Browsing by Author "Viviani García, Paola"

Now showing 1 - 20 of 40
  • Thumbnail Image
    Item
    Actividad física y obesidad en niños con asma
    (2007) Brockmann Veloso, Pablo Edmundo; Caussade Larraín, Marie Solange; Holmgren Palmen, Nils Linus Anders; Prado Atlogic, Francisco Javier; Reyes M., Bernardita; Viviani García, Paola; Bertrand N., Pablo
    Exercise- induced asthma is frequent among children. Objective: To compare physical activity (PA) and nutritional status in asthmatic (A) versus healthy (H) children. Methods: 81 school children were enrolled (40 A and 41 H). A validated interview with opinions and attitude towards PA was performed to parents in both groups. Nutritional status was classified according to body mass index. Answers were associated with χ2 test. Results: 44% girls, average age 9 years-old. Average hours per week of PA = 2.4 in H and 1.9 in A (p=NS); 88% of A versus 56% of H performed < 2 hours per week of PA (p < 0.05). 85% of A reported frequent symptoms associated to PA. Overweight and obesity were diagnosed in 15/40 A and 11/41 H (p < 0.05). Parents of A thought that PA was "dangerous" more frequently than parents of H (p < 0.05). Conclusions: Asthmatic children practice less PA than recommendations. There is an association between asthma, obesity and less PA level. Parents of asthmatic children have a negative opinion about PA, explaining the diminished PA performed by this group.
  • No Thumbnail Available
    Item
    Are topical oestrogens useful in faecal incontinence? Double-blind randomized trial
    (2009) Pinedo Mancilla, George; García, Eduardo; Zárate, Alejandro José; León Correa, Francisco Javier; Bellolio R., Felipe; Molina Pezoa, María Elena; Viviani García, Paola; Zúñiga, Álvaro
  • Thumbnail Image
    Item
  • Thumbnail Image
    Item
    Autoevaluación sobre formación en medicina paliativa en una cohorte de residentes
    (2004) Vial C, P.; Ibañez Lazo, Patricio; Umaña Valdivia, Alfredo; Reyes Donoso, María Margarita; Viviani García, Paola; Nervi, Flavio
    Background: Little is known about the status and level of medical education on palliative care, symptom control and aspects of end of life care provided by medical school programs in Chile. Aim: To determine if a cohort of residents had palliative care and end of life care education during pre graduate and post graduate training. Residents were also asked to self assess their proficiency in these areas. Material and Methods: In 2002, we contacted 200 of a total of 327 residents of the postgraduate programs of the Pontificia Universidad Catolica de Chile. They were asked to anonymously answer a preformed questionnaire addressing different aspects related to palliative care, symptom control and end of life issues. Results: Less than 25% of residents received some degree of palliative care education during their studies, and approximately half of them considered that the level of proficiency reached was less than 25%. This contrasted with a good self assessment in the management of pain and gastrointestinal symptoms. For the treatment of the anorexia-cachexia syndrome and delirium, approximately 50% of the cohort had a mean self assessment score of 3 in a scale of 1 to 7. More than 80% of residents considered that palliative medicine education is important for their medical career. Conclusions: Chilean medical schools must improve palliative care and end of life training as part of their mandatory curriculum in both the pre and post graduate levels (Rev Méd Chile 2004; 132: 445-52).
  • Thumbnail Image
    Item
    Autologous tolerogenic dendritic cells derived from monocytes of systemic lupus erythematosus patients and healthy donors show a stable and immunosuppressive phenotype
    (2017) Obreque Castro, Javiera Constanza; Vega, Fabian; Torres, Andy; Cuitino, Loreto; Mackern Oberti, Juan Pablo; Viviani García, Paola; Kalergis Parra, Alexis Mikes; Llanos Muñoz, Carolina
  • Thumbnail Image
    Item
    Baseline assessment of prevalence and geographical distribution of HPV types in Chile using self-collected vaginal samples
    (2008) Ferreccio Readi, Catterina; Corvalán R., Alejandro; Margozzini Maira, Paula; Viviani García, Paola; González, Claudia; Aguilera, Ximena; Gravitt, Patti E
    Abstract Background Chile has broad variations in weather, economics and population from the far desert north (Region 1) to the cold, icy south (Region 12). A home-based self-collected vaginal sampling was nested in the 2003 Chilean population-based health survey in order to explore the possibility of a type-specific geographical variation for human papillomavirus Methods The population was a national probability sample of people 17 years of age and over. Consenting women provided self-collected cervicovaginal swabs in universal collection media (UCM). DNA was extracted and typed to 37 HPV genotypes using PGMY consensus PCR and line blot assay. Weighted prevalence rates and adjusted OR were calculated. Results Of the 1,883 women participating in the health survey, 1,219 (64.7%) provided a cervicovaginal sample and in 1,110 (56.2% of participants and 66.5% of those eligible) the samples were adequate for analysis. Refusal rate was 16.9%. HPV prevalence was 29.2% (15.1% high-risk HPV and 14.1% low-risk HPV). Predominant high-risk types were HPV 16, 52, 51, 56 and 58. Predominant low-risk HPVs were HPV 84, CP6108, 62, 53 and 61. High-risk and low-risk HPV rates were inversely correlated between the regions. High-risk HPV prevalence was highest among the youngest women, whereas low-risk HPV increased slightly with age. Conclusion Self-obtained vaginal sampling is adequate for monitoring HPV in the community, for identifying high-risk areas, and for surveying the long term impact of interventions.
  • Thumbnail Image
    Item
    Biomarcadores coronarios y evolución clínica alejada en pacientes con síndromes coronarios agudos sin elevación del segmento ST
    (2005) Baeza Vergara, Ricardo Gabriel; Corbalán Herreros, Ramón; Castro Gálvez, Pablo Federico; Acevedo B., Mónica; Quiroga G., Teresa; Viviani García, Paola
    The use of new biomarkers improved risk stratification for patients with acute coronary syndromes (ACS). Aim: To evaluate the relationship between multiple biomarkers and long-term clinical outcome in ACS without ST segment elevation. Patients and Methods: Consecutive patients presenting with suspected ACS were studied. On admission to the emergency room, serum was obtained to determine highly sensitive C reactive protein (hsCRP), erythrocyte sedimentation rate (ESR), lipoprotein (a) (LPa) and soluble P selectin (sPS). Clinical endpoints were mortality and a composite endpoint of major adverse cardiovascular events (MACE) including death, re-infarction, and angina. Results: Seventy patients, aged 63±13 years, 54 males, were studied. Final diagnosis was unstable angina in 71% and non-ST-segment elevation myocardial infarction in 29%. MACE and mortality rate were 17% and 5.8%, respectively. We found higher plasma levels of hsCRP, ESR and Lp(a) in patients with MACE (p=0.032, p=0.015 and p=0.010, respectively). Plasma levels of hsCRP and ESR were also higher in patients who died during the follow up (p=0.002 y p=0.045, respectively). Conclusion: Plasma levels of inflammatory markers and atherosclerosis biomarkers are associated with a worse long-term clinical outcome in ACS without ST segment elevation. The inclusion of these biomarkers in the routine blood test on admission, could improve risk stratification of patients with ACS in the future (Rev Méd Chile 2005; 133: 1275-93).
  • Thumbnail Image
    Item
    Características psicológicas y estilos cognitivos de estudiantes de medicina y de otras carreras de la Pontificia Universidad Católica de Chile
    (2004) Bitrán Carreño, Marcela; Zúñiga Parada, Denisse Alejandra; Lafuente Gil, María Montserrat; Viviani García, Paola; Mena Concha, Beltrán
    The simila rity between the psychologica l fea tures of medi_x0002_ca l school freshmen of different cohorts suggests tha t Medicine a ttra cts students with specific psychologi_x0002_ca l types. However, it is a lso possible tha t medica l students a re simila r to the students a dmitted to a ny other ca reer with high a dmission requirements. Aim: To determine if medica l school freshmen a re dif_x0002_ferent from those of Engineering, Architecture, Psychology a nd Journa lism. Subjects and methods: The Spa nish version of the Myers Briggs Psychologica l Type Indica tor (MBTI) wa s a pplied to two cohorts of Medica l School freshmen (90 students of the 2000 cohort a nd 91 students of the 2001 cohort) a nd to a sa mple of 669 freshmen from the ca reers of Engineering, Psychology, Architecture a nd Journa lism. Results: Students entering Medica l School a re simila r to the students a dmitted to Engineering a nd dif_x0002_ferent from those tha t entered Architecture, Psychology a nd Journa lism in the Pontificia Universida d Ca tólica de Chile in 2000 a nd 2001. Medicine a ttra cts a la rger proportion of concrete a nd pra ctica l students tha t ha ve a n objective a nd systema tic a pproa ch to study a nd to life in genera l. Unlike Medi_x0002_cine, Psychology a nd Architecture a ttra ct more students tha t ha ve a cognitive style cha ra cterized by an intuitive perception, a nd tha t fa ce life with a n open a nd flexible a ttitude. Conclusions. This study re_x0002_vea ls tha t the psychologica l fea tures of undergra dua te students a re a ssocia ted to their ca reer choice. These psychologica l va ria bles, therefore, ma y be releva nt to the students’ voca tiona l preferences a nd possibly to their future specia lty choice
  • Thumbnail Image
    Item
    Caracterización epidemiológica de mordeduras en personas, según registro de atención de urgencia. Provincia de Los Andes, Chile
    (2017) Villagra, Vania; Cáceres, Dante; Alvarado, Sergio; Salinas, Elizabeth; Caldera, M. Loreto; Lucero, Erick; Viviani García, Paola; Torres Hidalgo, Marisa
    Background: Bites constitute a public health problem worldwide. Aim: To characterize epidemiologically bites by animals happened in the province of Los Andes (2005-2007). Method: Descriptive, retrospective epidemiological study. Studied variables: Bitten person (BP), accident by bite, biting animal and bite. It was not feasible to obtain more updated information by law of patient protection. Results: 2,360 BP were assisted in the emergency unit of San Juan de Dios Hospital and Rio Blanco clinic. An annual average rate of 729 BP/100,000 inhabitants and 1.99 daily average was recorded. The male gender was most affected (53.5%) and the age group from 6 to 10 years old. (Rate: .521/100,000). Most frequent topographic location was the lower limb, except in children under 5 year olds in whom predominated head and neck. The biting animal according to frequency was: the dog (67.1%) spider (7.1%) and cat (3.9%). The animal property was 35.6% known and 30.7% own. The most frequent problems were: nonspecific allergy; toxic effect by spider bites and among the infections, the disease made by cat’s scratch stands out. Regarding the record system, the biting animal complaint was applied to 47.6% of the BP and the 92.8% of the recorded information was incomplete. Conclusions: Bites reported higher rates in the province of Los Andes than the average of the country (729 versus 188/100,000), standing out the higher magnitude in 6 to 10 year-old-children. It is noticed that the record is low and incomplete. In this province, no bite control programs or updated studies have been carried out
  • Thumbnail Image
    Item
    Curva nacional de distribución de peso al nacer según edad gestacional. Chile, 1993 a 2000
    (2004) González P., Rogelio; Gómez M., Ricardo; Castro S., René; Nien, Jyh Kae; Merino O., Paulina; Etchegaray B., Alejandra; Carstens R., Mario; Medina H., Luis; Viviani García, Paola; Rojas T., Iván
    Background: The World Health Organization recently defined the criteria for constructing birth weight curves using population based data. Aim: To construct a national curve of weight, size and ponderal index at birth for Chile, following the criteria suggested by the World Health Organization (WHO) expert committee report from 1995. Material and methods: A national database from the Chilean Institute for Statistics was used. All alive singleton deliveries during the period from 1993 to 2000 were included. A birth weight curve for the total population as well as for size and ponderal index at birth was construted, including percentile distribution, mean and standard deviation of values for gestational age. Stratification by sex was performed. Results: A total of 2,049,446 singleton deliveries were analyzed. The 10 percentiles (raw data) for birth weight throughout gestation from 22 to 42 weeks were: 470, 520, 560, 630, 660, 749, 810, 926, 1,031, 1,160, 1,320, 1,480, 1,680, 1,920, 2,190, 2,500, 2,750, 2,910, 3,010, 3,080 and 3,090 g, respectively. Conclusions: A national birth weight for Chilean population (a predominant Hispanic population) was constructed. There are not differences between this curve and the standard proposed by WHO (population from California, USA) suggesting that under comparable perinatal indices, ethnicity is not a relevant factor determining birth weight.
  • Thumbnail Image
    Item
    Daños de salud respiratoria en comunas expuestas a centrales termoeléctricas a carbón en el norte de Chile: análisis de datos secundarios
    (2021) Viviani García, Paola; Leiva Cisternas, Cinthya Aracely; Ojeda Valenzuela, María José; Ahumada P., Ericka; Cortés Arancibia, Sandra
    Introducción: En Chile, el funcionamiento de las Centrales Termoeléctricas de Carbón (CTEC) representan un problema de salud pública debido a las consecuencias sanitarias que tienen en la población. Se han notificado daños en el sistema respiratorio. Materiales y Métodos: Se realizó un estudio ecológico, para evaluar los egresos hospitalarios de las personas que viven en las ciudades donde operan las CTEC (Tocopilla y Huasco), se comparó con una ciudad de control sin CTEC (Caldera), las comunas evaluadas tienen condiciones sociodemográficas similares. Se calcularon las tasas de morbilidad y tasas de morbilidad estandarizadas (SMR). Resultados: La tasa de morbilidad por enfermedades respiratorias en Tocopilla (2016) fue de 152,5 por 10.000 habitantes (habs) y para Huasco es de 135,2 por 10.000 habs. En la ciudad control, Caldera, la tasa es de 40,9 por 10.000 habs. Además, los habitantes de Tocopilla tienen 2,42 más riesgo de padecer bronquitis o bronquiolitis, 90% más riesgo de presentar enfermedades crónicas de las vías respiratorias bajas y 2,14 veces más riesgo de enfermar por asma. En Huasco, la población tiene 2,49 veces más riesgo de padecer enfermedades de las vías respiratorias inferiores con respecto a la región y 3,19 veces más riesgo de presentar asma. Conclusiones: El asma y la bronquitis, son las patologías que mostraron mayores riesgos en las ciudades de Tocopilla y Huasco. Nuestros hallazgos son similares a otras investigaciones realizadas en comunidades expuestas a centrales termoeléctricas de carbón. Es necesario tomar medidas urgentes para proteger la salud de la población.
  • No Thumbnail Available
    Item
    Detection of lymphatic micrometastases in patients with stages I and II colorectal cancer: Impact on five-year survival
    (2004) Kronberg, Udo; López Köstner, Francisco; Soto, Gonzalo; Zuñiga A., Alvaro; Wistuba Oyarzún, Ignacio; Miranda, Vanessa; Pinto, Eliana; Viviani García, Paola; Marshall Rivera, Guillermo
  • Thumbnail Image
    Item
    Epidemiología y factores de riesgo de enfermedad fúngica invasora en niños con cáncer
    (2023) Barraza Olivares, Marlon Francisco; Cerda, Jaime; Viviani García, Paola; Pontificia Universidad Católica de Chile. Facultad de Medicina
    Antecedentes: La enfermedad fúngica invasora (EFI) es la principal causa de morbi-mortalidad en niños con cáncer. Conocer los cambios epidemiológicos y factores de riesgo que se asocian a EFI permite mejorar las acciones preventivas y el enfrentamiento de estos pacientes, reduciendo su morbimortalidad.Metodología: Estudio de cohorte retrospectivo. Se evaluaron los episodios de neutropenia febril de alto riesgo de evolución desfavorable (NFAR-ED) y se estimó la incidencia de EFI. Se comparó la incidencia de EFI en niños con NFAR-ED en el periodo de estudio (2016-2020) con el período 2004-2006. Se evaluaron factores de riesgo asociados a EFI a partir de análisis bivariado y multivariado utilizando dos métodos distintos, regresión logística y análisis de sobrevida. Se estimaron los OR y HR, respectivamente. La capacidad predictiva de los modelos de regresión fue evaluada utilizando curvas ROC. Resultados: Se evaluaron 239 episodios de NFAR-ED y se encontraron 35 casos de EFI. La incidencia de EFI probada/probable en el periodo 2016-2020 fue de 14.6% (IC95% 10.5 – 19.9). Comparado al periodo 2004 – 2006, se detectó un aumento significativo de la incidencia de 6.1 % (IC95% 0.2 – 12.1). Los principales microorganismos causantes de EFI fueron hongos filamentosos en un 54.3% (N= 19) y levaduras en un 45.7% (N=16). Se observó un mayor riesgo de desarrollar EFI en pacientes adolescentes, de sexo masculino, con PCR al ingreso ≥ 90 mg/L y aquellos que requirieron traslado a una unidad de paciente crítico con OR de 4.65 (IC 95% 1.20- 21.87), 4.04 (IC 95% 1.58- 11.38), 3.13 (IC95% 1.26 - 8.20) y 10.73 (IC95% 4.26 -29.47), respectivamente. Estos resultados fueron concordantes con los análisis de sobrevida donde ser adolescente de sexo masculino, tener una PCR ≥ 90 mg/L y ser trasladado a UPC fueron factores de riesgo independientes de EFI con un HR de 3 ((IC95% 1.43- 6.4), 6.3 (IC95%1.97 – 20.5), 2.4 (IC95% 1.24 – 5) y 6.9 (IC95%3.23-14.8), respectivamente. Estas variables fueron utilizadas en la elaboración de un modelo predictivo, el cual fue capaz de diferenciar con un AUC 84.7% (IC95% 76.4 -92.9) si los pacientes desarrollaban EFI, con una sensibilidad de 79.4% y especificidad de 82.1%.Conclusión: En los últimos años hemos observado un aumento significativo de EFI con factores de riesgos relevantes. Estos hallazgos refuerzan la necesidad de medidas preventivas, como el uso de áreas con aire protegido y/o la implementación de profilaxis antifúngica para cierto grupo de pacientes, con el objetivo disminuir el desarrollo de EFI y consigo la morbi-mortalidad
  • Thumbnail Image
    Item
    Estimation of individual neonatal survival using birthweight and gestational age : A way to improve neonatal care
    (BMC, 2008) Mardones S., Francisco; Marshall Rivera, Guillermo; Viviani García, Paola; Villarroel del Pino, Luis A.; Mardones Restat, Francisco; Tapia Illanes, José Luis; Cerda Lorca, Jaime Rodrigo; Garcia Huidobro, Trinidad; Ralph, Constanza; Oyarzún Ebensperger, Enrique
  • Thumbnail Image
    Item
    Estrategias de tamizaje de cáncer de mama y cervicouterino en Chile y Encuesta Nacional de Salud : descripción de la cobertura en población objetivo acorde a variables socioeconómicas, psicosociales, de hábitos de vida y antecedentes en salud, en los años 2010 y 2017
    (2020) Carrasco Gutiérrez, María Alicia; Viviani García, Paola; Pontificia Universidad Católica de Chile. Facultad de Medicina
    El cáncer de mama es la primera causa de muerte por cáncer en mujeres en Chile y en países con mayor desarrollo. En tanto, el cáncer cervicouterino es la principal causa de muerte en mujeres en países de menores ingresos. Esta inequidad ecológica se replica a nivel local al interior de varios países incluidos Chile, tanto para la distribución de sus factores de riesgo como para su incidencia, AVISA y mortalidad. Se ha observado también que las medidas de prevención secundaria que tienen un importante impacto sobre la sobrevida y calidad de vida de las pacientes como la citología cervical comúnmente llamado Papanicolau y la mamografía tendrían una distribución desigual, reflejando diferencias en sus coberturas acorde a diversos determinantes sociales. Así surge la pregunta, ¿Cuáles son las coberturas de PAP y Mamografía acorde a variables sociodemográficas, psicosociales, de hábitos de vida y antecedentes en Salud? En base a la Encuesta Nacional de Salud (ENS) en sus dos últimas versiones (2009-2010 y 2016- 2017) se realiza un análisis descriptivo de las coberturas de ambos tamizajes acorde a las variables independientes construidas a partir de la información recolectada. Se realiza extrapolación a la población mediante el uso de planes de expansión del diseño estadístico de la ENS. Los resultados muestran una cobertura estimada en población objetivo del 80% para PAP y 71,9% para mamografía el año 2017, está última teniendo un aumento significativo desde 2010, donde su valor fue 51,3%. Este aumento fue significativo en zona urbana, Se observan diferencias significativas en las coberturas por grupo etario y región. Mamografía presenta significancia en diferencias de cobertura por previsión, consumo habitual de alcohol, autorreporte de enfermedades y control de patologías. Nivel educacional presenta una tendencia al aumento en cobertura a medida que se tiene más años de estudio. Resultados muestran mayores coberturas que las reportadas en el Sistema Nacional de Servicios de Salud, lo que fortalece evidencia que un porcentaje de usuarias del sistema público tiene preferencia por realizarse exámenes en el sistema privado. Factores de riesgo como obesidad, sedentarismo, dieta poco saludable, tabaquismo, consumo riesgoso de alcohol y antecedentes familiares (cáncer de mama) no presentan diferencias en cobertura, lo que sugiere intervenciones focalizadas desde la mirada de estrategia de población de alto riesgo. En tanto, la mayor adherencia por usuarias activas del sistema de salud establece la necesidad de captar a mujeres “sanas” para la realización de tamizaje a tiempo, lo que conlleva a sugerir fortalecimiento de la estrategia poblacional. El sistema Nacional de Servicios de Salud se encuentra altamente centralizado, y muy fragmentado, lo que puede ser un factor importante al momento de establecer inequidades en el acceso, sobre todo geográficas. Además, hay una influencia de factores culturales que estaría generando barreras como falta de conocimiento o falta de confianza y de trato digno en el servicio de salud público. Se recomienda realizar una regresión logística con ajuste por edad, y un modelo multivariado para asentar las observaciones, en base a la hipótesis de diferencias en coberturas acorde a las variables mencionadas.
  • Thumbnail Image
    Item
    Exploring Language Barriers to Evidence-based Health Care (EBHC) in Post-graduate Medical Students: A Randomised Trial
    (2007) Letelier Saavedra, Luz María; Zamarín Brocco, Nicolás Felipe; Andrade Anziani, Maricarmen Soledad; Gabrielli, L.; Caiozzi Apablaza, Gianella Caterina; Viviani García, Paola; Riquelme, A.
    Background: Understanding the written English language might be a barrier when teaching Evidence-based Health Care (EBHC) to Spanish-speaking physicians. Aim: To quantify the magnitude of this potential barrier. Method: Cochrane Review abstracts in English or in Spanish were randomly distributed among first-year residents at the Pontificia Universidad Catolica of Chile. Residents answered investigator-designed questionnaires to measure their comprehension while the time needed to complete the task was recorded. Results: Groups were similar at baseline. Mean score for those reading in Spanish was 11.9 ± 2.8 (range 5 to 18) compared to 10.5 ± 3.8 (range 1 to 17) for those reading in English (p=0.04). Low scores (£ 9) were twice as frequent for the English group than for the Spanish group (16.7% vs 34.7%; p=0.042). The time to complete the task was also longer for the group reading in English. Conclusion: Language should be taken into account when teaching EBHC to Spanish-speaking physicians.
  • No Thumbnail Available
    Item
    Factores determinantes en la aparición de fibrilación auricular post-cirugía de revascularización miocárdica. Un estudio prospectivo
    (2007) Baeza Vergara, Ricardo Gabriel; Garayar Pulgar, Bernardita; Morán Velásquez, Sergio; Zalaquett Sepúlveda, Ricardo; Irarrázaval Llona, Manuel José; Becker Rencoret, Pedro Antonio; Viviani García, Paola; Ferrada, Marcela; Corbalán Herreros, Ramón
    Background: Atrial fibrillation (AF) is a relevant complication after coronary artery bypass grafting (CABG). However there is controversy regarding possible contributing factors. Aim: To study the incidence of AF, its risk factors and its repercussion on hospital stay and charges, in patients undergoing CABG. Material and methods: We prospectively collected information from all patients undergoing CABG in our institution, including demographic, surgical and laboratory variables. Exclusion criteria were chronic AF, recent onset AF and patients who needed additional surgical procedures. The primary endpoint was the incidence of AF during the hospital stay. Secondary endpoints were hospital length of stay and hospital charges. Results: We included 250 patients aged 62±9 years (199 males) in the analysis. Incidence of AF was 22% (54 patients). Multivariable analysis showed that age (Odds Ratio (OR) =1.10), previous CABG (OR =9.39), previous use of ACE inhibitors (OR =3.28) and aortic clamp >57 minutes (OR =3.97) were significantly associated with an increased risk of postoperative AF. Previous use of beta-blockers was associated with risk reduction (OR =0.43). Patients who developed AF had a longer hospital stay (p <0.001) and higher hospital charges (p =0.003). Conclusion: AF is a frequent complication in patients undergoing CABG. Risk factors are age, time of aortic clamp, previous CABG and ACE inhibitors. Beta-blockers may prevent its occurrence. Furthermore, AF has a negative impact on both hospital stay and hospital charges
  • Thumbnail Image
    Item
    Factores pronósticos, evolución y mortalidad en el adulto inmunocompetente hospitalizado por neumonía neumocócica adquirida en la comunidad
    (2009) Saldías Peñafiel, Fernando; Viviani García, Paola; Pulgar B., Dahiana; Valenzuela Flores, Francisco Felipe; Paredes Engber, Sebastián; Díaz Patiño, Orlando
    Background: Streptococcus pneumoniae is the main cause of community-acquired pneumonia in adults. Aim: To describe baseline characteristics, risk factors and clinical outcomes of adult patients hospitalized with pneumococcal pneumonia. Material and methods: Prospective study of adult patients admitted for a community acquired pneumonia in a clinical hospital. Immune deficient patients and those with a history of a recent hospitalization were excluded. Results: One hundred fifty one immuno-competent patients, aged 16 to 92 years, 58% males, were studied. Seventy-five percent had other diseases, 26% were admitted to the intensive care unit and 9% needed mechanical ventilation. There were no differences in clinical features, ICU admission or hospital length of stay among bacteremic and non-bacteremic patients. Thirty days lethality for bacteremic and non-bacteremic patients was 10.9% and 11.5%, respectively. The predictive values for lethality of Fine pneumonia severity index and CURB-65 (Confusion, Urea nitrogen, Respiratory rate, Blood pressure, 65 years of age and older) had an area under the ROC curve of 0.8 and 0.69, respectively. Multivariate analysis disclosed blood urea nitrogen over 30 mg/ dL (odds ratio (OR), 6.8), need for mechanical ventilation (OR, 7.4) and diastolic blood pressure below 50 mmHg (OR, 3.9), as significant independent predictors of death. Conclusions: Pneumococcal pneumonia was associated with a substantial rate of complications and mortality. Clinical presentation and outcome did not differ significantly among patients with and without bacteremia.
  • Thumbnail Image
    Item
    Graphical diagnostics methods based on generalized residuals for logistic regression models
    (2012) Pardo, M.C.; Viviani García, Paola
    The logistic regression model is remarkably flexible. Nevertheless, lack of fit may also occur so to be able to detect departures from the model is important. In this paper, a generalized empirical probability plot based on generalized residuals is developed. The method is illustrated with simulated and real data.
  • Thumbnail Image
    Item
    HPV16/18 genotyping for the triage of HPV positive women in primary cervical cancer screening in Chile
    (2015) Lagos Lucero, Marcela; Van De Wyngard, Vanessa; Poggi, Helena; Cook, María Paz; Viviani García, Paola; Barriga Cosmelli, María Isabel; Ferreccio Readi, Catterina; Pruyas, Martha; Lagos Lucero, Marcela; Van De Wyngard, Vanessa; Poggi, Helena; Cook, María Paz; Viviani, Paola; Barriga, María I.; Ferreccio Readi, Catterina; Pruyas, Martha
    Abstract Background We previously conducted a population-based screening trial of high-risk human papillomavirus (hrHPV) testing and conventional cytology, demonstrating higher sensitivity (92.7 % vs 22.1 % for CIN2+) but lower positive predictive value (10.5 % vs 23.9 %) of hrHPV testing. Here we report the performance of HPV16/18 genotyping to triage the hrHPV positive participants. Methods Women aged 25 years and older received hrHPV (Hybrid Capture 2) and Papanicolaou testing; positives by either test underwent colposcopy and directed biopsy, as did a sample of double-negatives. hrHPV positive women were reflex-tested with HPV16/18 genotyping (Digene HPV Genotyping PS Test). Results Among the 8,265 participants, 10.7 % were hrHPV positive, 1.7 % had ASCUS+ cytology, 1.2 % had CIN2+; 776 (88 %) hrHPV positive women had complete results, of whom 38.8 % were positive for HPV16 (24.0 %), HPV18 (9.7 %) or both (5.1 %). CIN2+ prevalence in HPV16/18 positive women (16.3 %, 95 % CI 12.3-20.9) was twice that of HPV16/18 negative women (8.0 %, 95 % CI 5.7-10.8). HPV16/18 genotyping identified 40.5 % of CIN2, 66.7 % of CIN3 and 75.0 % of cancers. Compared to hrHPV screening alone, HPV16/18 triage significantly reduced the referral rate (10.7 % vs 3.7 %) and the number of colposcopies required to detect one CIN2+ (9 vs 6). When HPV16/18 negative women with baseline ASCUS+ cytology were also colposcopied, an additional 14 % of CIN2+ was identified; referral increased slightly to 4.2 %. Conclusions HPV16/18 triage effectively stratified hrHPV positive women by their risk of high-grade lesions. HPV16/18 positive women must be referred immediately; referral could be deferred in HPV16/18 negative women given the slower progression of non-HPV16/18 lesions, however, they will require active follow-up.Abstract Background We previously conducted a population-based screening trial of high-risk human papillomavirus (hrHPV) testing and conventional cytology, demonstrating higher sensitivity (92.7 % vs 22.1 % for CIN2+) but lower positive predictive value (10.5 % vs 23.9 %) of hrHPV testing. Here we report the performance of HPV16/18 genotyping to triage the hrHPV positive participants. Methods Women aged 25 years and older received hrHPV (Hybrid Capture 2) and Papanicolaou testing; positives by either test underwent colposcopy and directed biopsy, as did a sample of double-negatives. hrHPV positive women were reflex-tested with HPV16/18 genotyping (Digene HPV Genotyping PS Test). Results Among the 8,265 participants, 10.7 % were hrHPV positive, 1.7 % had ASCUS+ cytology, 1.2 % had CIN2+; 776 (88 %) hrHPV positive women had complete results, of whom 38.8 % were positive for HPV16 (24.0 %), HPV18 (9.7 %) or both (5.1 %). CIN2+ prevalence in HPV16/18 positive women (16.3 %, 95 % CI 12.3-20.9) was twice that of HPV16/18 negative women (8.0 %, 95 % CI 5.7-10.8). HPV16/18 genotyping identified 40.5 % of CIN2, 66.7 % of CIN3 and 75.0 % of cancers. Compared to hrHPV screening alone, HPV16/18 triage significantly reduced the referral rate (10.7 % vs 3.7 %) and the number of colposcopies required to detect one CIN2+ (9 vs 6). When HPV16/18 negative women with baseline ASCUS+ cytology were also colposcopied, an additional 14 % of CIN2+ was identified; referral increased slightly to 4.2 %. Conclusions HPV16/18 triage effectively stratified hrHPV positive women by their risk of high-grade lesions. HPV16/18 positive women must be referred immediately; referral could be deferred in HPV16/18 negative women given the slower progression of non-HPV16/18 lesions, however, they will require active follow-up.