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Author: search.filters.author.Fernando Lanas

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    Guías para la monitorización ambulatoria de presión arterial de 24 horas. Documento de la Sociedad Chilena de Cardiología y Cirugía Cardiovascular
    (SciELO Agencia Nacional de Investigacion y Desarrollo (ANID), 2017-12)
    Hernán Prat
    ;
    Alejandro Abufhele
    ;
    Gonzalo Alarcón
    ;
    Inés Barquín
    ;
    Edgardo Escobar
      2
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    Candidate Interventions for Integrating Hypertension and Cardiovascular-Kidney-Metabolic Care in Primary Health Settings: HEARTS 2.0 Phase 1
    (Ubiquity Press, Ltd., 2025-05-27)
    Andres Rosende
    ;
    Cesar Romero
    ;
    Donald J. DiPette
    ;
    Jeffrey Brettler
    ;
    Patrick Van der Stuyft
    <jats:p>Background: HEARTS in the Americas is the regional adaptation of the WHO Global HEARTS Initiative, aimed at helping countries enhance hypertension and cardiovascular disease (CVD) risk management in primary care settings. Its core implementation tool, the HEARTS Clinical Pathway, has been adopted by 28 countries. To improve the care of hypertension, diabetes, and chronic kidney disease (CKD), HEARTS 2.0 was developed as a three-phase process to integrate evidence-based interventions into a unified care pathway, ensuring consistency across fragmented guidelines. This paper focuses on Phase 1, highlighting targeted interventions to improve and update the HEARTS Clinical Pathway. Methods: First, the coordinating group defined the project’s scope, objectives, principles, methodological framework, and tools. Second, international experts from different disciplines proposed interventions to enhance the HEARTS Clinical Pathway. Third, the coordinating group harmonized these proposals into unique interventions. Fourth, experts appraised the appropriateness of the proposed interventions on a 1-to-9 scale using the adapted RAND/UCLA Appropriateness Method. Finally, interventions with a median score above 6 were deemed appropriate and selected as candidates to enhance the HEARTS Clinical Pathway. Results: Building on the existing HEARTS Clinical Pathway, 45 unique interventions were selected, including community-based screening, early detection and management of risk factors, lower blood pressure thresholds for diagnosing hypertension in high-CVD-risk patients, reinforcement of single-pill combination therapy, inclusion of sodium-glucose cotransporter-2 inhibitors for patients with diabetes, CKD, or heart failure, expanded roles for non-physician health workers in team-based care, and strengthened clinical documentation, monitoring, and evaluation. Conclusion: HEARTS 2.0 Phase 1 identifies key interventions to integrate and improve hypertension and cardiovascular-kidney-metabolic care within primary care, enabling their seamless incorporation into a unified and effective clinical pathway. This process will inform an update to the HEARTS Clinical Pathway, optimizing resources, reducing care fragmentation, improving care delivery, and advancing health equity, thereby supporting global efforts to combat the leading causes of death and disability.</jats:p>
      2
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      1
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      3Scopus© Citations 24
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    Percutaneous or surgical revascularization in patients with severe left main coronary artery disease in Latin America: A GRADE clinical practice guideline
    (Elsevier BV, 2025-10)
    Pablo Lamelas
    ;
    Michel Pompeu Sá
    ;
    Ariel Izcovich
    ;
    Federico Bottaro
    ;
    Matias Tisi Baña
      1Scopus© Citations 1
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    Characterization of microbial communities from gut microbiota of hypercholesterolemic and control subjects
    (2022)
    Cristian Morales
    ;
    Gabriel Rojas
    ;
    Camilo Rebolledo
    ;
    Marcelo Rojas-Herrera
    ;
    Raúl Arias-Carrasco
    <jats:sec><jats:title>Introduction</jats:title><jats:p>In recent years, several studies have evidenced the importance of the microbiome to host physiology as metabolism regulator, along with its potential role in triggering various diseases. In this study, we analyzed the gut microbiota in hypercholesterolemic (cases) and normocholesterolemic (controls) individuals to identify characteristic microbial signature for each condition.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Stool samples were obtained from 57 adult volunteers (27 hypercholesterolemic and 30 controls). The taxonomic profiling of microbial communities was performed using high-throughput sequencing of 16S rRNA V3-V4 amplicons, followed by data analysis using Quantitative Insights Into Microbial Ecology 2 (QIIME2) and linear discriminant analysis (LDA) effect size (LEfSe).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Significant differences were observed in weight, height, body mass index (BMI) and serum levels of triglycerides, total cholesterol and low-density lipoprotein cholesterol (LDL-C) between the groups (p&amp;lt;0.05). LEfSe showed differentially abundant prokaryotic taxa (α=0.05, LDA score &amp;gt; 2.0) in the group of hypercholesterolemic individuals (<jats:italic>Methanosphaera</jats:italic>, <jats:italic>Rothia</jats:italic>, Chromatiales, Clostridiales, Bacillaceae and Coriobacteriaceae) and controls (<jats:italic>Faecalibacterium</jats:italic>, <jats:italic>Victivallis</jats:italic> and <jats:italic>Selenomonas)</jats:italic> at various taxonomic levels. In addition, through the application of Phylogenetic Investigation of Communities by Reconstruction of Unobserved States 2 (PICRUSt2), the predominance of pathways related to biosynthesis in hypercholesterolemic patients was established, compared to controls in which degradation pathways were predominant. Finally, in the analysis of co-occurrence networks, it was possible to identify associations between the microorganisms present in both studied groups.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Our results point out to unique microbial signatures, which likely play a role on the cholesterol metabolism in the studied population.</jats:p></jats:sec>
    Scopus© Citations 10  2