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    Ultra‐Processed Foods and Markers of Systemic Inflammation in Children
    (Wiley, 2025-09)
    Camila Awad
    ;
    RUBILAR RAMIREZ, PAOLA ANDREA  
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    HIRMAS ADAUY, MACARENA SOLEDAD  
    ;
    Verónica Iglesias
    ;
    María Pía Muñoz
    Diets high in ultra-processed foods (UPF) have been associated with negative health outcomes in adults; however, UPF's impact on children's health and their underlying mechanisms remain underexplored, despite the rising prevalence of their intake in younger populations. We aimed to investigate the association between UPF intake and systemic inflammation in primary school children. This study included 450 children aged 7-10 years participating in a birth cohort in Arica, Chile (2023). Using the NOVA food classification system, we calculated the intake of UPF (expressed in %kcal) from a 44-item food frequency questionnaire (FFQ). The associations between UPF intake (exposure) and an array of cytokine levels (IL-6, IL-8, IL-10, IL-12, IL1 beta, TNF-alpha) were assessed using multiple linear regression models, adjusted for relevant covariates. The mean (SD) UPF intake was 29% (10.5%) of the total energy intake. Some of the associations appeared non-linear; therefore, participants were grouped into tertiles of UPF intake. In adjusted models, a suggestive trend across tertiles was observed for IL-1 beta (trend p-value 0.01). Stratified analyses by age suggested an association between UPF intake and IL-6 in older children (>= 9 years) only (p-value for interaction = 0.02). We found potential associations between UPF intake and cytokine levels in school-aged children. These results may suggest inflammation as a mechanism underlying the adverse health consequences of UPF consumption in children.
      7
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    Post-COVID-19 symptoms in a community sample: Exploratory study in two Chilean cities, 2023–2024
    (Elsevier BV, 2025-11)
    Xaviera Molina
    ;
    Camila Awad
    ;
    Muriel Ramírez-Santana
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    RUBILAR RAMIREZ, PAOLA ANDREA  
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    Loreto Nunez-Franz
      1
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    Arsenic Exposure During Pregnancy and Childhood: Factors Explaining Changes over a Decade
    (MDPI AG, 2025-03-16)
    RUBILAR RAMIREZ, PAOLA ANDREA  
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    HIRMAS ADAUY, MACARENA SOLEDAD  
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    APABLAZA SALINAS, MAURICIO IVÁN  
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    Camila Awad
    ;
    Xaviera Molina
    Arsenic chronic exposure, particularly in its inorganic form, represents a significant public health concern. This study was conducted in Arica, the northernmost city in the country, whose inhabitants have been exposed to inorganic arsenic both naturally through drinking water and anthropogenically due to a toxic waste disposal site. We explored changes in inorganic arsenic levels in a cohort of pregnant women and their children over a decade, identifying exposure trends and their determinants. We used data on arsenic exposure through maternal urine samples during pregnancy, collected by the Health Authority between 2013 and 2016 (measurement 1), and followed up with assessments of their children in 2023 (measurement 2). Temporal changes in inorganic arsenic concentration were analyzed using the Wilcoxon Signed-Rank test, and a mixed linear regression model was employed to determine which factors contributed to urinary inorganic arsenic levels. We did not observe significant differences in mean arsenic concentrations between the two-time points (p = 0.4026). The mixed linear regression model revealed that children consuming bottled water had 8.3% lower urinary inorganic arsenic concentrations than those drinking tap water (95% CI: −15.36 to −0.54%). Additionally, children from ethnic groups had 8.64% higher inorganic arsenic concentrations (95% CI: 0.49 to 17.5%), while those with caregivers with higher education showed a 13.67% reduction (95% CI: −25.06 to −0.56%). Despite mitigation efforts, these findings underscore the ongoing risk of inorganic arsenic exposure among vulnerable populations. They further emphasize the importance of addressing natural arsenic contamination in water and implementing targeted interventions to reduce disparities associated with socioeconomic and demographic factors.</jats:p>
    Scopus© Citations 1  6
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    Navigating Through Innovation in Elderly’s Health: A Scoping Review of Digital Health Interventions
    (Frontiers Media SA, 2024-12-19)
    HIRMAS ADAUY, MACARENA SOLEDAD  
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    CASTILLO LABORDE, CARLA CECILIA  
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    Fernando Soto
    ;
    Camila Awad
    ;
    Anita Jasmen
    <jats:sec><jats:title>Objectives</jats:title><jats:p>Comprehensively map and summarize digital health initiatives for the elderly and caregivers.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Scoping review between April and May 2022 based on Joanna Briggs methodology. Databases used included PubMed, Cochrane Library, CINAHL Plus, and Web of Science, along with grey literature and hand searches. Two reviewers independently conducted screening and eligibility phases, with a third resolving disagreements. Data were thematically analyzed.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The review included 421 documents. Most documents were published between 2013 and 2022, with a recent increase. Most studies, originating from high-income countries, focused on home applications and were mainly in the testing and validation stages. Telephones and computers were the predominant devices. Health objectives included monitoring, prevention, and treatment, with interventions utilizing directed communication and personal health monitoring for individuals, and telemedicine and decision support for healthcare providers.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Increasing integration of technology in older adults’ lives, along with their increasing proficiency, is driving a significant rise in digital health interventions. Despite this growth, further research in middle- and low-income countries, for caregivers and evaluating effectiveness and feasibility of these technological interventions is needed.</jats:p></jats:sec>
      6
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    Anti-inflammatory Effects of Topical Hypericum perforatum: A Systematic Review
    (2023)
    Monica Estrada
    ;
    Ruth E. Chávez-Nomberto
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    André Saul Crestani
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    Ana Paula Tsuneto
    ;
    Camila Awad
    Many inflammatory conditions directly impact the skin through different pathways, the understanding of which should be a priority to develop new medications to treat patients suffering from these conditions. Some studies have demonstrated the anti-inflammatory properties of Hypericum perforatum (HP), but no previous systematic reviews have described all the mechanisms by which topical HP may act on inflammation. Therefore, the purpose of this review was to assess the effects of topical HP on inflammatory markers in inflammatory skin conditions or models involving epithelial cells that have been described so far.
      2
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    Barriers and Facilitators in Access to Diabetes, Hypertension, and Dyslipidemia Medicines: A Scoping Review
    (2022)
    CASTILLO LABORDE, CARLA CECILIA  
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    Macarena Hirmas-Adauy  
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    MATUTE WILLEMSEM, MARIA ISABEL  
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    Anita Jasmen
    ;
    Oscar Urrejola
    <jats:p><jats:bold>Objective:</jats:bold> Identify barriers and facilitators in access to medicines for diabetes, hypertension, and dyslipidemia, considering patient, health provider, and health system perspectives.</jats:p><jats:p><jats:bold>Methods:</jats:bold> Scoping review based on Joanna Briggs methodology. The search considered PubMed, Cochrane Library, CINAHL, Academic Search Ultimate, Web of Science, SciELO Citation Index, and grey literature. Two researchers conducted screening and eligibility phases. Data were thematically analyzed.</jats:p><jats:p><jats:bold>Results:</jats:bold> The review included 219 documents. Diabetes was the most studied condition; most of the evidence comes from patients and the United States. Affordability and availability of medicines were the most reported dimension and specific barrier respectively, both cross-cutting concerns. Among high- and middle-income countries, identified barriers were cost of medicines, accompaniment by professionals, long distances to facilities, and cultural aspects; cost of transportation emerges in low-income settings. Facilitators reported were financial accessibility, trained health workers, medicines closer to communities, and patients’ education.</jats:p><jats:p><jats:bold>Conclusion:</jats:bold> Barriers and facilitators are determined by socioeconomic and cultural conditions, highlighting the role of health systems in regulatory and policy context (assuring financial coverage and free medicines); providers’ role bringing medicines closer; and patients’ health education and disease management.</jats:p>
    Scopus© Citations 12  1