Browsing by Author "Merino Lara, Tomas Rodrigo"

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    Barriers for research activities in residency programs: A mix-methods study
    (2023) Merino Lara, Tomas Rodrigo; Rojas Donoso, Viviana Isabel; Fuentes López, Eduardo; Sanchez Rojel, Cesar Giovanni; Pizarro Rojas, Margarita Alicia; Fuentes Cimma, Javiera Carolina; Cifuentes Aguila, Lorena Isabel; Cuello Fredes Mauricio Arturo; Carvajal Cabrera, Jorge Andrés; Balcells Marty, Maria Elvira; Riquelme Pérez, Arnoldo
    Introduction: Research activities have a positive impact on the performance of residents. However, information on research conducted by residents from developing countries is scarce. Our study sought to identify the barriers and facilitators for developing research in medical residency programs in a Latin-American faculty of medicine. Methods: A mixed methodology study design was carried out. We used a grounded theory approach for the qualitative phase, collecting data through semi-structured interviews and focus groups with faculty and residents. For the quantitative phase, surveys were administered to residents and teachers. We used factor analysis and scree plot (validity), Cronbach's alpha, and Intraclass correlation coefficient (reliability) to evaluate the surveys' psychometric properties. Results: Focus groups involving ten faculty members and 15 residents were conducted, and the following domains were identified: a) facilitators for resident participation, b) barriers, c) strategies for introducing research into the curriculum, d) arguments supporting research activities throughout medical residency, and e) profile of research-motivated residents. Both residents and faculty members identified a lack of protected time and adequate mentoring as the major barriers. A gender gap was found related to international publications (34% vs. 66% women/men); women perceived that research activities 'compete with other activities' (OR: 2.04, 95% CI 1.03 to 4.07). Conclusions: Research is highly valued by both residents and faculty members at a Latin-American university with a strong academic output. Major barriers to promoting research in this context include lack of protected time and effective mentoring, and gender gaps. Strategies proposed to improve research within medical residency programs include: establishing an interdisciplinary mentoring program between residents and researchers, promoting elective rotations, and rewarding proposals that consider gender equity.
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    Can histological grade and mitotic index replace Ki67 to determine luminal breast cancer subtypes?
    (2018) Oddo Benavides, David; Pulgar, Dahiana; Peña, José; Acevedo Claros, Francisco Nicolás; Razmilic Valdés, Dravna Nichi; Navarro Ortega, María Elena; Camus Appuhn, Mauricio Gonzalo; Merino Lara, Tomas Rodrigo; Sánchez, César; Pérez Sepúlveda, Alejandra Andrea; Villarroel, Alejandra; Galindo, Héctor; Elgueta, Nicole; Retamal, Ignacio
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    Clinical Significance of Accounting for Tissue Heterogeneity in Permanent Breast Seed Implant Brachytherapy Planning
    (2016) Mashouf, Shahrom; Fleury, Emmanuelle; Lai, Priscila; Merino Lara, Tomas Rodrigo; Lechtman, Eli; Beso, Alex; McCann, Claire; Pignol, Jean-Philippe
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    Eribulin-induced radiation recall dermatitis: a case report and brief review of the literature
    (2020) Tran, WT; Ibáñez Cáceres, Carolina.; Pinto, Mauricio P.; Sánchez Rojel, César Giovanni; Czarnota, GJ; Merino Lara, Tomas Rodrigo
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    Intensity-modulated radiotherapy versus radical prostatectomy in patients with localized prostate cancer: long-term follow-up
    (2013) Merino Lara, Tomas Rodrigo; San Francisco Reyes, Ignacio Felipe; Rojas, Pablo A.; Bettoli, Piero.; Zúñiga Díaz, Alvaro; Besa, Pelayo.
    Abstract Background The objective of this work was to assess the overall survival, cause-specific survival and biochemical failure-free survival of a contemporary cohort of patients with localized prostate cancer (PCa) treated with intensity-modulated radiation therapy (IMRT) or radical prostatectomy (RP). Methods We did a retrospective cohort study of our institution’s registry of patients undergoing either IMRT or RP between January 1999 and March 2010, and assessed Prostate Specific Antigen (PSA), age at diagnosis, Gleason score, and digital rectal examination. Two groups were separated according to RP or IMRT treatment and these groups were in turn divided into risk groups according to the D’Amico classification. Overall survival (OS), cause-specific survival (CSS), mortality from other causes (MOC), and biochemical disease-free survival (BDFS) were assessed. Results Twelve-hundred patients were included: 993 in the RP group and 207 in the IMRT group. The IMRT group had older age, PSA at diagnosis and a significantly higher percentage of cancer on the needle biopsy (p <0.001). Of the 207 patients who underwent IMRT, 54% presented comorbidities. Median follow-up was 91.7 months for the RP group and 76 months for the IMRT group. The OS at 5 and 7 was 96.2, and 93.7 for the RP group respectively and 88.4, and 83.1 for the IMRT group respectively (p <0.001). There were no significant differences in the CSS in relation to treatment received among the low- and high-risk groups, while in the intermediate-risk group, patients who underwent to RP had a higher CSS than patients who underwent IMRT (99.6% vs 94.1%, p = 0.003). The IMRT group had a significantly better BDFS than the RP group (86.4% vs. 74.3%, respectively, p = 0.016). Conclusions Patients treated with RP were significantly younger and had a better prognosis than patients treated using IMRT, and according to our results, RP had better outcomes in terms of OS while IMRT had greater MOC. Treatment modality did not affect the CSS.
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    Long-term risks of secondary cancer for various whole and partial breast irradiation techniques
    (2018) Hoekstra, Nienke; Fleury, Emmanuelle; Merino Lara, Tomas Rodrigo; Van der Baan, Peter; Bahnerth, Andy; Struik, Gerson; Hoogeman, Mischa; Pignol, Jean-Philippe
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    Measurement of Mean Cardiac Dose for Various Breast Irradiation Techniques and Corresponding Risk of Major Cardiovascular Event
    (2014) Merino Lara, Tomas Rodrigo; Fleury, Emmanuelle; Mashouf, Shahram; Helou, Joelle; McCann, Claire; Ruschin, Mark; Kim, Anthony; Makhani, Nadiya; Ravi, Ananth; Pignol, Jean-Philippe
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    Multimodal assessment of acute cardiac toxicity induced by thoracic radiotherapy in cancer patients : study protocol
    (2021) Merino Lara, Tomas Rodrigo; Pinto, Mauricio P.; Orellana Vargas, María Paz; Martínez, Gonzalo; Andía Kohnenkampf, Marcelo Edgardo; Muñoz Schuffenegger, Pablo; Acevedo Claros, Francisco Nicolás; Gabrielli, Luigi; Sánchez Rojel, César Giovanni; Pereira, Jaime
    Background : Today, cancer ranks as one of the leading causes of death. Despite the large number of novel available therapies, radiotherapy (RT) remains as the most effective non-surgical method to cure cancer patients. In fact, approximately 50% of all cancer patients receive some type of RT and among these 60% receive RT-treatment with a curative intent. However, as occurs with any other oncological therapy, RT treated patients may experience toxicity side effects that range from moderate to severe. Among these, cardiotoxicity represents a significant threat for premature death. Current methods evaluate cardiotoxic damage based on volumetric changes in the Left Ventricle Ejected Fraction (LVEF). Indeed, a 10% drop in LVEF is commonly used as indicator of cardiotoxicity. More recently, a number of novel techniques have been developed that significantly improve specificity and sensitivity of heart’s volumetric changes and early detection of cardiotoxicity even in asymptomatic patients. Among these, the Strain by Speckle Tracking (SST) is a technique based on echocardiographic analysis that accurately evaluates myocardial deformation during the cardiac cycle (ventricular and atrial function). Studies also suggest that Magnetic Resonance Imaging (MRI) is a high-resolution technique that enables a better visualization of acute cardiac damage. Methodology: This protocol will evaluate changes in SST and MRI in cancer patients that received thoracic RT. Concomitantly, we will assess changes in serum biomarkers of cardiac damage in these patients, including: high-sensitivity cardiac Troponin-T (hscTnT), N-Terminal pro-Brain Natriuretic Peptide (NTproBNP) and Circulating Endothelial Cells (CECs), a marker of endothelial dysfunction and vascular damage. Discussion: The presented protocol is to our knowledge the first to prospectively and with a multimodal approach, study serological and image biomarkers off early cardiac damage due to radiotherapy. With a practical clinical approach we will seek early changes that could potentially be in the future be linked to clinical mayor events with consequences for cancer survivors.
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    Re-irradiation for locally recurrent refractory breast cancer
    (2015) Merino Lara, Tomas Rodrigo; Tran, William T.; Czarnota, Gregory J.
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    Risk factors for loco-regional recurrence in breast cancer patients: A retrospective study
    (2018) Merino Lara, Tomas Rodrigo; Ip, Teresa; Domínguez Covarrubias, Francisco José; Acevedo Claros, Francisco Nicolás; Medina Araya, Lidia; Villarroel, Alejandra; Camus Appuhn, Mauricio Gonzalo; Vinés Vásquez, Eugenio; Sánchez Rojel, César Giovanni
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    Tratamiento sistémico actual para cáncer de mama avanzado hormono-dependiente
    (2023) Walbaum, Benjamín; Rodríguez Gutiérrez, Javier Ignacio; Acevedo Claros, Francisco Nicolás; Camus Appuhn, Mauricio Gonzalo; Manzor, Manuel; Martínez, Raúl; Veglia, Paulina; Murature, Geraldine; Muñiz Muñoz, María Sabrina; Merino Lara, Tomas Rodrigo; Sánchez Rojel, César Giovanni
    El cáncer de mama es la primera causa de muerte en mujeres chilenas. La mayoría de estos tumores dependen del estímulo estrogénico, por tanto, la deprivación de estrógenos es una parte relevante de su tratamiento. La combinación de terapia endocrina con tratamientos dirigidos ha demostrado prolongar la sobrevida global de pacientes con cáncer de mama avanzado estrógeno dependiente versus la terapia antiestrogénica aislada. Nuevas opciones de manejo sistémico en base a inmunoconjugados y la descripción de nuevos grupos de cáncer de mama estrógeno dependientes con baja expresión del receptor del factor de crecimiento epidérmico humano tipo 2 (HER2-bajo), han abierto otras opciones para pacientes con resistencia endocrina. Junto a una descripción de la experiencia local, mostramos una revisión narrativa de las nuevas opciones de tratamiento sistémico del cáncer de mama avanzado estrógeno dependiente.