Browsing by Author "Villarroel, Luis"

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    Adaptation and validation of a questionnaire to measure stigma toward mental illness among health professionals working in primary care in Chile
    (2019) Sapag Muñoz de la Peña, Jaime; Velasco Grandón, Paola Renée; Parra, Claudia; Anríquez, Samanta; Villarroel, Luis; Alvarado, Rubén; Poblete, Fernando; Jofré, Ana; Aracena Álvarez, Marcela; Bravo, Paulina; Mascayano, Franco; Álvarez, Cinthia; Chacón, Sergio; De Arcas, Michelle; Ulloa, Viviana; Barrios, Daniela; Díaz, Andrés; Sena, Brena
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    Antenatal Exposure to Magnesium Sulphate and Neonatal Outcomes in Very Low Birth Weight Infants: a multicenter study.
    (2023) Ferreira, María Vaz; Caro, José; Villarroel, Luis; Muñoz, Sergio; Álvarez, Patricia; Flores, Gerardo; Herrera, Tamara; Toso Milos, Alberto Antonio; Toso Milos Paulina Alejandra; Tapia, José
    Objective: To explore the association between antenatal magnesium sulphate ( MgSO4 ), mortality and incidence of intraventricular hemorrhage (IVH) in very low birth weight (VLBW) infants. Study design: Retrospective, cohort study of infants < 32 weeks’ GA born at centers of NEOCOSUR Network between January 2015 and December 2020. Subjects were categorized as exposed vs non-exposed to antenatal MgSO4. Primary outcomes were death, incidence of severe IVH (Grade III-IV) and severe IVH/death. Secondary outcomes included relevant morbidities. Results: 7418 VLBW infants were eligible. Antenatal MgSO4 was associated with a signicantly decreased death rate after admission (aOR 0.59 [95% CI, 0.46–0.74]) and severe IVH/ death (aOR 0.63 [95% CI, 0.490.83]). No signicant reduction in severe IVH was observed (aOR 0.89 [95% CI, 0.63–1.25]). No differences between groups were observed in rates of morbidities. Conclusion: Antenatal MgSO4 was associated with a decreased death rate after admission and in severe IVH/ death.
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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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    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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    Competences on hypoglycemia management among healthcare professionals in a clinical hospital
    (SOC MEDICA SANTIAGO, 2011) Rojas, Luis; Achurra, Pablo; Pino, Felipe; Ramirez, Pedro; Lopetegui, Marcelo; Sanhueza A, Luis Manuel; Villarroel, Luis; Aizman, Andres
    Background: A tight glycemic control of hospitalized patients increases the risk of hypoglycemia, whose management is not always optimal. Aim: To assess the hypoglycemia management competences of a multidisciplinary team in a clinical hospital. Material and Methods: An anonymous questionnaire about hypoglycemia management was answered by 11 staff physicians, 42 residents and 28 nurses of the department of medicine and critical care unit of a university hospital. Results: Respondents had a mean of 60% of correct answers, without significant differences between groups. The capillary blood glucose level that defines hypoglycemia was known by most of the respondents, but the value that defines severe episodes was known only by 60%. The initial management and follow up was well known only for severe episodes. Less than 50% knew the blood glucose value that required continuing with treatment. Conclusions: Although most professionals are able to recognize hypoglycemia, the knowledge about is management if insufficient. (Rev Med Chile 2011; 139: 848-855).
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    Does a clinical prediction rule anticipate the diagnosis for streptococcal pharyngitis in children aged 2 to 15?
    (SOC CHILENA INFECTOLOGIA, 2018) Katzulovic, Lorena; Garcia, Patricia; Wozniak, Aniela; Villarroel, Luis; Hirsch, Tamara; Concha, Ida; Catalan, Silvia; Cifuentes, Lorena
    Background: The etiology of a streptococcal pharyngitis must be documented by laboratory techniques to avoid unnecessary antimicrobial treatment, but this strategy increases cost for the patient. Available scores applied in children or adults are imperfect. Aim: To develop a clinical prediction rule to aid the diagnostic process of streptococcal pharyngitis (SP) in children in a low-resource setting. Methods: Three hundred and eighteen patients aged 2 to 15 years who were evaluated for suspected SP at the Pediatric Emergency Department and the Pediatric Ambulatory Unit of Red Salud UC-Christus entered the study. A throat culture and a rapid antigen detection test for Streptococcus pyogenes were obtained from each patient. Data were analyzed for possible clinical predictors of SP with univariate and multiple regression analyses. Results: Seventy-three cases of SP were diagnosed (23.9%). In the univariate analysis, fever was inversely associated with SP (p = 0.002). Odynophagia, palatal petechiae, and season of the year (autumn and winter) were positively associated with SP (p = 0.007, p < 0.001 and p = 0.03 respectively). In multiple regression analysis the models did not have sufficient power to predict streptococcal etiology. Conclusion: Clinical predictors, even those systematically included in clinical prediction rules, did not show sufficient predictive power to safely include or exclude SP in this setting, and thus, it is necessary to improve access to confirmatory tests.
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    Early Obesity: Risk Factor for Fatty Liver Disease
    (LIPPINCOTT WILLIAMS & WILKINS, 2020) Cuzmar, Valeriau; Alberti, Gigliola; Uauy, Ricardo; Pereira, Ana; Garcia, Cristian; De Barbieri, Florencia; Corvalan, Camila; Santos, Jose L.; Mericq, Veronica; Villarroel, Luis; Gana, Juan Cristobal
    Nonalcoholic fatty liver disease (NAFLD), defined as fat accumulation greater than 5% in hepatocytes, may progress to fibrosis or cirrhosis later in life. NAFLD prevalence in adolescents has increased significantly in direct relation with obesity prevalence. Fatty liver has become the most frequent indication for liver transplantation in adults. Objective: The aim of the study was to identify anthropometric variables during the first 10 years of life associated to the risk of developing NAFLD in adolescence. Methods: Longitudinal cohort study 'Growth and Obesity Chilean Cohort Study' (GOCS) consisting of 513 children born in 2002 to 2003, with yearly anthropometric data collected over a 10-year period. The presence of intrahepatic fat in the livers of subjects 14 to 16 years of age was determined using abdominal ultrasound. In addition, elastography was performed on all participants with ultrasound evidence of NAFLD. Results: 9.7% of the participants presented findings compatible with NAFLD. After 2 years of age, obesity significantly and progressively increased the probability of NAFLD occurrence in adolescence. Obesity at 5 years of age was associated with the highest OR for NAFLD, reaching values of 8.91 (95% CI 3.03-16.11). Among participants with NAFLD, those with altered liver elasticity (>= 7 kPa) had greater weight, BMIz-score, waist and hip circumference, and altered liver enzymes (P < 0.05). Conclusion: The risk of developing NAFLD in adolescence increases progressively with early obesity starting at age 2 years.
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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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    Gallbladder disease is associated with insulin resistance in a high risk Hispanic population
    (ELSEVIER SCIENCE BV, 2006) Nervi, Flavio; Miquel, Juan Francisco; Alvarez, Manuel; Ferreccio, Catterina; Garcia Zattera, Maria Jose; Gonzalez, Robinson; Perez Ayuso, Rosa Maria; Rigotti, Attilio; Villarroel, Luis
    Background/Aims: We tested whether cholesterol gallstone disease (GS) is associated to insulin resistance and serum C-reactive protein (CRP) in a high risk population.
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    Genetic evidence that apolipoprotein E4 is not a relevant susceptibility factor for cholelithiasis in two high-risk populations
    (AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC, 2007) Mella, Juan G.; Schirin Sokhan, Ramin; Rigotti, Attilio; Pimentel, Fernando; Villarroel, Luis; Wasmuth, Hermann E.; Sauerbruch, Tilman; Nervi, Flavio; Lammert, Frank; Miquel, Juan Francisco
    Apolipoprotein E (apoE) isoforms are genetic determinants of interindividual variations in lipid metabolism. To assess whether apoE is a genetic risk factor for cholesterol gallstone disease (GD), we analyzed apoE variants in populations from Chile and Germany, two countries with very high prevalence rates of this disease. ApoE genotypes were determined in Chilean gallstone patients (n = 117) and control subjects (n = 122) as well as in German gallstone patients ( n 5 184) and matched controls (n = 184). In addition, we studied apoE variants in subgroups of Chilean patients with strong differences in their susceptibility to acquire gallstones: 50 elderly subjects without gallstones in spite of well-known risk factors for this disease (gallstone-resistant) and 32 young individuals with gallstones but without risk factors (gallstone-susceptible). Furthermore, correlation analysis of apoE genotypes with cholesterol crystal formation times, biliary cholesterol saturation index (CSI), and gallstone cholesterol contents was performed in 81 cholecystectomized patients. In this study analyzing the largest sample set available, apoE4 genotype was not associated with an increased frequency of GD in either population. Moreover, in the Chilean population after adjusting for risk factors such as gender, age, body mass index, serum lipids, and glucose, the odds ratio for the association of the apoE4 allele and GD was significantly (P < 0.05) < 1. Also, genotypes were not correlated with cholesterol crystal formation time, CSI, or gallstone cholesterol content. In contrast to previous smaller studies, apoE polymorphisms were not associated with susceptibility to cholesterol GD in high-risk populations.
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    Health impact of Mediterranean diets in food at work
    (CAMBRIDGE UNIV PRESS, 2009) Leighton, Federico; Polic, Gianna; Strobel, Pablo; Perez, Druso; Martinez, Carlos; Vasquez, Luis; Castillo, Oscar; Villarroel, Luis; Echeverria, Guadalupe; Urquiaga, Ines; Mezzano, Diego; Rozowski, Jaime
    Objective: To evaluate the feasibility of diet mediterranisation, in a food-at-work context, and its consequence on metabolic syndrome in a mid-age unselected healthy male Population group.
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    Impact of Delirium on Short-Term Mortality in Elderly Inpatients: A Prospective Cohort Study
    (ELSEVIER SCIENCE INC, 2009) Gonzalez, Matias; Martinez, Gabriel; Calderon, Jorge; Villarroel, Luis; Yuri, Francisca; Rojas, Carlos; Jeria, Alvaro; Valdivia, Gonzalo; Marin, Pedro Paulo; Carrasco, Marcela
    Background: Delirium is an important problem especially in older medical inpatients. Objective: The authors asked whether delirium and its duration are associated with higher mortality in a 3-month follow-up period. Method: In this prospective cohort study, inpatients age 65 and older were assessed every 48 hours with the Confusion Assessment Method. Results: Of 542 patients enrolled, 192 (35.4%) developed delirium. After 3 months, mortality in the delirium cohort was 25.9%, and in the nondelirium cohort was 5.8%. Delirium was independently associated with mortality, and increased by 11% for every 48 hours of delirium. Conclusion: Delirium and increased delirium durations are significantly associated with higher mortality. (Psychosomatics 2009; 50: 234-238)
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    Individualized dose of anti-thymocyte globulin based on weight and pre-transplantation lymphocyte counts in pediatric patients: a single center experience
    (Springer Nature, 2024) Barriga, Francisco; Wietstruck Pena, Maria Angelica; Schulze Schiappacasse, Clara Edith; Catalan Martinez, Paula Valentina; Sotomayor, Cristian; Zuñiga Contreras, Pamela Alejandra; Aguirre Rioseco, Noemi Doris; Vizcaya Altamirano, Maria Cecilia; Le Corre Perez, Monique Nicole; Villarroel, Luis
    Anti-thymocyte globulin (ATG) has become a standard in preventing GVHD in related and unrelated donor transplantation, but there is no consensus on the best administration schedule. The PARACHUTE trial reported excellent CD4 immune reconstitution (CD4 IR) using a dosing schedule based on the patient's weight and pre-conditioning absolute lymphocyte count (ALC). In 2015 we introduced the PARACHUTE dosing schedule for pediatric patients at our center. One hundred one patients were transplanted for malignant and non-malignant diseases. In this non-concurrent cohort CD4 IR+, defined by a single CD4 count >50/µL on day 90, was seen in 81% of patients. The incidence of grade II-IV and III to IV aGvHD was 26.6% and 15.3% and 5% for cGvHD with no severe cases. We found no difference in aGvHD between donor type and stem cell sources. Five-year EFS and OS were 77.5% and 83.5%. Grade III-IV GFRS was 75.2%. CD4 IR+ patients had better EFS (93.1% vs. 77.7%, p = 0.04) and lower non-relapse mortality (2.7% vs. 22.2%, p = 0.002). The PARACHUTE ATG dosing schedule individualized by weight and ALC results in good early immune reconstitution, low incidence of cGvHD, and favorable survival for patients with different disease groups, donor types, and stem cell sources.
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    Influence of obesity on health care costs and absenteeism among employees of a mining company
    (SOC MEDICA SANTIAGO, 2009) Zarate, Aldo; Crestto, Marco; Maiz, Alberto; Ravest, Gonzalo; Ines Pino, Maria; Valdivia, Gonzalo; Moreno, Manuel; Villarroel, Luis
    Background: The health associated costs of obesity can represent obesity on health care costs and absenteeism in a cohort of mine workers. Patients and methods: Prospective study of 4.673 of men, employees of a mining company, aged 49 +/- 7 years that were followed for 24 +/- 11 months. Total health care costs and days of sick leave were recorded for each individual. The association between obesity and these variables and analyzed by logistic regression adjusting for co-morbidities, age and other variables. Results: Mean annual health care cots for obese workers were 17% higher (p<0.001) compared to workers with normal weight and 58% higher (p<0.001) for workers with severe and morbid obesity. Mean annual days of sick leave increased by 25% in the obese (p=0.002) and by 57% in subjects with severe and morbid obesity (p<0.001). For health care costs the most significant predictors were: presence of diabetes mellitus (Odds ratio (OR) 6.21, 95% confidence intervals (95% CI) 4.9 to 7.9), hypertension (OR 3.99; 95% CI 3.4 to 4.6) and severe and morbid obesity (OR 2.55, 95% CI 1.9 to 3.4). For absenteeism the most significant predictors were; presence of diabetes mellitus (OR 1.58, 95% CI 1.2 to 2.0), hypertension (OR 1.34, 95% CI 1.2 to 1.6) and severe and morbid obesity (OR 1.50, 95% CI 1.1 to 2.1). Conclusions: Obesity increases significantly health care costs and absenteeism (Rev Med Chile 2009; 137: 337-44).
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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 profile of schoolchildren from different socio-economic levels in Santiago, Chile
    (CAMBRIDGE UNIV PRESS, 2011) Liberona, Yessica; Castillo, Oscar; Engler, Valerie; Villarroel, Luis; Rozowski, Jaime
    Objective: To assess the nutritional status, food intake and physical activity patterns in schoolchildren attending 5th and 6th grade in basic schools from different socio-economic levels in the metropolitan region of Santiago.
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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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    Phytosterol and cholesterol precursor levels indicate increased cholesterol excretion and biosynthesis in gallstone disease
    (WILEY-BLACKWELL, 2012) Krawczyk, Marcin; Luetjohann, Dieter; Schirin Sokhan, Ramin; Villarroel, Luis; Nervi, Flavio; Pimentel, Fernando; Lammert, Frank; Francisco Miquel, Juan
    In hepatocytes and enterocytes sterol uptake and secretion is mediated by Niemann-Pick C1-like 1 (NPC1L1) and ATP-binding cassette (ABC)G5/8 proteins, respectively. Whereas serum levels of phytosterols represent surrogate markers for intestinal cholesterol absorption, cholesterol precursors reflect cholesterol biosynthesis. Here we compare serum and biliary sterol levels in ethnically different populations of patients with gallstone disease (GSD) and stone-free controls to identify differences in cholesterol transport and synthesis between these groups. In this case-control study four cohorts were analyzed: 112 German patients with GSD and 152 controls; two distinct Chilean ethnic groups: Hispanics (100 GSD, 100 controls), and Amerindians (20 GSD, 20 controls); additionally an 8-year follow-up of 70 Hispanics was performed. Serum sterols were measured by gas chromatography / mass spectrometry. Gallbladder bile sterol levels were analyzed in cholesterol GSD and controls. Common ABCG5/8 variants were genotyped. Comparison of serum sterols showed lower levels of phytosterols and higher levels of cholesterol precursors in GSD patients than in controls. The ratios of phytosterols to cholesterol precursors were lower in GSD patients, whereas biliary phytosterol and cholesterol concentrations were elevated as compared with controls. In the follow-up study, serum phytosterol levels were significantly lower even before GSD was detectable by ultrasound. An ethnic gradient in the ratios of phytosterols to cholesterol precursors was apparent (Germans > Hispanics > Amerindians). ABCG5/8 variants did not fully explain the sterol metabolic trait of GSD in any of the cohorts. Conclusion: Individuals predisposed to GSD display increased biliary output of cholesterol in the setting of relatively low intestinal cholesterol absorption, indicating enhanced whole-body sterol clearance. This metabolic trait precedes gallstone formation and is a feature of ethnic groups at higher risk of cholesterol GSD. (HEPATOLOGY 2012)
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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).