Browsing by Author "Castro, Felipe"

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    Association of inflammatory and other immune markers with gallbladder cancer: Results from two independent case-control studies
    (2016) Koshiol, Jill; Castro, Felipe; Kemp, Troy J.; Gao, Yu-Tang; Carlos Roa, Juan; Wang, Bingsheng; Nogueira, Leticia; Carlos Araya, Juan; Shen, Ming-Chang; Rashid, Asif; Hsing, Ann W.; Hildesheim, Allan; Ferreccio, Catterina; Pfeiffer, Ruth M.; Pinto, Ligia A.
    Most gallbladder cancer (GBC) cases arise in the context of gallstones, which cause inflammation, but few gallstone patients develop GBC. We explored inflammation/immune-related markers measured in bile and serum in GBC cases compared to gallstone patients to better understand how inflammatory patterns in these two conditions differ. We measured 65 immune-related markers in serum and bile from 41 GBC cases and 127 gallstone patients from Shanghai, China, and calculated age- and sex-adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) for GBC versus gallstones. We then focused on the markers that were significantly elevated in bile and serum to replicate the findings in serum from 35 GBC cases and 31 gallstone controls from Chile. Comparing the highest versus lowest quantile, 15 markers (23%) were elevated in both serum and bile from GBC versus gallstone patients in the Shanghai study (p <0.05). The strongest OR was for CXCL8 (interleukin-8) in serum (96.8, 95% CI: 11.9-790.2). Of these 15 markers, 6 were also significantly elevated in serum from Chile (CCL20, C -reactive protein, CXCL8, CXCL10, resistin, serum amyloid A). Pooled ORs from Shanghai and Chile for these 6 markers ranged from 7.2 (95% CI: 2.8-18.4) for CXCL10 to 58.2 (95% CI: 12.4-273.0) for CXCL8. GBC is associated with inflammation above and beyond that generated by gallstones alone. This local inflammatory process is reflected systemically. Future longitudinal studies are needed to identify the key players in cancer development, which may guide translational efforts to identify individuals at high risk of developing GBC. Published by Elsevier Ltd.
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    Impact of a Curriculum Reform in Graduate Students Self-Reported Palliative Care Competencies
    (Elsevier Inc., 2025) Grez Artigues, Mónica Bernardita; Rodríguez Núñez, Alfredo; Maldonado Morgado, Armando José; Castro, Felipe; Orozco Soto, Nicolás Ignacio; Crispino Gastelumendi, Luciana; Villouta Cassinelli, María Francisca; Jaña Pozo, Carolina Andrea; Leiva, Ofelia; Pérez Cruz, Pedro
    Introduction. Expanding quality basic palliative care (PC) training for undergraduate health professionals is a key strategy to secure timely access to PC for the large population in need. However, evidence on the impact of changes in undergraduate medical curriculum in PC remains limited. This study aimed to assess the impact of expanded undergraduate PC training on students’ self-perceived competencies, knowledge, and training adequacy, comparing cohorts before and after a curricular reform. Methods. In this cross-sectional study, recently graduated medical students from two cohorts at the same university—one with limited exposure and the other with extended exposure to a PC curriculum—were invited to complete an electronic survey. The aim was to assess their perception of the PC training received during medical school, their self-assessed core competencies, and their knowledge in the field. Results. 157 (64%) out of 244 graduates answered the survey. Students exposed to the extended PC curriculum, more frequently reported that the theoretical and practical contents received were sufficient (P < 0.001), had higher scores in PC knowledge assessment and, reported having significantly more skills to deliver bad news (P = 0.01), to evaluate physical symptoms (P = 0.04), spiritual symptoms (P = 0.01), to explain what the PC consist of (P = 0.028) and to evaluate emotional symptoms (P = 0.003). Conclusions. Integrating and increasing exposure to PC training throughout the entire medical school curriculum enhances recently graduated medical students’ perception of the adequacy of their training, strengthens their self-perceived competencies, and improves their knowledge in PC. J Pain Symptom Manage 2025;000:1−10.