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Author: search.filters.author.Arnoldo RiquelmeStart date: 2020

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    A snapshot of cancer in Chile II: an update on research, strategies and analytical frameworks for equity, innovation and national development
    (Springer Science and Business Media LLC, 2024-12-18)
    Cristóbal Vacarezza
    ;
    Julieta Araneda
    ;
    Pamela Gonzalez
    ;
    Oscar Arteaga
    ;
    Katherine Marcelain
    <jats:title>Abstract</jats:title><jats:sec> <jats:title>Introduction</jats:title> <jats:p>Chile has achieved developed nation status and boasts a life expectancy of 81 + years; however, the healthcare and research systems are unprepared for the social and economic burden of cancer. One decade ago, the authors put forward a comprehensive analysis of cancer infrastructure, together with a series of suggestions on research orientated political policy.</jats:p> </jats:sec><jats:sec> <jats:title>Objectives</jats:title> <jats:p>Provide an update and comment on policy, infrastructure, gender equality, stakeholder participation and new challenges in national oncology. Assess the funding and distribution of cancer investigation. Present actions for the development of oncology research, innovation and patient care.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>Triangulating objective system metrics of economic, epidemiological, private and public sector resources together with policy analysis, we assessed cancer burden, infrastructure, and investigation. We analyzed governmental and private-sector cancer databases, complemented by interviews with cancer stakeholders.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>Governmental policy and patient advocacy have led to the recognition of cancer burden, a cancer law, and a national cancer plan. Cancer has become the leading cause of death in Chile (59,876 cases and 31,440 cancer deaths in 2022), yet only 0.36% gross domestic product (GDP) is directed to research and development. Inequalities in treatment regimens persist. Prevention policy has lowered tobacco consumption, sugar intake via soft drinks and offered a high coverage of HPV vaccines. A high-quality cancer research community is expanding, and internationally sponsored clinical oncology trials are increasing.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>The cancer law has facilitated advancement in policy. Prevention policies have impacted tobacco and sugar intake, while gender equality and care inequality have entered the public forum. Cancer research is stagnated by the lack of investment. Implementation of a cancer registry and biobanking, reinforcement of prevention strategies, development of human resources, promotion of clinical trial infrastructure and investment in new technologies must be placed as a priority to permit advancements in innovation and equitable cancer care.</jats:p> </jats:sec>
      8
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    Quadruple therapies show a higher eradication rate compared to standard triple therapy for <i>Helicobacter pylori</i> infection within the LEGACy consortium. A multicenter observational study in European and Latin American countries
    (2024)
    Patricio Medel‐Jara
    ;
    Diego Reyes Placencia
    ;
    Eduardo Fuentes López
    ;
    Oscar Corsi
    ;
    Gonzalo Latorre
    <jats:title>Abstract</jats:title><jats:sec><jats:title>Introduction</jats:title><jats:p>Gastric cancer (GC) is one of the most lethal malignancies worldwide. <jats:italic>Helicobacter pylori</jats:italic> is the primary cause of GC; therefore, its eradication reduces the risk of developing this neoplasia. There is extensive evidence regarding quadruple therapy with relevance to the European population. However, in Latin America, data are scarce. Furthermore, there is limited information about the eradication rates achieved by antibiotic schemes in European and Latin American populations.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>To compare the effectiveness of standard triple therapy (STT), quadruple concomitant therapy (QCT), and bismuth quadruple therapy (QBT) in six centers in Europe and Latin America.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>A retrospective study was carried out based on the LEGACy registry from 2017 to 2022. Data from adult patients recruited in Portugal, Spain, Chile, Mexico, and Paraguay with confirmed <jats:italic>H</jats:italic>. <jats:italic>pylori</jats:italic> infection who received eradication therapy and confirmatory tests at least 1 month apart were included. Treatment success by each scheme was compared using a mixed multilevel Poisson regression, adjusting for patient sex and age, together with country‐specific variables, including prevalence of <jats:italic>H</jats:italic>. <jats:italic>pylori</jats:italic> antibiotic resistance (clarithromycin, metronidazole, and amoxicillin), and <jats:italic>CYP2C19</jats:italic> polymorphisms.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>772 patients were incorporated (64.64% females; mean age of 52.93 years). The total <jats:italic>H</jats:italic>. <jats:italic>pylori</jats:italic> eradication rates were 75.20% (255/339) with STT, 88.70% (159/178) with QCT, and 91.30% (191/209) with QBT. Both quadruple therapies (QCT‐QBT) showed significantly higher eradication rates compared with STT, with an adjusted incidence risk ratio (IRR) of 1.25 (<jats:italic>p</jats:italic>: &lt;0.05); and 1.24 (<jats:italic>p</jats:italic>: &lt;0.05), respectively. The antibiotic‐resistance prevalence by country, but not the prevalence of <jats:italic>CYP2C19</jats:italic> polymorphism, showed a statistically significant impact on eradication success.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Both QCT and QBT are superior to STT for <jats:italic>H</jats:italic>. <jats:italic>pylori</jats:italic> eradication when adjusted for country‐specific antibiotic resistance and <jats:italic>CYP2C19</jats:italic> polymorphism in a sample of individuals residing in five countries within two continents.</jats:p></jats:sec>
    Scopus© Citations 3  5
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    Scopus© Citations 5  2  1
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    Percepción del ambiente educacional de postgrado en residentes de especialidades médicas de universidades chilenas
    (2022)
    Carolina González
    ;
    Alina Ahtamon
    ;
    Walter Brokering
    ;
    María Catalina Budge
    ;
    María José Cadagan
    Scopus© Citations 2  2
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    Terapias cuádruples son superiores a terapia triple estándar en primera línea de erradicación de Helicobacter pylori en Chile
    (2022)
    Diego Reyes
    ;
    Javier Ortiz
    ;
    Eduardo Fuentes López
    ;
    Sigall Budnik
    ;
    Vicente Gándara
    Scopus© Citations 9  11
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    Profesionalismo y auto cuidado de los residentes, ¿cómo debemos enfocar su formación?
    (2021)
    Carla Benaglio
    ;
    MATURANA PEREA, ANDRES  
    ;
    Luigina Mortari
    ;
    Arnoldo Riquelme
    <jats:p>El profesionalismo es una competencia bien definida en la educación de los residentes, sin embargo, es un constructo complejo, sensible a variables sociales y culturales. Puede definirse como el nivel de destreza, buen juicio y comportamiento adecuado esperable de personas entrenadas para realizar bien su trabajo. Es una competencia que no se mantiene estable en el tiempo y decae cuando el profesional está sometido a altos niveles de estrés y se asocia a calidad de cuidado, educación, ética, moral, filosofía y humanismo. Es una competencia esencial en el profesional por lo cual debemos replantear los currículos para incluir formas de enseñar y evaluar el profesionalismo. Es fundamental pensar en programas que logren equilibrar la carga de trabajo con el bienestar de los futuros profesionales. Debemos generar un clima adecuado de aprendizaje donde el profesional en entrenamiento sea un protagonista activo, y el auto cuidado sea visibilizado como una competencia esencial para mantener el equilibrio entre la vida personal y profesional. Este articulo plantea una revisión y reflexión de este tema que cobra cada vez mas importancia en la formación de postgrado de futuros especialistas.</jats:p>
      22Scopus© Citations 1