Browsing by Author "Pastore Thomson, Antonia"

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    Is cholecystectomy a real risk factor for Metabolic dysfunction-associated steatotic liver disease (MASLD)? A longitudinal cohort study from a population with a high burden of gallbladder diseases.
    (2025) Corsi Sotelo, Óscar Felipe; Jara Jara, Constanza Andrea; Fernández, Magdalena; Pastore Thomson, Antonia; Pérez, Diego; Valdés Quezada, Alonso Esteban; Huete Garin, Isidro Álvaro; Briceño Valenzuela, Eduardo Andrés; Arab Verdugo, Juan Pablo; Barrera Martínez, Francisco José; Arrese Jiménez, Marco Antonio; Candia Balboa, Roberto Andrés
    Background: : Cholecystectomy due to gallstones is one of the most frequent surgeries worldwide. Observational studies suggest that cholecystectomy may be a risk factor for metabolic dysfunction associated with steatotic liver disease (MASLD). However, gallstone disease and MASLD share common risk factors, which could make cholecystectomy a confounder.Aim: To assess the relationship among cholecystectomy, gallstones, and MASLD in a longitudinal cohort study from a population at high risk of gallbladder diseases.Methods: A longitudinal retrospective cohort study compared consecutive patients undergoing cholecystectomy with a control group composed of patients with their gallbladder intact. All participants had normal liver imaging and biochemistry at baseline. Participants with incomplete clinical records or significant alcohol consumption were excluded. The primary outcome was the development of MASLD after a follow-up of at least 3 years. Cox regression models were used to conduct multivariable analyses.Results: We included 427 participants 132 in the cholecystectomy group and 295 controls. The mean age was 47.2 years, with 71.7% being female, and 43.6% having gallstone disease. The median follow-up was 9.7 years.In the Cox multivariate analysis, male gender (aHR: 1.56 [1.09-2.24]), gallstone disease (aHR: 2.18 [1.42-3.36]), prediabetes (aHR: 1.56 [1.06-2.3]), diabetes (aHR: 2.39 [1.38-4.13]), and overweight/obesity (aHR: 5.7 [3.19-10.21]) were independent risk factors for MASLD. After adjustment, cholecystectomy was not associated with MASLD incidence (aHR: 0.68 [0.44-1.03]). Sensitivity analyses supported these findings.Conclusion: Cholecystectomy was not found to significantly influence the incidence of MASLD after adjusting formetabolic risk factors. The risk of developing MASLD is likely driven by metabolic factors and previous gallstone disease.
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    Long-term mortality of coronavirus disease 2019 critically ill patients that required percutaneous tracheostomy in Chile: A multicenter cohort study
    (Wolters Kluwer Health, Inc., 2024) Ulloa Morrison, Rodrigo; Escalona, José; Navarrete, Pablo; Espinoza, Javiera; Bravo Morales, Sebastián Ignacio; Pastore Thomson, Antonia; Reyes, Sebastián; Bozinovic, Milan; Abbott, Francisco; Pairumani, Ronald; Noguera, Roselyn; Vera Alarcón, María Magdalena; González, Felipe; Valle, Felipe; Bakker, Jan; Bugedo Tarraza, Guillermo; Kattan Tala, Eduardo José
    Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection leads to mechanical ventilation (MV) in approximately 20% of hospitalized patients. Tracheostomy expedites weaning of respiratory support. Moreover, there is a paucity of data regarding long-term outcomes of tracheostomized coronavirus disease 2019 (COVID-19) patients. The objective of this study was to describe 1-year mortality in a cohort of COVID-19 critically ill patients who required percutaneous tracheostomy in Chile and to assess the impact of age on outcomes. Methods: A multicenter prospective observational study was conducted in 4 hospitals in Chile between March 2020 and July 2021. Patients with confirmed SARS-CoV-2 infection connected to MV and required percutaneous tracheostomy were included. Baseline data, relevant perioperative and long-term outcomes, such as 1-year mortality, MV duration, intensive care unit (ICU), and hospital length of stay were registered. Patients were dichotomized according to age group (< and ≥ 70 years). Univariate and multivariate logistic regressions were performed to identify predictors of 1-year mortality. Results: Of 1319 COVID-19 ventilated critically ill patients, 23% (304) required a percutaneous tracheostomy. One-year mortality of the study group was 25% (20.2%-30.3%). ICU and hospital length of stay (LOS) were of 37 (27-49) and 52 (40-72) days. One-year mortality was higher in patients ≥ 70 years (36.9% vs. 21.2%, P = 0.012). Multivariate analysis confirmed age and baseline sequential organ failure assessment (SOFA) score as independent predictors, while time from intubation to tracheostomy was not. Conclusion: In COVID-19 critically ill patients who required percutaneous tracheostomy in Chile, the 1-year mortality rate was 25%, with a relevant impact of age on outcomes. An appropriate patient selection likely accounted for the low mortality rate. Future studies should confirm these results.
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    SARS-CoV-2 vaccine booster in solid organ transplant recipients previously immunised with inactivated versus mRNA vaccines: A prospective cohort study
    (2022) Dib Marambio, Martín Javier; Le Corre Pérez, Monique Nicole; Ortiz Koh, Catalina Alejandra; García, Daniel; Ferrés, Marcela; Martínez Valdebenito, Constanza; Ruiz-Tagle, Cinthya; Ojeda Valenzuela, María José; Espinoza Sepúlveda, Manuel Antonio; Jara Contreras, Aquiles; Arab Verdugo, Juan Pablo; Rabagliati B., Ricardo; Vizcaya Altamirano, Cecilia; Ceballos, María Elena; Sarmiento Maldonado, Mauricio; Mondaca Contreras, Sebastián Patricio; Viñuela Morales, Macarena Rocío; Pastore Thomson, Antonia; Szwarcfiter Neiman, Vania; Galdames Lavín, Elizabeth Alejandra; Barrera Vásquez, Aldo Vincent; Castro Gálvez, Pablo Federico; Gálvez Arriagada, Nicolás Marcelo Salvador; Soto Ramírez, Jorge Andrés; Bueno Ramírez, Susan; Kalergis Parra, Alexis Mikes; Nervi Nattero, Bruno; Balcells Marty, María Elvira
    Solid-organ transplant (SOT) recipients have worse COVID-19 outcomes than general population and effective immunisation in these patients is essential but more difficult to reach. We aimed to determine the immunogenicity of an mRNA SARS-CoV-2 vaccine booster in SOT recipients previously immunised with either inactivated or homologous SARS-CoV-2 mRNA vaccine. Methods: Prospective cohort study of SOT recipients under medical care at Red de Salud UC-CHRISTUS, Chile, previously vaccinated with either CoronaVac or BNT162b2. All participants received a BNT162b2 vaccine booster. The primary study end point was anti-SARS-CoV-2 total IgG antibodies (TAb) seropositivity at 8-12 weeks (56-84 days) post booster. Secondary end points included neutralising antibodies (NAb) and specific T-cell responses. Findings: A total of 140 (50% kidney, 38% liver, 6% heart) SOT recipients (mean age 54 [13.6] years; 64 [46%] women) were included. Of them, 62 had homologous (three doses of BNT162b2) and 78 heterologous vaccine schedules (two doses of CoronaVac followed by BNT162b2 booster). Boosters were received at a median of 21.3 weeks after primary vaccination. The proportion achieving TAb seropositivity (82.3% vs 65.4%, P = 0.035) and NAb positivity (77.4% vs 55.1%, P = 0.007) were higher for the homologous versus the heterologous group. On the other hand, the number of IFN-γ and IL-2 secreting SARS-CoV-2-specific T-cells did not differ significantly between groups. Interpretation: This cohort study shows that homologous mRNA vaccine priming plus boosting in SOT recipients, reaches a significantly higher humoral immune response than inactivated SARS-CoV-2 vaccine priming followed by heterologous mRNA booster.