Artículos de revistas

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Esta colección incluye artículos de revistas de profesores de la Pontificia Universidad Católica de Chile, publicados en revistas nacionales y extranjeras.

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47-Fold rise of diabetes in childbearing age Chilean women: Markov model and cost-effectiveness of prevention of birth defects
(2018) Olmos Coelho, Pablo Roberto; Borzone, Gisella; Poblete, Andres
A comparative pharmacokinetic study of micronized estradiol valerate administered alone and in combination with medroxyprogesterone acetate in postmenopausal women
(LIPPINCOTT WILLIAMS & WILKINS, 2004) Saavedra, I; Leon, J; Prado, J; Sanchez, MP; Lopez, F; Gaete, L
The objective of this study was to evaluate a possible pharmacokinetic interaction between 17beta-estradiol (E-2) and medroxyprogesterone (MP) when administered together in a combined tablet because both hormones have common metabolic routes of biotransformation. The study assessed the mean pharmacokinetics parameters of E2 found after 1-dose administration of 2 different tablets containing E-2, 1 containing 2 mg of micronized 17beta-estradiol valerate (E2V) and the other, administered after 2 weeks, 2 mg of E,V in combination with 5 mg of medroxyprogesterone acetate (MPA). The subjects were 15 healthy postmenopausal women with normal laboratory and clinic tests. The study was randomized, double blind, crossover, with 2 periods and 2 sequences. The blood samples were obtained at 0, 1, 2, 3, 4, 6, 8, 10, 12, and 24 hours after each administration. The F, serum concentrations were determined by electrochemoluminiscence assay. From these data, the following pharmacokinetic parameters were calculated for E, alone and E, in combination with MPA (E2V/MPA): C-max = 104.89 +/- 26.96, 103.27 +/- 44.40; AUC(0-24) = 1900.30 +/- 392.23, 1783.70 +/- 756.39; AUC(0-infinity) = 5576.06 +/- 4065.87, 5317.89 +/- 3702.54; k(a) = 1.06 +/- 0.31, 1.09 +/- 0.13; t1/2 = 35.65 +/- 20.62, 36.12 +/- 18.04; MRT = 16.29 +/- 8.77,16.27 +/- 4.88; V/F = 16.29 +/- 8.76, 16.27 +/- 4.88. No significant differences between the pharmacokinetic parameters of E-2 and E-2/MPA were found, which led us to conclude that there is no pharmacokinetic interaction.
A comparison of single and combined visual, cytologic, and virologic tests as screening strategies in a region at high risk of cervical cancer
(AMER ASSOC CANCER RESEARCH, 2003) Ferreccio Readi, Catterina; Bratti, María C.; Sherman, Mark E.; Herrero, Rolando; Marshall Rivera, Guillermo; Wacholder, Sholom; Hildesheim, Allan; Burk, Robert D.; Hutchinson, Martha; Alfaro, Mario; Greenberg, Mitchell D.; Morales, Jorge; Rodríguez, Ana C.; Schussler, John; Eklund, Claire; Schiffman, Mark
A complex intervention to support breastfeeding: A feasibility and acceptability study
(2023) Lucchini-Raies, Camila; Marquez-Doren, Francisca; Perez, J. Carola; Campos, Solange; Beca, Paulina; Lopez-Dicastillo, Olga
AimsThe aims of this study are to assess the acceptability and feasibility of a multicomponent intervention to support breastfeeding women and their families and explore its effectiveness. MethodsA pilot study with control and intervention groups was conducted using the complex intervention framework in two primary healthcare centres. Overall, 44 childbearing women, their partners/relatives and 20 healthcare professionals participated in the study. The intervention's feasibility and acceptability were measured. The percentage of exclusive breastfeeding rates and women's self-efficacy were measured at pre-intervention, at 10 days postpartum, and again at 2, 4 and 6 months postpartum. Postpartum depression risk was measured at 2 and 6 months postpartum. Professional self-efficacy was measured at pre-intervention and 3 months later. ResultsThe intervention was feasible and acceptable. No difference in self-efficacy existed between the intervention and control groups. Preliminary effects of the intervention were found in exclusive breastfeeding percentage and postpartum depression risk in the intervention group. ConclusionThe intervention is feasible and acceptable. The results are promising not only for breastfeeding maintenance but also for preventing postpartum depression and recovering exclusive breastfeeding during pandemics. Trial registration ID: NCT03944642.
A DETECTIVE ON THE CLUE OF FEMICIDE. EL LEVE ALIENTO DE LA VERDAD BY RAMON DIAZ ETEROVIC
(UNIV CONCEPCION, FAC HUMANIDADES ARTE, 2016) Vasquez Mejias, Ainhoa
El leve aliento de la verdad, novel by Chilean writer Ramon Diaz Eterovic is inserted in the Latin American neopolicial in his criticism of a corrupt, patriarchal and sexist society, a system that violent women in sexual, domestic, labor field, until culminating in femicide. A criticism adds a complaint regarding the existence of corrupt and inefficient police and unequal application of laws in Chile. However, this novel Diaz Eterovic can not fully defined under the model neopolicial - and it also detaches from his previous novels- because the detective gets a criminal punishment for femicidal who murdered prostitutes, triumphing over corrupt authorities.
A Generation 1.5 Palestinian Diaspora Child Refugee in Chile
(2021) Arancibia, Hector; Leihy, Pete; Samari, Davood
This study follows a former child refugee's experience of family resettlement in Chile. Born into the Palestinian Iraqi community further imperiled by the 2003 invasion of Iraq, his family fled first to the Al-Tanf refugee camp before placement in Chile. While most of the world's refugees dwell in marginal conditions in areas neighboring conflicts, another strain of permanent settlement has been highly developed amongst some of the wealthiest countries. For countries such as Chile-by strict definition now high-income, but only newly considering a role as a haven for refugees-tentative steps toward resettlement protocols mean that case data are limited. By carefully studying a family's resettlement and subsequent experience from a child refugee's reflections, it is possible to sketch out and understand a range of challenges at the human scale of supporting refugees.
A genetic association study of maternal and fetal candidate genes that predispose to preterm prelabor rupture of membranes (PROM)
(MOSBY-ELSEVIER, 2010) Romero, Roberto; Friel, Lara A.; Edwards, Digna R. Velez; Kusanovic, Juan Pedro; Hassan, Sonia S.; Mazaki Tovi, Shali; Vaisbuch, Edi; Kim, Chong Jai; Erez, Offer; Chaiworapongsa, Tinnakorn; Pearce, Brad D.; Bartlett, Jacquelaine; Salisbury, Benjamin A.; Anant, Madan Kumar; Vovis, Gerald F.; Lee, Min Seob; Gomez, Ricardo; Behnke, Ernesto; Oyarzun, Enrique; Tromp, Gerard; Williams, Scott M.; Menon, Ramkumar
OBJECTIVE: We sought to determine whether maternal/fetal single-nucleotide polymorphisms (SNPs) in candidate genes are associated with preterm prelabor rupture of membranes (pPROM).
A Group Videoconferencing Intervention (C@nnected) to Improve Maternal Sensitivity: Protocol for a Randomized Feasibility Trial
(JMIR Publications Inc., 2022) Binda V.; Castanon C.; Olhaberry M.; Abarca C.; Caamano C.
© 2022 JMIR Publications. All rights reserved.Background: Early childhood development is highly dependent on the sensitive care provided by caregivers, and interventions focused on supporting parents to improve their sensitivity have shown to be effective. The COVID-19 pandemic has had a significant impact on mental health, with pregnant women and mothers of infants being an especially vulnerable group and maternal sensitivity particularly affected. However, access to face-to-face interventions is restricted; thus, it is important to have remote interventions to support this group of mothers. Objective: The objective of this study is to evaluate the feasibility and acceptability of C@nnected, a group videoconferencing intervention to improve maternal sensitivity aimed at mother-infant dyads attending primary health care centers in vulnerable areas of Santiago, Chile. Methods: This is a randomized feasibility single-masked (outcome assessor) study with a qualitative component. It will involve a block randomization procedure to generate a 3:2 allocation ratio (with more people allocated to the intervention arm). The intervention consists of 4 group videoconferencing sessions adapted from a face-to-face intervention with proven effectiveness. The control group will receive treatment as usual, along with educational brochures. The feasibility and acceptability of this study will be quantitatively and qualitatively assessed. Changes in clinical outcomes relating to maternal sensitivity, depressive symptoms, postpartum maternal attachment, and infant socioemotional development will also be evaluated. Results: We finished adapting the face-to-face intervention to the videoconferencing format in July 2021. The study began recruitment in August 2021, and enrollment is expected to end in August 2022, with final study results expected in December 2022. Conclusions: This study will contribute evidence for the use of eHealth interventions to promote maternal sensitivity. It will also inform the design and implementation of a future randomized clinical trial.
A key role for NLRP3 signaling in preterm labor and birth driven by the alarmin S100B
(2023) Galaz, Jose; Motomura, Kenichiro; Romero, Roberto; Liu, Zhenjie; Garcia-Flores, Valeria; Tao, Li; Xu, Yi; Done, Bogdan; Arenas-Hernandez, Marcia; Kanninen, Tomi; Farias-Jofre, Marcelo; Miller, Derek; Tarca, Adi L.; Gomez-Lopez, Nardhy
Preterm birth remains the leading cause of neonatal morbidity and mortality worldwide. A substantial number of spontaneous preterm births occur in the context of sterile intra-amniotic inflammation, a condition that has been mechanistically proven to be triggered by alarmins. However, sterile intra-amniotic inflammation still lacks treatment. The NLRP3 inflammasome has been implicated in sterile intra-amniotic inflammation; yet, its underlying mechanisms, as well as the maternal and fetal contributions to this signaling pathway, are unclear. Herein, by utilizing a translational and clinically relevant model of alarmin-induced preterm labor and birth in Nlrp3-/- mice, we investigated the role of NLRP3 signaling by using imaging and molecular biology approaches. Nlrp3 deficiency abrogated preterm birth and the resulting neonatal mortality induced by the alarmin S100B by impeding the premature activation of the common pathway of labor as well as by dampening intra-amniotic and fetal inflammation. Moreover, Nlrp3 deficiency altered leukocyte infiltration and functionality in the uterus and decidua. Last, embryo transfer revealed that maternal and fetal Nlrp3 signaling contribute to alarmin-induced preterm birth and neonatal mortality, further strengthening the concept that both individuals participate in the complex process of preterm parturition. These findings provide novel insights into sterile intra-amniotic inflammation, a common etiology of preterm labor and birth, suggesting that the adverse perinatal outcomes resulting from prematurity can be prevented by targeting NLRP3 signaling.
A longitudinal study of angiogenic (placental growth factor) and anti-angiogenic (soluble endoglin and soluble vascular endothelial growth factor receptor-1) factors in normal pregnancy and patients destined to develop preeclampsia and deliver a small for gestational age neonate
(TAYLOR & FRANCIS LTD, 2008) Romero, Roberto; Nien, Jyh Kae; Espinoza, Jimmy; Todem, David; Fu, Wenjiang; Chung, Hwan; Kusanovic, Juan Pedro; Gotsch, Francesca; Erez, Offer; Mazaki Tovi, Shali; Gomez, Ricardo; Edwin, Sam; Chaiworapongsa, Tinnakorn; Levine, Richard J.; Karumanchi, S. Ananth
Introduction. Accumulating evidence suggests that an imbalance between pro-angiogenic (i.e., vascular endothelial growth factor (VEGF) and placental growth factor (PlGF)) and anti-angiogenic factors (i.e., soluble VEGF receptor-1 (sVEGFR-1, also referred to as sFlt1)) is involved in the pathophysiology of preeclampsia (PE). Endoglin is a protein that regulates the pro-angiogenic effects of transforming growth factor , and its soluble form has recently been implicated in the pathophysiology of PE. The objective of this study was to determine if changes in maternal plasma concentration of these angiogenic and anti-angiogenic factors differ prior to development of disease among patients with normal pregnancies and those destined to develop PE (preterm and term) or to deliver a small for gestational age (SGA) neonate.
A Pooled Analysis to Compare the Clinical Characteristics of Human Papillomavirus-positive and -Negative Cervical Precancers
(2020) Castle, Philip E.; Pierz, Amanda J.; Adcock, Rachael; Aslam, Shagufta; Basu, Partha S.; Belinson, Jerome L.; Cuzick, Jack; El-Zein, Mariam; Ferreccio, Catterina; Firnhaber, Cynthia; Franco, Eduardo L.; Gravitt, Patti E.; Isidean, Sandra D.; Lin, John; Mahmud, Salaheddin M.; Monsonego, Joseph; Muwonge, Richard; Ratnam, Samuel; Safaeian, Mahboobeh; Schiffman, Mark; Smith, Jennifer S.; Swarts, Avril; Wright, Thomas C.; Van De Wyngard, Vanessa; Xi, Long Fu
Given that high-risk human papillomavirus (HPV) is the necessary cause of virtually all cervical cancer, the clinical meaning of HPV-negative cervical precancer is unknown. We, therefore, conducted a literature search in Ovid MEDLINE, PubMed Central, and Google Scholar to identify English-language studies in which (i) HPV-negative and -positive, histologically confirmed cervical intraepithelial neoplasia grade 2 or more severe diagnoses (CIN2+) were detected and (ii) summarized statistics or deidentified individual data were available to summarize proportions of biomarkers indicating risk of cancer. Nineteen studies including 3,089 (91.0%) HPV-positive and 307 (9.0%) HPV-negative CIN2+ were analyzed. HPV-positive CIN2+ (vs. HPV-negative CIN2+) was more likely to test positive for biomarkers linked to cancer risk: a study diagnosis of CIN3+ (vs. CIN2; 18 studies; 0.56 vs. 0.24; P < 0.001) preceding high-grade squamous intraepithelial lesion cytology (15 studies; 0.54 vs. 0.10; P < 0.001); and high-grade colposcopic impression (13 studies; 0.30 vs. 0.18; P = 0.03). HPV-negative CIN2+ was more likely to test positive for low-risk HPV genotypes than HPV-positive CIN2+ (P < 0.001). HPV-negative CIN2+ appears to have lower cancer risk than HPV-positive CIN2+. Clinical studies of human high-risk HPV testing for screening to prevent cervical cancer may refer samples of HPV test-negative women for disease ascertainment to correct verification bias in the estimates of clinical performance. However, verification bias adjustment of the clinical performance of HPV testing may overcorrect/underestimate its clinical performance to detect truly precancerous abnormalities.
A population-based cohort study of breastfeeding according to gestational age at term delivery
(2013) Lutsiv, Olha; Giglia, Lucia; Pullenayegum, Eleanor; Foster, Gary; Vera Pérez-Gacitúa, Claudio Mauricio; Chapman, Barbara; Fusch, Christoph; McDonald, Sarah D.
A PREPUBERTAL SURGE OF THYROTROPIN PRECEDES AN INCREASE IN THYROXINE AND 3,5,3'-TRIIODOTHYRONINE IN NORMAL-CHILDREN
(ENDOCRINE SOC, 1991) MICHAUD, P; FORADORI, A; RODRIGUEZPORTALES, JA; ARTEAGA, E; LOPEZ, JM; TELLEZ, R
The variations in plasma levels of TSH, T4, T3, and rT3, during the pubertal period, were studied in 647 school students from the urban area of Santiago in Chile (47% males and 53% females) with ages ranging between 7.5 and 15 yr. The subjects were grouped by age in consecutive intervals of 6 months each, and pubertal development was determined in every subject. TSH showed a significant increase, reaching a peak in the 9- to 9.5-yr interval. The same was found for T3 and T4, which reached a peak by 10 and 11 yr. The T4/T3 ratio did not show any significant variation with age. After 9.5 yr, a decrease in rT3 and increase in the T4/rT3 ratio was found. The TSH peak preceded the onset of clinical pubertal development, while the T3 and T4 peaks coincided with this onset. The variations in rT3 suggest an increase of peripheral conversion of T4 to T3. These transient events, not described until now, could be termed thyroidarche and could have a significant effect on pubertal growth and development.
A Protocol for Evaluating Vital Signs and Maternal-Fetal Parameters Using High-Resolution Ultrasound in Pregnant Mice
(2020) Galaz, Jose; Romero, Roberto; Arenas-Hernandez, Marcia; Panaitescu, Bogdan; Garcia-Flores, Valeria; Gomez-Lopez, Nardhy
Pregnancy is a unique physiological state in which two individuals coexist: the mother and the fetus. Disruption of maternal-fetal crosstalk leads to pregnancy and neonatal pathologies. Therefore, assessing maternal-fetal well-being is essential for understanding the physiological and pathological processes occurring during pregnancy. Herein, we provide a protocol that allows for the determination of body temperature, blood pressure, and the evaluation of uterine and umbilical arteries as well as maternal and fetal heart rate using high-resolution ultrasound in pregnant mice. For complete details on the use and execution of this protocol, please refer to Gomez-Lopez et al. (2020).
A rapid MMP-8 bedside test for the detection of intra-amniotic inflammation identifies patients at risk for imminent preterm delivery
(2006) Nien, J. K.; Yoon, B. H.; Espinoza, J.; Kusanovic, Juan Pedro; Erez, O.; Soto, E.; Richani, K.; Gómez Mora, Ricardo Alberto; Hassan, S.; Mazor, M.; Edwin, S.; Bahado-Singh, R.; Romero, R.
Objective: Matrix metalloproteinase-8 (MMP-8) is an enzyme that is released during neutrophil activation. MMP-8 amniotic fluid concentrations are elevated not only in patients with intra-amniotic infection, but also in patients with negative amniotic fluid cultures who deliver preterm neonates. The objective of this study was to determine whether the results of a rapid MMP-8 bedside test predict imminent preterm delivery. This test can be performed in 15 minutes and without laboratory equipment. Study design: Amniotic fluid was retrieved from 331 patients admitted with increased preterm uterine contractions and intact membranes who met the inclusion criteria. Amniotic fluid was processed for microbial cultures, Gram stain, glucose concentration, and white blood cell count. Amniotic fluid samples were stored, and the MMP-8 rapid test was performed after delivery. End points included spontaneous preterm delivery within 48 hours, 7 days, and 14 days. Diagnostic indices, predictive values, and likelihood ratios were calculated. Results: The prevalence of spontaneous preterm delivery within 48 hours, 7 days, and 14 days was 11.6% (38/327), 20.2% (66/327), and 24.5% (80/327), respectively (4 patients with augmentation of labor were excluded). A positive MMP-8 rapid test had a positive predictive value of 70% (23/33) for the identification of patients who delivered spontaneously within 48 hours, and 94% (31/33) for patients who were delivered within 7 days and 14 days (likelihood ratios: 17.5 [95% CI, 9-33.9], 61.3 [95% CI, 15.1-250], and 50 [95% CI, 12-196], respectively). Conclusion: The MMP-8 rapid test can identify patients at risk for preterm delivery within 7 days and 14 days. Moreover, a positive MMP-8 rapid test result can identify patients with intraamniotic infection/inflammation with a high sensitivity and specificity. This rapid test will give clinicians a fast and accurate assessment of the inflammatory status of the amniotic cavity and allow for better identification of patients at risk for impending preterm delivery.
A scoping review of sexual minority women's health in Latin America and the Caribbean
(2019) Caceres, Billy A.; Jackman, Kasey B.; Ferrer Lagunas, Lilian Marcela; Cato, Kenrich D.; Hughes, Tonda L.
A short cervix in women with preterm labor and intact membranes: A risk factor for microbial invasion of the amniotic cavity
(MOSBY-ELSEVIER, 2005) Gomez, R; Romero, R; Nien, JK; Chaiworapongsa, T; Medina, L; Kim, YM; Yoon, BH; Carstens, M; Espinoza, J; Iams, JD; Gonzalez, R
Objective: The purpose of this study was to determine whether there was a relationship between sonographic cervical length and the presence of culture-proven microbial invasion of the ammotic cavity in women with preterm labor and intact membranes.
A single-cell atlas of murine reproductive tissues during preterm labor
(2023) Garcia-Flores, Valeria; Romero, Roberto; Peyvandipour, Azam; Galaz, Jose; Pusod, Errile; Panaitescu, Bogdan; Miller, Derek; Xu, Yi; Tao, Li; Liu, Zhenjie; Tarca, Adi L.; Pique-Regi, Roger; Gomez-Lopez, Nardhy
Preterm birth, the leading cause of perinatal morbidity and mortality worldwide, frequently results from the syndrome of preterm labor. The best-established causal link to preterm labor is intra-amniotic infection, which involves premature activation of the parturition cascade in the reproductive tissues. Herein, we utilize single-cell RNA sequencing (scRNA-seq) to generate a single-cell atlas of the murine uterus, decidua, and cervix in a model of infection-induced preterm labor. We show that preterm labor affects the transcriptomic profiles of specific immune and non-immune cell subsets. Shared and tissue-specific gene expression sig-natures are identified among affected cells. Determination of intercellular communications implicates spe-cific cell types in preterm labor-associated signaling pathways across tissues. In silico comparison of murine and human uterine cell-cell interactions reveals conserved signaling pathways implicated in labor. Thus, our scRNA-seq data provide insights into the preterm labor-driven cellular landscape and communications in reproductive tissues.
A sonographic short cervix as the only clinical manifestation of intra-amniotic infection
(2006) Hassan, S; Romero, R; Hendler, I; Gomez, R; Khalek, N; Espinoza, J; Nien, JK; Berry, SM; Bujold, E; Camacho, N; Sorokin, Y
Objective: A sonographically short cervix is a powerful predictor of spontaneous preterm delivery. However, the etiology and optimal management of a patient with a short cervix in the mid-trimester of pregnancy remain uncertain. Microbial invasion of the amniotic cavity (MIAC) and intra-amniotic inflammation are frequently present in patients with spontaneous preterm labor or acute cervical insufficiency. This study was conducted to determine the rate of MIAC and intra-amniotic inflammation in patients with a cervical length < 25 mm in the mid-trimester.
A STUDY ON THE FEASIBILITY OF SUPPRESSING OVARIAN ACTIVITY FOLLOWING THE END OF POSTPARTUM AMENORRHEA BY INCREASING THE FREQUENCY OF SUCKLING
(1988) DIAZ, S; MIRANDA, P; BRANDEIS, A; CARDENAS, H; CROXATTO, HB
The aim of the study was to test the effect of increasing the frequency of breastfeeding upon ovarian function following the end of postpartum amenorrhoea. Women exclusively breastfeeding (n = 14) who experienced their first postpartum menstruation between the third and fifth month after delivery were randomly allocated to an experimental (n = 7) and a control (n = 7) group and studied during the next two cycles. Women in the experimental group agreed to increase the number of breastfeeding episodes per day throughout the second cycle. Blood samples were drawn twice a week from the first to the third postpartum menstruation for prolactin, oestradiol and progesterone determinations. The number of breastfeeding episodes per day and night and the length of each episode were recorded daily. An average frequency of 11 nursing episodes per 24 h was reported during the first study cycle in both groups. The experimental group increased by 50% of the breastfeeding frequency after the second menstruation while the control group kept its spontaneous feeding pattern. The increase of suckling frequency occurred mainly during day hours. The total breastfeeding time per 24 h was not increased. The length of the menstrual cycle was not altered by the increased suckling frequency. The endocrine pattern differed neither between the first and second cycle of the experimental group nor between the experimental and control group, with the exception of PRL levels which were higher in the experimental gorup throughout both cycles. Twenty cycles (71%) showed progesterone values compatible with ovulation (> 9.5 nmol/l). The highest progesterone values and the highest oestradiol values observed in the ovulatory cycles of lactating women were within the range found in non-nursing fertile women. Plasma levels of PRL were significantly elevated in all cycles but one, in comparison with PRL levels in non-nursing women. It is concluded that if cyclic ovarian function is reestablished early in fully nursing women, a mere increase in the number of breastfeeding episodes, without augmenting total suckling time and the frequency of nocturnal episodes, does not provide a sufficient stimulus to resuppress the pituitary-ovarian axis.

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