CRIS

Permanent URI for this communityhttps://investigadores.udd.cl/handle/123456789/1

Browse

Search Results

Now showing 1 - 10 of 14
  • Some of the metrics are blocked by your 
    Item type:Publication,
    Scopus© Citations 221  1
  • Some of the metrics are blocked by your 
    Item type:Publication,
    Disparities in Stroke Incidence Over Time by Sex and Age in Latin America and the Caribbean Region 1997 to 2021: A Systematic Review and Meta‐Analysis
    <jats:sec sec-type="background" xml:lang="en"> <jats:title>Background</jats:title> <jats:p xml:lang="en">High‐income country studies show unfavorable trends in stroke incidence (SI) in younger populations. We aimed to estimate temporal change in SI disaggregated by age and sex in Latin America and the Caribbean region.</jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Methods and Results</jats:title> <jats:p xml:lang="en"> A search strategy was used in MEDLINE, WOS, and LILACS databases from 1997 to 2021, including prospective population‐based observational studies with first‐ever stroke incidence in Latin America. Reports without data broken down by age and sex were excluded. Risk of bias was assessed with The Joanna Briggs Institute's guide. The main outcomes were incidence rate ratio and relative temporal trend ratio of SI, comparing time periods before 2010 with after 2010. Pooled relative temporal trend ratios considering only studies with 2 periods in the same population were calculated by random‐effects meta‐analysis. Meta‐regression analysis was used to evaluate incidence rate determinants. From 9242 records identified, 6 studies were selected including 4483 first‐ever stroke in 4 101 084 individuals. Crude incidence rate ratio in younger subjects (&lt;55 years) comparing before 2010:after 2010 periods showed an increase in SI in the past decade (incidence rate ratio, 1.37 [95% CI, 1.23–1.50]), in contrast to a decrease in older people during the same period (incidence rate ratio, 0.83 [95% CI, 0.76–0.89]). Overall relative temporal trend ratio (&lt;55:≥55 years) was 1.65 (95 CI%, 1.50–1.80), with higher increase in young women (pooled relative temporal trend ratio, 3.08 [95% CI, 1.18–4.97]; <jats:italic>P</jats:italic> for heterogeneity &lt;0.001). </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Conclusions</jats:title> <jats:p xml:lang="en">An unfavorable change in SI in young people, especially in women, was detected in population‐based studies in the past decade in Latin America and the Caribbean. Further investigation of the explanatory variables is required to ameliorate stroke prevention and inform local decision‐makers.</jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Registration</jats:title> <jats:p xml:lang="en"> URL: <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://www.crd.york.ac.uk/prospero/">https://www.crd.york.ac.uk/prospero/</jats:ext-link> Identifier: CRD42022332563. </jats:p> </jats:sec>
      7Scopus© Citations 5
  • Some of the metrics are blocked by your 
    Item type:Publication,
    Breaking Down Barriers: Findings from a Literature Review on Housing for People with Disabilities in Latin America
    Accessibility to housing is crucial for people with disabilities as it provides them with equal opportunities and allows them to live independently. A systematic literature review has been conducted to understand the current research on accessibility in housing for people with disabilities in Latin America. The study analysed 56 papers and used co-word analysis to identify common themes and topics within the documents. The results of the analysis showed that Brazil (61%) is the country with the most research on the subject, physical disability, at 36%, is the impairment most analysed, and interventions or analysis for the older people (45%) in their homes is the most researched type of population. The co-word analysis revealed that topics such as policy, regulations, the use of technologies, ergonomics interventions, and architectural criteria or barriers to the daily life of disabled people were frequently discussed in the papers. Although this work shows a substantial and growing increase in research on housing for people with disabilities in Latin America, it also demonstrates the importance of increasing research on other types of impairment, such as visual and cognitive-intellectual disabilities, and including children, caregivers, or even young adults.
    Scopus© Citations 3  9
  • Some of the metrics are blocked by your 
    Item type:Publication,
    Risk factors for recurrences and visual impairment in patients with ocular toxoplasmosis: A systematic review and meta-analysis
    (2023)
    Carlos Cifuentes-González
    ;
    William Rojas-Carabali
    ;
    Álvaro Olate Pérez
    ;
    Érika Carvalho
    ;
    Felipe Valenzuela
    <jats:sec id="sec001"> <jats:title>Background</jats:title> <jats:p>Ocular toxoplasmosis (OT) is caused by the parasite <jats:italic>Toxoplasma gondii</jats:italic>. OT is the leading cause of posterior uveitis globally; it is a recurrent disease that may result in visual impairment and blindness. This systematic review and meta-analysis aim to summarize and evaluate the risk factors for recurrences, visual impairment, and blindness described in the literature worldwide.</jats:p> </jats:sec> <jats:sec id="sec002"> <jats:title>Methods and findings</jats:title> <jats:p>We performed a systematic literature search in PubMed, Embase, VHL, Cochrane Library, Scopus, and DANS EASY Archive. All studies reporting patients with clinically and serologically confirmed OT presenting any clinical or paraclinical factor influencing recurrences, visual impairment, and blindness were included. Studies presenting secondary data, case reports, and case series were excluded. An initial selection was made by title and abstract, and then the studies were reviewed by full text where the eligible studies were selected. Then, the risk of bias was assessed through validated tools. Data were extracted using a validated extraction format. Qualitative synthesis and quantitative analysis were done. This study was registered on PROSPERO (CRD42022327836).</jats:p> </jats:sec> <jats:sec id="sec003"> <jats:title>Results</jats:title> <jats:p>Seventy two studies met the inclusion criteria. Fifty-three were summarized in the qualitative synthesis in three sections: clinical and environmental factors, parasite and host factors, and treatment-related factors. Of the 72 articles, 39 were included in the meta-analysis, of which 14 were conducted in South America, 13 in Europe, four in Asia, three multinational, two in North America and Central America, respectively, and only one in Africa. A total of 4,200 patients with OT were analyzed, mean age ranged from 7.3 to 65.1 year of age, with similar distribution by sex. The frequency of recurrences in patients with OT was 49% (95% CI 40%–58%), being more frequent in the South American population than in Europeans. Additionally, visual impairment was presented in 35% (95% CI 25%–48%) and blindness in 20% (95% CI 13%–30%) of eyes, with a similar predominance in South Americans than in Europeans. On the other hand, having lesions near the macula or adjacent to the optic nerve had an OR of 4.83 (95% CI; 2.72–8.59) for blindness, similar to having more than one recurrence that had an OR of 3.18 (95% CI; 1.59–6.38). Finally, the prophylactic therapy with Trimethoprim/Sulfamethoxazole versus the placebo showed a protective factor of 83% during the first year and 87% in the second year after treatment.</jats:p> </jats:sec> <jats:sec id="sec004"> <jats:title>Conclusion</jats:title> <jats:p>Our Systematic Review showed that clinical factors such as being older than 40 years, patients with de novo OT lesions or with less than one year after the first episode, macular area involvement, lesions greater than 1 disc diameter, congenital toxoplasmosis, and bilateral compromise had more risk of recurrences. Also, environmental and parasite factors such as precipitations, geographical region where the infection is acquired, and more virulent strains confer greater risk of recurrences. Therefore, patients with the above mentioned clinical, environmental, and parasite factors could benefit from using prophylactic therapy.</jats:p> </jats:sec>
      4Scopus© Citations 18
  • Some of the metrics are blocked by your 
    Item type:Publication,
    Global Retinoblastoma Presentation and Analysis by National Income Level
    (2020)
    Ido Didi Fabian
    ;
    Elhassan Abdallah
    ;
    Shehu U. Abdullahi
    ;
    Rula A. Abdulqader
    ;
    Sahadatou Adamou Boubacar
      4Scopus© Citations 287
  • Some of the metrics are blocked by your 
    Item type:Publication,
    Three-Year Follow-up of 2-Dose Versus 3-Dose HPV Vaccine
    (2021)
    Jacob Bornstein
    ;
    Surita Roux
    ;
    Lone Kjeld Petersen
    ;
    Li-Min Huang
    ;
    Simon R. Dobson
    <jats:sec> <jats:title /> </jats:sec> <jats:sec> <jats:title>BACKGROUND AND OBJECTIVES:</jats:title> <jats:p>Human papillomavirus (HPV) antibody responses to the 9-valent human papillomavirus (9vHPV) vaccine among girls and boys (aged 9–14 years) receiving 2-dose regimens (months 0, 6 or 0, 12) were noninferior to a 3-dose regimen (months 0, 2, 6) in young women (aged 16–26 years) 4 weeks after last vaccination in an international, randomized, open-label trial (NCT01984697). We assessed response durability through month 36.</jats:p> </jats:sec> <jats:sec> <jats:title>METHODS:</jats:title> <jats:p>Girls received 2 (months 0 and 6 [0, 6]: n = 301; months 0 and 12 [0, 12]: n = 151) or 3 doses (months 0,2, and 6 [0, 2, 6]: n = 301); boys received 2 doses ([0, 6]: n = 301; [0, 12]: n = 150); and young women received 3 doses ([0, 2, 6]: n = 314) of 9vHPV vaccine. Anti-HPV geometric mean titers (GMTs) were assessed by competitive Luminex immunoassay (cLIA) and immunoglobulin G-Luminex immunoassay (IgG-LIA) through month 36.</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS:</jats:title> <jats:p>Anti-HPV GMTs were highest 1 month after the last 9vHPV vaccine regimen dose, decreased sharply during the subsequent 12 months, and then decreased more slowly. GMTs 2 to 2.5 years after the last regimen dose in girls and boys given 2 doses were generally similar to or greater than GMTs in young women given 3 doses. Across HPV types, most boys and girls who received 2 doses (cLIA: 81%–100%; IgG-LIA: 91%–100%) and young women who received 3 doses (cLIA: 78%–98%; IgG-LIA: 91%–100%) remained seropositive 2 to 2.5 years after the last regimen dose.</jats:p> </jats:sec> <jats:sec> <jats:title>CONCLUSIONS:</jats:title> <jats:p>Antibody responses persisted through 2 to 2.5 years after the last dose of a 2-dose 9vHPV vaccine regimen in girls and boys. In girls and boys, antibody responses generated by 2 doses administered 6 to 12 months apart may be sufficient to induce high-level protective efficacy through at least 2 years after the second dose.</jats:p> </jats:sec>
      13  1Scopus© Citations 18
  • Some of the metrics are blocked by your 
    Item type:Publication,
      13  1Scopus© Citations 40
  • Some of the metrics are blocked by your 
    Item type:Publication,
    Estimating the effect of social inequalities on the mitigation of COVID-19 across communities in Santiago de Chile
    (2021)
    Nicolò Gozzi
    ;
    Michele Tizzoni
    ;
    Matteo Chinazzi
    ;
    ;
    Alessandro Vespignani
    We study the spatio-temporal spread of SARS-CoV-2 in Santiago de Chile using anonymized mobile phone data from 1.4 million users, 22% of the whole population in the area, characterizing the effects of non-pharmaceutical interventions (NPIs) on the epidemic dynamics. We integrate these data into a mechanistic epidemic model calibrated on surveillance data. As of August 1, 2020, we estimate a detection rate of 102 cases per 1000 infections (90% CI: [95–112 per 1000]). We show that the introduction of a full lockdown on May 15, 2020, while causing a modest additional decrease in mobility and contacts with respect to previous NPIs, was decisive in bringing the epidemic under control, highlighting the importance of a timely governmental response to COVID-19 outbreaks. We find that the impact of NPIs on individuals’ mobility correlates with the Human Development Index of comunas in the city. Indeed, more developed and wealthier areas became more isolated after government interventions and experienced a significantly lower burden of the pandemic. The heterogeneity of COVID-19 impact raises important issues in the implementation of NPIs and highlights the challenges that communities affected by systemic health and social inequalities face adapting their behaviors during an epidemic.
    Scopus© Citations 124  1
  • Some of the metrics are blocked by your 
    Item type:Publication,
    Total mutational load and clinical features as predictors of the metastatic status in lung adenocarcinoma and squamous cell carcinoma patients
    (2022)
    Karen Y. Oróstica
    ;
    Juan Saez-Hidalgo
    ;
    Pamela R. de Santiago
    ;
    ;
    Sebastian Contreras
    <jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>Recently, extensive cancer genomic studies have revealed mutational and clinical data of large cohorts of cancer patients. For example, the Pan-Lung Cancer 2016 dataset (part of The Cancer Genome Atlas project), summarises the mutational and clinical profiles of different subtypes of Lung Cancer (LC). Mutational and clinical signatures have been used independently for tumour typification and prediction of metastasis in LC patients. Is it then possible to achieve better typifications and predictions when combining both data streams?</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>In a cohort of 1144 Lung Adenocarcinoma (LUAD) and Lung Squamous Cell Carcinoma (LSCC) patients, we studied the number of missense mutations (hereafter, the Total Mutational Load TML) and distribution of clinical variables, for different classes of patients. Using the TML and different sets of clinical variables (tumour stage, age, sex, smoking status, and packs of cigarettes smoked per year), we built Random Forest classification models that calculate the likelihood of developing metastasis.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>We found that LC patients different in age, smoking status, and tumour type had significantly different mean TMLs. Although TML was an informative feature, its effect was secondary to the "tumour stage" feature. However, its contribution to the classification is not redundant with the latter; models trained using both TML and tumour stage performed better than models trained using only one of these variables. We found that models trained in the entire dataset (i.e., without using dimensionality reduction techniques) and without resampling achieved the highest performance, with an F1 score of 0.64 (95%CrI [0.62, 0.66]).</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Clinical variables and TML should be considered together when assessing the likelihood of LC patients progressing to metastatic states, as the information these encode is not redundant. Altogether, we provide new evidence of the need for comprehensive diagnostic tools for metastasis.</jats:p> </jats:sec>
      2Scopus© Citations 3  1
  • Some of the metrics are blocked by your 
    Item type:Publication,
    Mechanical power in pediatric acute respiratory distress syndrome: a PARDIE study
    (2022)
    Anoopindar K. Bhalla
    ;
    Margaret J. Klein
    ;
    Vicent Modesto I Alapont
    ;
    Guillaume Emeriaud
    ;
    Martin C. J. Kneyber
    <jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>Mechanical power is a composite variable for energy transmitted to the respiratory system over time that may better capture risk for ventilator-induced lung injury than individual ventilator management components. We sought to evaluate if mechanical ventilation management with a high mechanical power is associated with fewer ventilator-free days (VFD) in children with pediatric acute respiratory distress syndrome (PARDS).</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>Retrospective analysis of a prospective observational international cohort study.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>There were 306 children from 55 pediatric intensive care units included. High mechanical power was associated with younger age, higher oxygenation index, a comorbid condition of bronchopulmonary dysplasia, higher tidal volume, higher delta pressure (peak inspiratory pressure—positive end-expiratory pressure), and higher respiratory rate. Higher mechanical power was associated with fewer 28-day VFD after controlling for confounding variables (per 0.1 J·min<jats:sup>−1</jats:sup>·Kg<jats:sup>−1</jats:sup> Subdistribution Hazard Ratio (SHR) 0.93 (0.87, 0.98), <jats:italic>p</jats:italic> = 0.013). Higher mechanical power was not associated with higher intensive care unit mortality in multivariable analysis in the entire cohort (per 0.1 J·min<jats:sup>−1</jats:sup>·Kg<jats:sup>−1</jats:sup> OR 1.12 [0.94, 1.32], <jats:italic>p</jats:italic> = 0.20). But was associated with higher mortality when excluding children who died due to neurologic reasons (per 0.1 J·min<jats:sup>−1</jats:sup>·Kg<jats:sup>−1</jats:sup> OR 1.22 [1.01, 1.46], <jats:italic>p</jats:italic> = 0.036). In subgroup analyses by age, the association between higher mechanical power and fewer 28-day VFD remained only in children &lt; 2-years-old (per 0.1 J·min<jats:sup>−1</jats:sup>·Kg<jats:sup>−1</jats:sup> SHR 0.89 (0.82, 0.96), <jats:italic>p</jats:italic> = 0.005). Younger children were managed with lower tidal volume, higher delta pressure, higher respiratory rate, lower positive end-expiratory pressure, and higher PCO<jats:sub>2</jats:sub> than older children. No individual ventilator management component mediated the effect of mechanical power on 28-day VFD.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Higher mechanical power is associated with fewer 28-day VFDs in children with PARDS. This association is strongest in children &lt; 2-years-old in whom there are notable differences in mechanical ventilation management. While further validation is needed, these data highlight that ventilator management is associated with outcome in children with PARDS, and there may be subgroups of children with higher potential benefit from strategies to improve lung-protective ventilation.</jats:p> <jats:p><jats:bold>Take Home Message</jats:bold>: Higher mechanical power is associated with fewer 28-day ventilator-free days in children with pediatric acute respiratory distress syndrome. This association is strongest in children &lt;2-years-old in whom there are notable differences in mechanical ventilation management.</jats:p> </jats:sec>
      7Scopus© Citations 23