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A nomogram for predicting serious complications in patients with solid tumors and apparently stable febrile neutropenia: prospective data on 781 consecutive episodes from the FINITE study
(2014) Ghanem, Ismael; Rebollo, Maite Antonio; Garrido, Marcelo; Martínez, Jerónimo; Font, Carme; Ramchandani, Avinash; Biosca, Merce; Beato, Carmen; Martínez de Castro, Eva; Castanon, Eduardo; Virizuela Echaburu, Juan; Espinosa, Javier; Sevillano, Elena; Aragon Manrique, Isabel; Cardona, Merce; Mondejar, Rebeca; Baron, Francisco; Acevedo Claros, Francisco Nicolás; Jiménez-Fonseca, Paula; Carmona Bayonas, Alberto
Background: An accurate estimate of the likelihood of serious complications in patients with otherwise apparently stable febrile neutropenia (FN) may assist in decision-making regarding individualized therapy. Our group has developed a prognostic score for predicting complications in patients with solid tumors and apparently stable episodes called CISNE (Clinical Index for Stable Febrile Neutropenia). The purpose of this study is to present a nomogram based on the previously mentioned index in a broader dataset of patients. Methods: FINITE is a prospective and multicenter study which aims to investigate prognostic factors and outcomes of FN episodes with clinical stability at first assessment, defined as events without acute organ dysfunction, vital signs abnormalities or major infections. We performed a nomogram based on the CISNE score which includes the following prognostic variables: ECOG PS≥2, chronic obstructive pulmonary disease, cardiovascular disease, mucositis NCI grade ≥2, monocytes <200/mm3 and stress-induced hyperglycemia. A calibration plot was used to analyze the accuracy of this multivariate nomogram. Results: From October 2012 to December 2013, 781 patients with apparently stable FN were recruited in 21 Spanish hospitals. The rate of infection-related complications and death was 15.6% (95% confidence interval [CI], 12.9-18.6%) and 1.7% (95% CI, 0.98%-3.01%). A nomogram was designed according to the CISNE score. The area under the ROC curve was 0.836 (95% CI, 0.808-0.861). The observed and predicted probabilities also matched closely. Conclusions: Our group has developed a user-friendly nomogram for predicting complications in patients with apparently stable FN. This nomogram may be particularly useful to prevent premature discharges of cancer patients starting inpatient management.
A randomized controlled trial of mindfulness-based stress reduction (MBSR) in health workers (E-Poster Presentations)
(Cambridge Univ. Press, 2020) Errazuriz Concha, Antonia; Figueroa Cabello, Rodrigo Andrés
Abstract PS6-37: Clinical stage is the only predictor of survival in breast cancer patients with a complete pathological response
(2021) Acevedo, Francisco; Walbaum, Benjamin; Merino, Tomas; Petric, Militza; Sanchez, Cesar
INTRODUCTION In breast cancer (BC) patients, achieving a complete pathological response (pCR) after neoadjuvant chemotherapy (NCT) is associated with better prognosis. Despite this, some of these patients will experience recurrences of the disease and will eventually die of BC. We identified clinical factors that can affect recurrence and survival in BC patients who achieve pCR.METHODSRetrospective analysis of a Chilean BC database including patients treated in public and private hospitals in Santiago, Chile from 2010 to 2019. pCR was defined as the absence of residual invasive disease in the breast and in the axillary lymph nodes (ypT0/is N0) at the completion of the NCT. Invasive Disease-Free Survival (IDFS), Distant Disease-Free Survival (DDFS) and BC-specific survival (BCS) was measured from the time of diagnosis to the event or lost to follow-up. We performed Cox regression analysis to identify factors associated with prognosis.RESULTSFrom 855 patients who received NCT, 195 (22.8%) achieved pCR and were included in this study. Clinical characteristics are shown in table 1. 76 (37.9%) patients had hormone receptor positive (HR+) and 113 (57.4%) had Human epidermal growth factor 2 (HER2) positive tumors. 88.7% were treated with a regimen that included anthracyclines and taxanes. With a median follow-up of 36 months, three-year IDFS, DDFS and BCS and their 95% confidence intervals were 90.9% (84.7 - 94.6), 91.8% (86.0 - 95.3) and 93.8% (87.8 - 97.5); respectively. The stage at diagnosis was the only predictor associated with IDFS (Hazard ratio (HR) = 5.6; p = 0.02), DDFS (HR = 4.1, p = 0.07), and BCS (HR = 8.3, p = 0.04). Body mass index (BMI), age, hospital, HR or HER2 status, lymph node involvement, or the presence of an in-situ component, were not associated with prognosis in the multivariate analysis.CONCLUSIONThe clinical stage at diagnosis was the only predictor of survival in patients who achieved pCR after NCT. Short follow-up and few events may have affected these results. This data is consistent with previously published work. Table 1. Tumor and patient characteristicsMedian age49 (24 – 78)HospitalPublic57.4%Private43.6%BMIMedian27.2 (18.5 – 44.7)Overweight38.0%Obese31.9%Receptor StatusRH+/HER2-16.4%RH+/HER2+21.5%RH-/HER2+35.9%RH-/HER2-26.2%Clinical StageI2.1%II47.4%III50.5%Lymph Node +69.7%ypT0/N078.1%ChemotherapyAnthracycline5.1%Taxane6.2%Anthracycline-Taxane88.7% Citation Format: Francisco Acevedo, Benjamin Walbaum, Tomas Merino, Militza Petric, Cesar Sanchez. Clinical stage is the only predictor of survival in breast cancer patients with a complete pathological response [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS6-37.
Adrenal dysregulation in children who were born extremely premature - a pilot study
(2016) Carmen Campino; Alejandro Martinez-Aguayo; Rene Baudrand; Cristian Carvajal; Hernan Garcia; Marlene Aglony; Rodrigo Bancalari; Lorena Garcia; Carolina Loureiro; Andrea Vecchiola; Alejandra Tapia; Carolina Valdivia; Cristobal Fuentes; Carlos Lagos; Sandra Solari; Fidel Allende; Alexis Kalergis; Carlos Fardella
Attenuated Salmonella typhimurium encoding the HpaA antigen of Helicobacter pylori elicit a Th1 and Th2 immune response
(2007) Serrano Honeyman, Carolina Andrea; Olmos, Marco; Bruce, Elsa; Martinez, Patricio; Torres, Javiera; Venegas, Alejandro; Harris Diez, Paul Richard
Brain affordances: an approach to design for performers with locked-in syndrome
(2016) Aparicio Alonso, Andrés
Can Cushioned Shoes with Anatomical Insole Correct theImpact in Runners with Recurring Shin Splint?
(2015) De La Fuente Cancino Carlos Ignacio; Henríquez, Ramírez, Hugo; Ramírez-Campillo, Rodrigo; Delgado Bravo Mauricio Antonio; Chamorro Lange, Claudio Hernán; Ruidiaz, Sebastián; Campos Jara, Christian Alex; Carcuro, Giovanni
Characterization of Drug Use Patterns Using Process Mining and Temporal Abstraction Digital Phenotyping
(2019) Rojas, Eric; Capurro Nario, Daniel Alejandro
Understanding and identifying executed patterns, activitiesand processes for patients of different characteristics provides medicalexperts a deep understanding of which tasks are critical in the providedcare, and may help identify ways to improve them. However, extractingthese events and data for patients with complex clinical phenotypes isnot a trivial task. This paper provides an approach to identifying specificpatient cohorts based on complex digital phenotypes as a starting pointto apply process mining tools and techniques and identify patterns orprocess models. Using temporal abstraction-based digital phenotypingand pattern matching, we identified a cohort of patients with sepsis fromthe MIMIC II database, and then apply process mining techniques todiscover medication use patterns. In the case study we present, the useof temporal abstraction digital phenotyping helped us discover a relevantpatient cohort, aiding in the extraction of the data required to generatedrug use patterns for medications of different types such as vasopressors,vasodilators and systemic antibacterial antibiotics. For sepsis patients,combining the use of temporal abstraction digital phenotyping and process mining tools and techniques, was proven to help extract accuratecohorts of patients for health care process mining.
Characterization of exposures in preschoolers reported to a Chilean Poison Control Center in 2020
(TAYLOR & FRANCIS LTD, 2023) Sateler Villanueva, Antonia; Bettini Silva, Marli Francesca; Silva Peña, Lorena Alejandra; Medel Jara, Patricio Andres; Iturra Montecinos, Pablo Andres; Figueroa Silva, Francisco Julio Antonio; Irarrazabal Vargas, Lisette Paola; Rios Bustamante, Juan Carlos
Clusters of Autoimmune Diseases in Children and the Role of PTPN22 C1858T Gene Polymorphism in Pediatric Polyautoimmunity
(2014) Borzutzky Schachter, Arturo; Seiltgens, Cristián; Iruretagoyena B., Mirentxu; Cristi, Francisca; Ponce, María Jesús ; Melendez, Patricia; Martínez Aguayo, Alejandro; Hodgson Bunster, María Isabel; Talesnik Guendelman, Eduardo; Riera Cassorla, Francisca Paz; Méndez, Cecilia; Harris D., Paul R.; García Bruce, Hernán; Gana Ansaldo, Juan Cristóbal; Godoy, Claudia; Cattani Ortega, Andreína
Background/Purpose:Autoimmune diseases (AIDs) have familial aggregation and frequently share a common genetic background, but few studies have evaluated autoimmune clusters in children with AIDs and their families. Children with more than one AID (pediatric polyautoimmunity) may have a stronger genetic component than children with a single AID. The objectives of this study were to identify clusters of AIDs in children and their first-degree relatives and to evaluate the association of PTPN22 C1858T gene polymorphism with pediatric polyautoimmunity.Methods:A cross-sectional study was performed in subjects with an AID of pediatric onset (<18 years)recruited at Pediatric Rheumatology, Endocrinology and Gastroenterology Clinics at the Health Network of the Pontificia Universidad Católica de Chile School of Medicine. Clusters of AIDs were identified by K-means cluster analysis. The PTPN22 C1858T gene polymorphism was determined by RT-PCR in subjects with pediatric polyautoimmunity and in subjects with three common AIDs: juvenile idiopathic arthritis (JIA), autoimmune thyroid disease (AITD), and type I diabetes (T1D).Results:191 subjects with pediatric AIDs were included, of which 45 (24%) had polyautoimmunity. Mean age was 12.1 years (range 1–19) and 68% were female. Most frequent AIDs were JIA (36%), AITD (25%), T1D (19%), uveitis (8%), celiac disease (6%), and vitiligo (6%). 59% of subjects with pediatric autoimmunity had first-degree relatives with an AID. Five clusters of AID were identified in families of children with autoimmunity (Table 1). Among the 45 subjects with pediatric polyautoimmunity, four clusters of AIDs were identified (Table 2). Genomic DNA from 128 subjects was evaluated for PTPN22 C1858T gene polymorphism revealing common homozygosity (C/C) in 85.2%, heterozygosity (C/T) in 13.3%, and rare homozygosity (T/T) in 1.6 %, in equilibrium with Hardy Weinberg equation (P = 0.4). 26% of polyautoimmune subjects had the T allele in contrast with 11% of monoautoimmune subjects (P = 0.04). No significant difference was found in the age of onset of autoimmunity between mono and polyautoimmune subjects (P = 0.44) or between subjects with C/C genotype vs. C/T and T/T genotypes (P = 0.81).
Comparison of the effectiveness of peripheral nerve blockers made with neurostimulator versus ultrasound: Systematic review and meta-analysis
(2008) Cabrera Viera, Francisca; Torres Perez, David; Altermatt Couratier, Fernando Rene
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
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
Docohexaenoic acid improves the reduced umbilical vein relaxation observed in the offspring of pregnancies with maternal obesity
(2017) Farías Jofré, Marcelo Enrique; Villalobos Labra, Roberto Esteban; Solari Gajardo, Sandra; Aguirre Polanco, Carolina; Samith Catalán, Bárbara Patricia; Rojas Vidal, María José
Background and objectives: Maternal obesity (MO) is associated with increased risk of long term metabolic risk in the offspring (REF), probably involving mechanisms such as early programming of insulin resistance in fetal and neonatal tissues. On the other hand, exposure to the polyunsaturated acid Docohexaenoic acid (DHA) has been related with increased insulin response in multiple cell types. The aims of our study were to evaluate the in vitro effect of DHA on vascular response of umbilical vein to insulin, and the role of the intracellular inhibitory phosphorylation of the insulin receptor substrate-1. Methods: Umbilical cords from normal and MO pregnant woman attending to obstetrics service at the Clinical Hospital of Pontificia Universidad Catolica de Chile were obtained after informed consent. Isolated rings of umbilical vein were used to evaluate vasodilatation capacity by wire-myography, in absence or presence of insulin (10-10 to 10-6 uM, 0-20 min) and DHA (100 uM, 12 h). Primary cultures of human umbilical vein endothelial cells (HUVEC) were used to evaluated phosphorylated and total protein levels of IRS-1 in cells exposed or not to insulin (1 nM, 30 min), in absence or presence of DHA (100 uM, 12 h). 308 Ann Nutr Metab 2017;71(suppl 2):1–1433 Oral Abstracts Results: Insulin produces a significant vasodilation (20%) in umbilical vein rings from normal pregnancies, an effect that was absent in MO-derived umbilical rings. This vasodilator effect of insulin was recovered in umbilical vein rings from MO pregnancies pre-incubated with DHA. In addition, HUVEC from MO pregnancies showed increased levels of IRS-1 phosphorylated in serine307, compared with normal cells, a difference that was reduced by DHA, even in presence of insulin. Conclusions: In vitro addition of DHA recovers the reduced vascular response to insulin in umbilical vein from MO pregnancies, involving a reduction of the inhibitory phosphorylation of IRS in serine307.
Dynamics of metals in street dust after a mudslide: Case of mining city in Chile
(2019) Vega Contreras, Alejandra Soledad; Arce, Guillermo; Carkovic Aguilera, Athena B.; Moya, Pablo; Coquery, Marina; Pastén González, Pablo Arturo; CEDEUS (Chile)
Feature space optimization for virtual chromoendoscopy augmented by topography.
(2014) González, Germán; Parot Fernández, Vicente José; Lo, William; Vakoc, Benjamin J.; Durr, Nicholas J.
Glutamate release through glial hemichannels: Focus on neuronal damage
(2013) Orellana Roca, Juan Andrés
Helicobacter pylori-induced TH1-mediated gastric inflammation is exacerbated in interleukin-4, but not interferon-gamma, gene-deficient mice
(1999) Smythies, LE; Waites, KB; Lindsey, JR; Harris Diez, Paul Richard; Ghiara, P; Smith, PD
Hepatic fatty acid profile in mice with nonalcoholic fatty liver disease using magnetic resonance spectroscopy
(2019) Xavier, Aline Carvalho da Silva; Zacconi, Flavia C. M.; Cabrera García, Daniel Alejandro; Fuenzalida, Karen; Andía Kohnenkampf, Marcelo Edgardo
Nonalcoholic fatty liver disease (NAFLD) is characterized by the accumulation of intracellular fatty acids in the liver. The only method to confirm the stage of this disease is the biopsy, but it is invasive and risky to patients. The idea of defining a classifier using magnetic resonance spectroscopy (MRS) emerges due to the need to find a way to replace biopsy with a non-invasive method that can classify NAFLD based on the chemical structure of fatty acids stored in the liver. The purpose of this study is to investigate and compare the composition of fatty acids to the metabolites signals in MRS in NAFLD mice liver at 2 time-point during the progression of the disease. A group of C57BL/6 mice was fed with high-fat diet for one month (N = 8) and for three months (N = 6). First, we made a histological analysis to the liver. Then, we analysed the fatty acids with gas chromatography (GC) and MRS. As a result, the histological analysis showed the progression of fat content, and the GC analysis detected a different fatty acid liver composition during the progression of NAFLD along with an increase of the total fat storage in the liver. The differences in the composition fatty acids are also reflected in the MR Spectrum, which could have clinical potential for monitoring the progression of this disease with a non-invasive technique.
Historical exposure to arsenic in drinking water and risk of late fetal and infant mortality - Chile 1950-2005
(2014) Ríos, P.; Cortés, S.; Villarroel, L.; Ferreccio, C.
A previous study comparing two Chilean cities demonstrated significant increase in fetal mortality in relation to increase in arsenic (As) exposure. Our aim was to confirm this association increasing size and variation of the comparison group, extending the time interval and measuring additional potential confounders. We used time series analysis of infant mortality indicators. We confirmed the clear excess of risk of late fetal death following the increase of the As concentration in drinking water, and the rapid return to the baseline mortality rate in response to the removal of arsenic after 1973. The effect was lower for neonatal and post-neonatal mortality. This study confirms that fetus is more sensitive to As and that regulations should consider additional protection for pregnant women and small children.

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