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Cost-effectiveness of screening, decolonisation and isolation strategies for carbapenem-resistant Enterobacterales and methicillin-resistant Staphylococcus aureus infections in hospitals: a sex-stratified mathematical modelling study
(Elsevier BV, 2025-03)
Kasim Allel
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Patricia Garcia
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Anne Peters
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MUNITA SEPULVEDA, JOSE MANUEL
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Eduardo A. Undurraga
2
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Retrospective study on disparities in time-to-treatment by health insurance system in Chilean breast cancer patients
(Medwave Estudios Limitada, 2025-04-10)
ACEVEDO ROMO, JOHANNA PATRICIA
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Teresa Ip
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Lea Maureira
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Cesar Sanchez
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Claudia Osorio
Introduction Breast cancer is the most common malignancy in the Americas, and the second leading cause of cancer death. Disparities in the time to treatment can significantly impact patient outcomes and typically affect lower socioeconomic individuals and/or ethnic minorities. Our study sought to evaluate disparities in time to treatment at three health institutions in Chile according to their type of health insurance (public or private). Methods Our study analyzed a database of breast cancer patients diagnosed between 2017 and 2018. Analyses included descriptive statistics and a linear regression model that incorporated clinical and demographic variables. Additionally, using a proportional risks model, we analyzed the association between clinical variables and mortality. Results Public health insurance (National Health Fund, FONASA) was associated with longer time-to-treatment and extended treatment times versus private health insurance (Social Security Institutions, ISAPRE; p < 0.0001). As expected, a more advanced stage at diagnosis was associated with lower survival. Our proportional risks model found that age was a predictor of breast cancer mortality in stage II patients. Also, total treatment time significantly increased the risk of breast cancer mortality in stage I patients. Conversely, total treatment time did not affect mortality on stages II or III. Conclusions We found significant disparities in the time to treatment of Chilean breast cancer patients using FONASA versus private ISAPRE. FONASA patients experience delays in the initiation of treatment and longer total treatment times compared to their private insurance counterparts. Finally, longer time-to-treatment was associated with more advanced stages and increased mortality.
3
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Return-to-sport tests: Do they reduce risk of re-rupture after anterior cruciate ligament reconstruction?
(Elsevier BV, 2025-04)
FIGUEROA POBLETE, DAVID HUMBERTO
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Waldo Gonzalez Duque
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Daniela Landea Caroca
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Camila Tapia Castillo
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Daniela Erskine Ventura
Scopus© Citations 1 1
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Machine learning-based identification of efficient and restrictive physiological subphenotypes in acute respiratory distress syndrome
(Springer Science and Business Media LLC, 2025-03-01)
Gabriela Meza-Fuentes
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DELGADO BECERRA, OROZIMBA IRIS
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Mario Barbé
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Ignacio Sánchez
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RETAMAL LUCERO, MAURICIO ANTONIO
Acute respiratory distress syndrome (ARDS) is a severe condition with high morbidity and mortality, characterized by significant clinical heterogeneity. This heterogeneity complicates treatment selection and patient inclusion in clinical trials. Therefore, the objective of this study is to identify physiological subphenotypes of ARDS using machine learning, and to determine ventilatory variables that can effectively discriminate between these subphenotypes in a bedside setting with high performance, highlighting potential utility for future clinical stratification approaches.</jats:p> Methodology A retrospective cohort study was conducted using data from our ICU, covering admissions from 2017 to 2021. The study included 224 patients over 18 years of age diagnosed with ARDS according to the Berlin criteria and undergoing invasive mechanical ventilation (IMV). Data on physiological and ventilatory variables were collected during the first 24 h IMV. We applied machine learning techniques to categorize subphenotypes in ARDS patients. Initially, we employed the unsupervised Gaussian Mixture Classification Model approach to group patients into subphenotypes. Subsequently, we applied supervised models such as XGBoost to perform root cause analysis, evaluate the classification of patients into these subgroups, and measure their performance.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Our models identified two ARDS subphenotypes with significant clinical differences and significant outcomes. Subphenotype Efficient (<jats:italic>n</jats:italic> = 172) was characterized by lower mortality, lower clinical severity and presented a less restrictive pattern with better gas exchange compared to Subphenotype Restrictive (<jats:italic>n</jats:italic> = 52), which showed the opposite. The models demonstrated high performance with an area under the ROC curve of 0.94, sensitivity of 94.2% and specificity of 87.5%, in addition to an F1 score of 0.85. The most influential variables in the discrimination of subphenotypes were distension pressure, respiratory frequency and exhaled carbon dioxide volume.Conclusion This study presents an approach to improve subphenotype categorization in ARDS. The generation of clustering and prediction models by machine learning involving clinical, ventilatory mechanics, and gas exchange variables allowed for more accurate stratification of patients. These findings have the potential to optimize individualized treatment selection and improve clinical outcomes in patients with ARDS.</jats:p> Graphical Abstract
Scopus© Citations 2 5
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Transolecranon fracture dislocation and transolecranon basal coronoid fracture dislocation; results of standardized treatment in a retrospective cohort
(Elsevier BV, 2025-05)
Joaquín De la Paz
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LECAROS URZUA, JUAN ALBERTO
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Andres Calvo
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Antonio Ariztia
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Cristian Aravena
2
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Cáncer de vesícula: ¿Es momento de modificar el GES?
(SciELO Agencia Nacional de Investigacion y Desarrollo (ANID), 2024-10)
Camila P. Samaniego
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Xabier de Aretxabala
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Felipe Castillo
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Álvaro Paredes
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M. Trinidad González
14
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Imaging of intraluminal duodenal diverticulum in adults, an infrequent entity: pictorial essay
(Springer Science and Business Media LLC, 2024-12-02)
WHITTLE PINTO, CAROLINA
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Ignacio Maldonado
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Oscar Campos
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Franco Orellana
<jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>An intraluminal duodenal diverticulum (IDD) is an infrequent abnormality consisting of a sac-like projection within the duodenum secondary to a congenital web of the membrane in the second portion of the duodenum near the papilla of Vater, due to incomplete lumen recanalization of the embryological foregut, with a typical imaging appearance of a “windsock.”</jats:p> <jats:p>The purpose is to present the radiological and tomographic findings characteristics of “IDD.”</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>The IDD in barium upper gastrointestinal imaging and computed tomography (CT) was presented. On upper barium gastrointestinal examination, it is possible to detect an intraluminal duodenal image, that can be distended with gas or barium contrast and delimited by a thin wall (halo sign), mimicking a windsock or a double lumen. On CT, it is possible to identify a windsock sign on the duodenum, most often on the second part, distended by gas and contrast agent.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusion</jats:title> <jats:p>IDD imaging in barium upper gastrointestinal imaging and CT is pathognomonic of this infrequent entity in adults that needs to be recognized by the radiologist. In our small series, IDD images of the windsock sign on barium studies and the characteristic presentation on CT can help to exclude another duodenal conditions, guiding appropriate management.</jats:p> </jats:sec>
1Scopus© Citations 1
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Early prediction of functional mobility severity after stroke: two key milestones
(2024)
Patricia Vargas
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Marcos Maldonado-Diaz
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Tania Gutiérrez-Panchana
Scopus© Citations 4
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Excess burden of antibiotic-resistant bloodstream infections: evidence from a multicentre retrospective cohort study in Chile, 2018–2022
(2024)
Kasim Allel
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Anne Peters
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Hassan Haghparast-Bidgoli
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Maria Spencer-Sandino
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Jose Conejeros
Scopus© Citations 2 4
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Porcentaje de éxito de erradicación de Helicobacter pylori con tratamiento antibiótico empírico en pacientes pediátricos de un Hospital Terciario
(2023)
Sofía Darritchon Lama
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Diego Díaz García
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Marcela Toledo Cumplido
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LUCERO ALVAREZ, YALDA CECILIA
<jats:p>La infección por Helicobacter pylori es una condición frecuente, que a largo plazo se asocia con desarrollo de enfermedad ulceropéptica y eventualmente cáncer gástrico, que se podrían prevenir con un tratamiento oportuno. Lo óptimo sería lograr un éxito de erradicación mayor al 90%, pero los tratamientos empíricos recomendados no logran esas tasas en condiciones reales.Objetivo: Determinar el porcentaje de éxito del tratamiento empírico de erradicación de primera línea contra H. pylori en pacientes pediátricos atendidos en un hospital terciario.Pacientes y Método: Estudio descriptivo retrospectivo en pacientes con infección por H. pylori detectado en biopsias gástricas y que hubieran recibido tratamiento antibiótico de primera línea durante el periodo 2017-2021. Se consideró erradicación exitosa el resultado negativo de test de antígeno en deposiciones o nuevas biopsias luego de ≥ 1 mes de finalizado el tratamiento.Resultados: Se identificaron 82 pacientes con infección por H. pylori, de los cuales 53 recibieron tratamiento de erradicación. De éstos, 26 (49%) fueron controlados con test de erradicación luego del tratamiento y en ellos el porcentaje de éxito fue de solo 38% (10/26).Conclusiones: La tasa de erradicación con los esquemas empíricos utilizados fue menor a la esperada, lo que evidencia el desafío de buscar estrategias más efectivas de tratamiento incluyendo el estudio de susceptibilidad a antimicrobianos. La adherencia de los pacientes al protocolo de seguimiento también fue baja, lo que deberá reforzarse en el futuro para poder realizar un manejo clínico más adecuado. </jats:p>
Scopus© Citations 4 2

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