low or high birth weights. The RM chart defines categories of maternal nutritional status in early gestation based on weight/height, expressed either as percentage of standard weight (PSW) or body mass index (BMI), and desirable gestational weight gains for each of these categories. Weight gain recommendations of the RM chart are proportional to maternal height. For underweight women the weight recommendation was derived from actual data, while for overweight and obese women it is based on data extrapolations. Since 1987 the Chilean National Health Service has used the RM chart as a standard in prenatal care in all its clinics, covering approximately 70% of the country's population, mostly middle and low income women. During the 1987-2001 period the proportion of underweight pregnant women and infants with birth weight <3000 g decreased significantly and proportionally. Nevertheless, the proportion of obese pregnant women and infants with birth weight >= 4000 g increased during this period. Multifactorial social changes including a decade of substantial economic growth in the country with improved family income, precludes the possibility of determining the efficacy of the RM chart in this group. However, the widespread use of the RM chart indicates that it is a helpful and easy-to-use instrument in the field. Further, by its clear graphical presentation of maternal nutritional status it helps draw the attention of health personnel to women who need special nutritional advice and support.
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    ASSOCIATION BETWEEN PERINATAL FACTORS AND COMPONENTS OF THE METABOLIC SYNDROME AND INSULIN RESISTANCE IN CHILDREN OF PUENTE ALTO, SANTIAGO, CHILE
    (2013) Mardones, Francisco; Pacheco, M.; Dominguez, Angélica; Villarroel del Pino, Luis A.; Eriksson, J. G.; Arnáiz Gómez, Pilar; Barja Y., Salesa; Castillo Valenzuela, Oscar; Farías Jofré, Marcelo
    Background and objectives: we have previously studied the association of prenatal growth with metabolic syndrome (MS) components, including insulin resistance (IR), in about two thousand Chilean low-income urban school-age children (J Devel Orig Health Dis. 2012; 3(4): 237-244). We aim to ascertain with a higher sample size the influence of the above mentioned variables. Methods: retrospective cohort study linking information on MS and IR in school-age, with perinatal records. 3325 children were enrolled in schools in the district of Puente Alto (Santiago, Chile) during 2009-2011. Anthropometry and blood pressure (BP) were assessed. A blood sample for determination of glycemia, insulinemia (quimioluminiscence) and blood lipids was taken; HOMA was calculated and a national standard was applied to select HOMA-IR cases. Cook et al standard was used to define MS. We used Pearson correlation, chi-square test and logistic regression step-by-step. Linear and quadratic associations were tested with Poisson regression. Results: 3290 children had complete information at birth (98.9%) 52.01% women; aged 11.4 + 1 years. The prevalence of MS and IR was 7.26% and 25.47%, respectively. Logistic regression analysis showed an inverse association between birth length (BL), gestational age and birth weight (BW) with most dependent variables studied. However BW showed a direct association with the majority of the dependent variables studied. The waist circumference > 90th percentile, BP > 90th percentile and triglycerides > 110 mg/dl were associated with U-shaped BW, BL and ponderal index, respectively. Conclusions: In this new study we could demonstrate a higher number of U-shaped associations with perinatal variables. New studies with higher sample sizes would permit to show this kind of associations and improve our understanding of the early origins of metabolic diseases.
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    Association of carotid intima media thickness with blood pressure and HDL cholesterol in children
    (SOC MEDICA SANTIAGO, 2012) Arnaiz, Pilar; Villarroel, Luis; Barja, Salesa; Godoy, Ivan; Cassis, Berta; Dominguez, Angelica; Castillo, Oscar; Farias, Marcelo; Carvajal, Jacqueline; Cristina Tinoco, Ana; Mardones, Francisco
    Background: Cardiovascular risk factors must be controlled since childhood. Aim: To assess the association of carotid intima media thickness (CIMT) with the components of the metabolic syndrome in Children. Material and Methods: Cross sectional assessment of 299 children aged 11.5 +/- 0.9 years (58% women) with and without metabolic syndrome components. Anthropometric parameters and blood pressure were measured and a blood sample was obtained to measure blood glucose and lipids. CIMT was measured using high resolution ultrasound. Results: Ninety three percent of children were post puberal, 64% were overweight and 25% had metabolic syndrome. Mean and maximum CIMT correlated with systolic blood pressure (r = 0.21 and 0.21 respectively p < 0.01). Children with a CIMT over the 75th percentile had higher blood pressure and lower HDL cholesterol. A stepwise logistic regression accepted both variables as predictors of CIMT with odds ratios for mean CIMT of 1.46 (1.19-1-79) and 0.81 (0.7-0.94) per five units of change, respectively. Conclusions: In this group of children systolic blood pressure and HDL cholesterol are associated to CIMT. (Rev Med Chile 2012; 140: 1268-1275).
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    Association of perinatal factors and obesity in 6-to 8-year-old Chilean children
    (OXFORD UNIV PRESS, 2008) Mardones, Francisco; Villarroel, Luis; Karzulovic, Lorena; Barja, Salesa; Arnaiz, Pilar; Taibo, Marcela; Mardones Restat, Francisco
    Background It has been reported in Chile that obesity figures in children of 6- to 8-years-old are associated with height for age. We studied the possible influence of perinatal variables on obesity at 6- to 8-years-old controlling for height for age.
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    ASSOCIATION OF SUBCLINICAL ATHEROSCLEROSIS WITH DIFFERENT STANDARDS OF THE METABOLIC SYNDROME AND INSULIN RESISTANCE
    (2013) Arnai, P.; Dominguez, Angélica; Barja Y., Salesa; Godoy, I.; Villarroel del Pino, Luis A.; Castillo Valenzuela, Oscar; Farías Jofré, Marcelo; Mardones, Francisco
    Background and objectives: we have previously selected two metabolic syndrome (MS) components blood pressure (BP) and high density lipoprotein cholesterol (HDLC) as associated with carotid intima media thickness (CIMT) a surrogate marker of subclinical atherosclerosis in children (Rev Med Chile 2012; 140: 1268-75). We aimed to ascertain with a higher sample size the influence of the above mentioned variables and three standards defining the MS plus three standards defining insulin resistance (IR). Methods: A cross-sectional study of 447 children 10-14 years old of low socio-economic strata from an urban area of Chile was performed during years 2009-2011. This sample was selected considering the presence of one or more MS component and IR. Anthropometry and BP were assessed. A blood sample for determination of glycaemia, insulinemia (quimioluminiscence) and blood lipids were taken; HOMA was calculated and three standards were applied to select HOMA-IR cases. Three standards to define MS were also used. Medium CIMT was assessed using ultrasonography with automated software. Chi-squared test and stepwise regression were used. Results: Mean age was 11.5 ±1.0 years old; 59% girls; 92.6% pubertal; 72% excess weight. Three standards for MS had prevalence of 24.4% (Cook, 2004), 14.1% (IDF, 2007), 42.9% (De Ferranti, 2004). Three standards for HOMA-IR had the following prevalence: 15.2% (Barja, 2011), 37.4% (Burrows, 2006), 23.0% (De Onis, 2012). Elevated blood pressure and reduced CHDL had significant associations with CIMT ≥ percentile 75. The logistic regression for CIMT ≥ percentile 75 only selected BP ≥ percentile 90 (OR = 2.963) and CHDL < 40 mg/dL (OR = 1.789) Conclusions: None of the various classifications for the MS and the HOMA-IR were selected in the multivariate analysis confirming the previously found influence of increased BP and reduced CHDL on medium CIMT.
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    Ateroesclerosis subclinica y sindrome metabolic en ninos
    (AULA MEDICA EDICIONES, 2013) Arnaiz, Pilar; Barjal, Salesa; Villarroel, Luis; Dominguez, Angelica; Godoy, Ivan; Castillo, Oscar; Farias, Marcelo; Mardones, Francisco
    Introduction: Metabolic syndrome (MS) in children has been associated to subclinical atherosclerosis as estimated by carotid intima-media thickness (CIMT).
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    Ateroesclerosis subclínica y síndrome metabólico en niños
    (2013) Arnáiz Gómez, Pilar; Barja Y., Salesa; Villarroel del Pino, Luis A.; Domínguez, Angélica; Godoy J., Iván; Castillo Valenzuela, Oscar; Farías Jofré, Marcelo Enrique; Mardones, Francisco
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    Comparison of Three Gestational Weight Gain Guidelines Under Use in Latin America
    (FRONTIERS MEDIA SA, 2021) Mardones, Francisco; Rosso, Pedro; Erazo, Alvaro; Farias, Marcelo
    Presently, three guidelines are used in Latin America to assess adequacy of maternal body mass index (BMI) during pregnancy: (1) the chart proposed by the Institute of Medicine of the United States (IOM), (2) the Rosso-Mardones Chart (RM), and (3) a modified RM chart proposed by Atalah et al. (AEA). The aim of the present review was to explore available information on the sensitivity, specificity, and both positive (PPV) and negative predictive values (NPV) of these charts to detect women at risk of delivering babies with the following signs of abnormal fetal growth: (a) length at birth (BL) <50 cm; (b) birth weight (BW) <3,000 g; and (c) BW >= 4,000 or 4,250 g. Data from studies conducted in large samples of Chilean and Uruguayan women indicate that the RM chart has the greatest sensitivity to identify at risk cases. However, predictive values were similar for the three charts. Thus, the use of the RM chart should be preferred. The main limitation for using the IOM weight gain recommendations in Latin American women stems from the fact that their average height is approximately 20 cm lower than US women.
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    COMPARISON OF TWO PREGNANCY NUTRITIONAL EVALUATION STANDARDS IN ADOLESCENT CHILEAN PREGNANT WOMEN
    (2017) Villalobos Restovic, Andrea; Mardones, Francisco; Rosso R., Pedro Pablo; Farías Jofré, Marcelo; Villarroel del Pino, Luis A.; Bacallao, Jorge; Rojas, Ivan
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    COMPARISON OF TWO PREGNANCY NUTRITIONAL EVALUATION STANDARDS USING NATIONAL DATA FROM URUGUAY
    (2017) Mardones, Francisco; Gonzalez, Nely; Bove, Maria Isabel; Rosso R., Pedro Pablo; Villarroel del Pino, Luis A.; Bacallao, Jorge; Farías Jofré, Marcelo
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    Composición corporal de neonatos con alteraciones en el crecimiento fetal
    (1999) Mardones, Francisco; Bastías, Gabriel; Farías Jofré, Marcelo; Dinamarca V., Raúl; Olavarría FM., Fernando; Rada G., Gabriel; Rojas González, Álvaro Miguel; Rojas González, Pamela
    Con el objetivo de estudiar la asociación entre la composición corporal en recién nacidos con el peso al nacer y las alteraciones del crecimiento fetal, se estimó las masas magra y grasa de 224 recién nacidos de familias de bajos ingresos en Santiago de Chile, utilizando el método antropométrico de Dauncey. En el total de estos niños sanos de término la proporción de masa grasa fue 16,5%. Hubo una fuerte y significativa asociación positiva del peso al nacer con la masa magra (r2 = 88,9%) y con la masa grasa (r2= 58,2%). Aunque la masa grasa constituyó sólo 16,5% del peso al nacer, explicó una gran proporción de su varianza (58,2%). En los neonatos con retardo del crecimiento fetal o con bajo índice ponderal hubo una composición corporal particular. Esos recién nacidos tuvieron valores absolutos inferiores tanto de la masa grasa como de la masa magra, pero sólo la masa grasa fue proporcionalmente menor que en los niños normales o con sobrepaso. El déficit nutricional de estos niños está asociado con un mayor riesgo de afecciones perinatales, por lo que debiera ser prevenido con una adecuada alimentación de la madre durante el embarazo. Los resultados obtenidos, similares a los de estudios previos en países desarrollados, sugieren que la estimación de la composición corporal podría ser útil para evaluar el crecimiento fetal al momento del nacimiento.
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    Effects of a dairy product fortified with multiple micronutrients and omega-3 fatty acids on birth weight and gestation duration in pregnant Chilean women
    (CAMBRIDGE UNIV PRESS, 2008) Mardones, Francisco; Urrutia, Maria Teresa; Villarroel, Luis; Rioseco, Alonso; Castillo, Oscar; Rozowski, Jaime; Tapia, Jose Luis; Bastias, Gabriel; Bacallao, Jorge; Rojas, Ivan
    objective: To test the hypothesis that maternal food fortification with omega-3 fatty acids and multiple micronutrients increases birth weight and gestation duration, as primary outcomes.
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    Influencia combinada del índice de masa corporal pregestacional y de la ganancia de peso en el embarazo sobre el crecimiento fetal
    (SOC MEDICA SANTIAGO, 2011) Mardones, Francisco; Garcia Huidobro, Trinidad; Ralph, Constanza; Farias, Marcelo; Dominguez, Angelica; Rojas, Ivan; Teresa Urrutia, M.
    Background: The Chilean Ministry of Health has been using standards for nutritional evaluation and weight gain recommendations during pregnancy in the last 25 years. In the meantime new standards have been developed. Aim: To study the combined influence of preconception maternal nutritional status and gestational weight gain, using new standards to classify those parameters, on perinatal outcomes. Material and Methods: A cohort of 11,465 healthy pregnant women was prospectively followed until term. Their pre-gestational nutritional status was classified using the body mass index cut-offs in use in the United States (USA). Their gestational weight gain was classified using categories proposed in a Danish study. Perinatal outcomes included were risky birth weight, i.e. < 3000 g and >= 4000 g, and cesarean delivery Relative risks for those perinatal outcomes were calculated for all combined categories of pre-gestational nutritional status and gestational weight gain. Results: Relative risks of almost all gestational weight gain results were statistically significant for women having a normal pre-gestational nutritional status meanwhile all of them were not significant for underweight women. Overweight and obese women had similar relative risks values as normal women. However, many of them were not significant, especially in obese women. Conclusions: There is an independent and combined influence of preconception nutritional status and gestational weight gain on perinatal outcomes, when using standards to classify those parameters developed in the USA and Denmark, respectively (Rev Med Chile 2011; 139: 710-716).
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    Neonates from women with pregestational maternal obesity show reduced umbilical vein endothelial response to insulin
    (2019) Villalobos Labra, Roberto Esteban; Westermeier, F.; Pizarro, C.; Sáez Pedraza, Pablo José; Pardo, F.; Kusanovic, Juan Pedro; Mardones, Francisco; Poblete L., José A.; Sobrevía Luarte, Luis Alberto; Farías Jofré, Marcelo Enrique; Toledo, F.
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    Normal plasma insulin and HOMA values among chilean children and adolescents
    (SOC MEDICA SANTIAGO, 2011) Barja, Salesa; Arnaiz, Pilar; Dominguez, Angelica; Villarroel, Luis; Cassis, Berta; Castillo, Oscar; Salomo, Gianina; Farias, Marcelo; Goycoolea, Manuela; Quiroga, Teresa; Mardones, Francisco
    Background: Plasma insulin and HOMA (homeostasis model assessment) index, used to determine insulin resistance, do not have local standard values for children and adolescents in Chile. Aim: To establish the normal reference intervals for insulin and HOMA in children and adolescents aged 10-15 years, according to sex and puberal maturation. Material and Methods: A cross-sectional study of 2,153 children and adolescents from Puente Alto County was performed, during 2009 and 2010. Anthropoinetry and self-report of puberal maturation were assessed. Fasting glucose (hexoquinase) and insulin blood levels (chemiluminiscence), were determined and HOMA index was calculated. Percentile distributions of these variables were calculated. Results: The reference group included only subjects with normal body mass index and fasting blood glucose (n = 1,192). Girls had higher insulin and HOMA values than boys (12.5 +/- 6.0 and 9.1 +/- 4.9 mu U/mL (p <0.01) and 2.7 +/- 1.4 and 2.1 +/- 1,1 (p <0.01), respectively). Subjects with Tanner land II puberal stages had lower insulin and HOMA mean values than subjects with Tanner III and IV (9.0 +/- 4.3 and 12.5 +/- 6.2 mu U/ml (p < 0.01) and 2.0 +/- 1 and 2.8 +/- 1.4 (p <0.01), respectively). Conclusions: The 90th percentile of insulin and HOMA distributions according to sex and maturation, was selected as the upper cut-off point to identify individuals with insulin resistance. HOMA cutoff point for Tanner I and II boys was 3.2, for Tanner land II girls was 4.1, for Tanner III and IV boys was 4.2 and for Tanner III and IV girls was 5.0. (Rev Med Chile 2011; 139: 1435-1443).
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    NUTRITIONAL STATUS, METABOLIC SYNDROME AND INSULIN RESISTANCE IN CHILDREN FROM SANTIAGO (CHILE)
    (ARAN EDICIONES, S L, 2013) Mardones, Francisco; Arnaiz, Pilar; Barja, Salesa; Giadach, Carolina; Villarroel, Luis; Dominguez, Angelica; Castillo, Oscar; Farias, Marcelo
    Background: The origin of most non-communicable diseases (NCDs) is in early life. Consequently obtaining information on risk factors for NCDs is important for preventive purposes. However, there is no information available on the prevalence of obesity, metabolic syndrome (MS) and insulin resistance (IR) in Chilean children.
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    Regarding: Impact of the change of the Atalah standard cut-off point to classify underweight nutritional status during pregnancy
    (SOC CHILENA NUTRICION, BROMATOLOGIA & TOXICOLOGIA, 2022) Mardones, Francisco; Rosso, Pedro; Erazo, Alvaro; Farias, Marcelo
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    Relación médico-paciente en la Pontificia Universidad Católica de Chile: evaluación de una escala de medición
    (SOC MEDICA SANTIAGO, 2012) Rodriguez, Angel; Mardones, Francisco; Villarroel, Luis
    Background: Beneficence, respecting autonomy of patients to make their own decisions, is crucial for good physician-patient relations (PPR), a leading objective in health care. Aim: To validate a previously designed scale to assess PPR in Chile. Material and Methods: A scale with 55 questions grouped in six dimensions, was applied to a convenience sample of 146 individuals, composed by physicians, patients and medical students, at the school of medicine from the Pontificia Universidad Catolica de Chile (PUC). Internal consistency (Alpha of Cronbach) of answers was analyzed. The existence of correlations between answers that may justify the application of a factorial analysis was assessed using Bartlett and Kaiser-Meyer-Olkin (KMO) tests. Factorial analysis was used to identify specific dimensions and reduce the number of questions. Results: Factorial analysis performed in 125 subjects with complete answers allowed to reduce the scale to 28 questions, grouped in six dimensions. Cronbach alpha value was 0.78. Bartlett test was highly significant (p <0.0001), and KMO score was 0.784, considered as meritorious. Conclusions: The validated scale will allow the performance of new studies among physicians and patients, to assess and compare their respective scores. (Rev Med Chile 2012; 140: 176-185).