Browsing by Author "Castro Rodríguez, José Antonio"

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    A new childhood asthma phenotype: obese with early menarche.
    (2016) Castro Rodríguez, José Antonio
    Three concomitant phenomena occur in the later years of childhood: increases in the incidence ofasthma, obesity and early menarche. This article is an overview of the current epidemiologic, basic,genetic and epigenetic evidence about this relationship. As a consequence we propose that obese girlswho have an early menarche ( 11 years of age) constitute a new asthma phenotype in childhood. Futurestudies need to be carried out in order to find the best control and treatment of this new asthmaphenotype.
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    Adding nebulized corticosteroids to systemic corticosteroids for acute asthma in children: A systematic review with meta‐analysis
    (2020) Castro Rodríguez, José Antonio; Pincheira, Mauricio A.; Escobar‐Serna, Diana P.; Sossa‐Briceño, Monica P.; Rodriguez‐Martinez, Carlos E.
    International guidelines have recommended the use of inhaled beta-2 agonists and systemic corticosteroids (SCs) as the first-line treatment for acute asthma.
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    Automated chart review utilizing natural language processing algorithm for asthma predictive index
    (2018) Kaur, Harsheen; Sohn, Sunghwan; Wi, Chung-Il; Ryu, Euijung; Park, Miguel A.; Bachman, Kay; Kita, Hirohito; Croghan, Ivana; Castro Rodríguez, José Antonio; Voge, Gretchen A.
    Abstract Background Thus far, no algorithms have been developed to automatically extract patients who meet Asthma Predictive Index (API) criteria from the Electronic health records (EHR) yet. Our objective is to develop and validate a natural language processing (NLP) algorithm to identify patients that meet API criteria. Methods This is a cross-sectional study nested in a birth cohort study in Olmsted County, MN. Asthma status ascertained by manual chart review based on API criteria served as gold standard. NLP-API was developed on a training cohort (n = 87) and validated on a test cohort (n = 427). Criterion validity was measured by sensitivity, specificity, positive predictive value and negative predictive value of the NLP algorithm against manual chart review for asthma status. Construct validity was determined by associations of asthma status defined by NLP-API with known risk factors for asthma. Results Among the eligible 427 subjects of the test cohort, 48% were males and 74% were White. Median age was 5.3 years (interquartile range 3.6–6.8). 35 (8%) had a history of asthma by NLP-API vs. 36 (8%) by abstractor with 31 by both approaches. NLP-API predicted asthma status with sensitivity 86%, specificity 98%, positive predictive value 88%, negative predictive value 98%. Asthma status by both NLP and manual chart review were significantly associated with the known asthma risk factors, such as history of allergic rhinitis, eczema, family history of asthma, and maternal history of smoking during pregnancy (p value < 0.05). Maternal smoking [odds ratio: 4.4, 95% confidence interval 1.8–10.7] was associated with asthma status determined by NLP-API and abstractor, and the effect sizes were similar between the reviews with 4.4 vs 4.2 respectively. Conclusion NLP-API was able to ascertain asthma status in children mining from EHR and has a potential to enhance asthma care and research through population management and large-scale studies when identifying children who meet API criteria.Abstract Background Thus far, no algorithms have been developed to automatically extract patients who meet Asthma Predictive Index (API) criteria from the Electronic health records (EHR) yet. Our objective is to develop and validate a natural language processing (NLP) algorithm to identify patients that meet API criteria. Methods This is a cross-sectional study nested in a birth cohort study in Olmsted County, MN. Asthma status ascertained by manual chart review based on API criteria served as gold standard. NLP-API was developed on a training cohort (n = 87) and validated on a test cohort (n = 427). Criterion validity was measured by sensitivity, specificity, positive predictive value and negative predictive value of the NLP algorithm against manual chart review for asthma status. Construct validity was determined by associations of asthma status defined by NLP-API with known risk factors for asthma. Results Among the eligible 427 subjects of the test cohort, 48% were males and 74% were White. Median age was 5.3 years (interquartile range 3.6–6.8). 35 (8%) had a history of asthma by NLP-API vs. 36 (8%) by abstractor with 31 by both approaches. NLP-API predicted asthma status with sensitivity 86%, specificity 98%, positive predictive value 88%, negative predictive value 98%. Asthma status by both NLP and manual chart review were significantly associated with the known asthma risk factors, such as history of allergic rhinitis, eczema, family history of asthma, and maternal history of smoking during pregnancy (p value < 0.05). Maternal smoking [odds ratio: 4.4, 95% confidence interval 1.8–10.7] was associated with asthma status determined by NLP-API and abstractor, and the effect sizes were similar between the reviews with 4.4 vs 4.2 respectively. Conclusion NLP-API was able to ascertain asthma status in children mining from EHR and has a potential to enhance asthma care and research through population management and large-scale studies when identifying children who meet API criteria.Abstract Background Thus far, no algorithms have been developed to automatically extract patients who meet Asthma Predictive Index (API) criteria from the Electronic health records (EHR) yet. Our objective is to develop and validate a natural language processing (NLP) algorithm to identify patients that meet API criteria. Methods This is a cross-sectional study nested in a birth cohort study in Olmsted County, MN. Asthma status ascertained by manual chart review based on API criteria served as gold standard. NLP-API was developed on a training cohort (n = 87) and validated on a test cohort (n = 427). Criterion validity was measured by sensitivity, specificity, positive predictive value and negative predictive value of the NLP algorithm against manual chart review for asthma status. Construct validity was determined by associations of asthma status defined by NLP-API with known risk factors for asthma. Results Among the eligible 427 subjects of the test cohort, 48% were males and 74% were White. Median age was 5.3 years (interquartile range 3.6–6.8). 35 (8%) had a history of asthma by NLP-API vs. 36 (8%) by abstractor with 31 by both approaches. NLP-API predicted asthma status with sensitivity 86%, specificity 98%, positive predictive value 88%, negative predictive value 98%. Asthma status by both NLP and manual chart review were significantly associated with the known asthma risk factors, such as history of allergic rhinitis, eczema, family history of asthma, and maternal history of smoking during pregnancy (p value < 0.05). Maternal smoking [odds ratio: 4.4, 95% confidence interval 1.8–10.7] was associated with asthma status determined by NLP-API and abstractor, and the effect sizes were similar between the reviews with 4.4 vs 4.2 respectively. Conclusion NLP-API was able to ascertain asthma status in children mining from EHR and has a potential to enhance asthma care and research through population management and large-scale studies when identifying children who meet API criteria.
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    Bronchial Hyperreactivity to Methacholine in Atopic Versus Nonatopic Asthmatic Schoolchildren and Preschoolers
    (2010) Castro Rodríguez, José Antonio; Navarrete Contreras, Pamela; Holmgren Palmen, Nils Linus Anders; Sánchez Díaz, Ignacio; Caussade Larraín, Marie Solange
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    Cost-effectiveness analysis of phenotypic-guided versus guidelines-guided bronchodilator therapy in viral bronchiolitis
    (2021) Rodriguez Martinez, Carlos E.; Nino, Gustavo; Castro Rodríguez, José Antonio; Pérez, Geovanny F.; Sossa Briceño, Mónica P.; Buendia, Jefferson A.
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    Cost-effectiveness of the utilization of "good practice" or the lack thereof according to a bronchiolitis evidence-based clinical practice guideline
    (2019) Rodríguez Martínez, Carlos E.; Sossa Briceño, Mónica P.; Castro Rodríguez, José Antonio
    Rationale, aims, and objectives: The aim of the present study was to determine the cost-effectiveness of the utilization of “good practice” according to a bronchiolitis clinical practice guideline (CPG) in a population of infants hospitalized for acute bronchiolitis. Method: A decision-analysis model was developed in order to estimate the cost-effectiveness of the utilization of “good practice” compared with the lack of use of “good practice” according to a bronchiolitis evidence-based CPG. The effectiveness parameters and costs of the model were obtained from electronic medical records. The main outcome was the readmission of the patients within 10 days of post discharge. Results: Compared with lack of “good practice,” the utilization of “good practice” in the diagnosis and management of patients with bronchiolitis was associated with both fewer patients readmitted within 10 days of post discharge (0.88 vs 0.99 on average per patient) and lower costs (US$1529.3 versus $1709.1 average cost per patient), thus leading to dominance. Results were robust to deterministic and probabilistic sensitivity analyses. Conclusions: Compared with lack of “good practice,” the utilization of “good practice” in the diagnosis and management of acute bronchiolitis according to a bronchiolitis CPG is a dominant strategy because it involves both fewer patients readmitted within 10 days of post discharge and lower costs.
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    Cost-Utility Analysis of the Inhaled Steroids Available in a Developing Country for the Management of Pediatric Patients with Persistent Asthma
    (2013) Rodríguez Martínez, Carlos E.; Sossa Briceño, Mónica P.; Castro Rodríguez, José Antonio
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    Daily inhaled corticosteroids or montelukast for preschoolers with asthma or recurrent wheezing : A systematic review
    (2018) Castro Rodríguez, José Antonio; Rodríguez Martínez, Carlos E.; Ducharme, Francine M.
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    Diagnóstico y tratamiento de la tos crónica en pediatría
    (2013) Saranz, Ricardo J.; Lozano, Alejandro; Lozano, Natalia; Castro Rodríguez, José Antonio
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    Direct medical costs of pediatric asthma exacerbations requiring hospital attendance in a middle-income country
    (2020) Rodríguez Martínez, C. E.; Sossa Briceño, M. P.; Castro Rodríguez, José Antonio
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    Early origins of allergy and asthma (ARIES): study protocol for a prospective prenatal birth cohort in Chile.
    (2020) Hernández Vargas, Caroll Daffner; Casanello Toledo, Paola Cecilia; Harris D., Paul R.; Castro Rodríguez, José Antonio; Iturriaga, Carolina; Pérez Mateluna, Guillermo; Farías Jofré, Marcelo Enrique; Urzúa, Marcela; Hernández Carreño, Cherie Francisca; Serrano Honeyman, Carolina; Hernández Vargas, Caroll Daffner; Casanello Toledo, Paola Cecilia; Harris D., Paul R.; Castro Rodríguez, José Antonio; Iturriaga, Carolina; Pérez Mateluna, Guillermo; Farías Jofré, Marcelo Enrique; Urzúa, Marcela; Hernández Carreño, Cherie Francisca; Serrano Honeyman, Carolina
    Abstract Background Growing evidence shows that atopic dermatitis (AD), food allergy (FA), allergic rhinitis, and asthma are largely determined during the first 1000 days (time elapsed from conception to the 2nd birthday). The ARIES birth cohort aims to determine prenatal and perinatal conditions, as well as genetic and epigenetic factors, that participate in the early setting of immune responses, and the role of these in the later determination of the risk of allergic diseases and asthma in the offspring. Methods We have designed a birth cohort of 250 families with prenatal recruitment (~ 14 weeks). We will genotype relevant allergy/asthma-associated variants in trios and will perform immunophenotyping and evaluation of allergy biomarkers in cord blood. At 1 and 2 years of age we will assess if infants have developed allergic sensitization, AD, FA, as well as biomarkers of asthma including the asthma predictive index. We will also evaluate how maternal conditions modify immune programming through epigenetic modifications and will then depict newborn epigenetic cues of allergy/asthma risk. Next, we will assess composition/diversity of maternal gut, placenta, breastmilk and infant gut microbiome and their association with immunophenotype and biomarkers at birth, and clinical outcomes at age 1 and 2. Finally, we plan to assess how environmental exposures (perinatal outdoor and indoor pollution, allergens and endotoxin) affect the incidence of allergic sensitization, AD, FA, and risk of asthma. Discussion The in-depth study of the ARIES birth cohort shall provide crucial information to understand the rising incidence of allergies and asthma in developing countries, and hopefully provide cues on how to prevent and treat these diseases. Trial registration clinicaltrials.gov NCT04186949, retrospectively registered on December 5, 2019.
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    Effect of foods and Mediterranean diet during pregnancy and first years of life on wheezing, rhinitis and dermatitis in preschoolers
    (2016) Castro Rodríguez, José Antonio; Ramírez Hernández, M.; Padilla Pérez, Oslando; Pacheco Gonzalez, R.M.; Pérez Fernández, Virginia; García Marcos, L.
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    Effect of Obesity on Bronchial Hyperreactivity Among Latino Children
    (2013) Del Rio Navarro, Blanca E.; Blandon Vijil, Virginia; Escalante Domínguez, Alberto J.; Berber, Arturo; Castro Rodríguez, José Antonio
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    Efficacy of inhaled corticosteroids in wheezy infants/preschoolers
    (2013) Castro Rodríguez, José Antonio; Rodrigo, Gustavo J.
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    Efficacy of Oral Corticosteroids in the Treatment of Acute Wheezing Episodes in Asthmatic Preschoolers : Systematic Review With Meta-Analysis
    (2016) Castro Rodríguez, José Antonio; Beckhaus, Andrea A.; Forno, Erick
    Rationale: Systemic corticosteroids (SCS) are used for treat preschoolers with acute asthma or wheezing exacerbations, with conflicting results. Objective: To evaluate the effectiveness of oral corticosteroids (OCS) compared to placebo in preschoolers presenting with acute asthma/wheezing exacerbations. Methods: Five electronic databases were searched for all placebo-controlled, randomized clinical trials of OCS in children <6 years of age presenting with recurrent wheezing/asthma exacerbations of any severity. Primary outcomes were hospitalizations, unscheduled emergency department (ED) visits in following month, need of additional OCS courses, and length of stay (ED or hospital). Results: Eleven studies met inclusion criteria (n = 1,733); four were conducted on an outpatient basis, five in inpatients, and two in the ED. Significant heterogeneity was found when pooling all studies, and thus analysis was stratified by trial setting. Among the outpatient studies, children who received OCS had a higher hospitalization rate (RR: 2.15 [95%CI = 1.08–4.29], I2 = 0%) compared to those to received placebo. Among the ED studies, children who received OCS had a lower risk of hospitalization (RR: 0.58 [0.37–0.92], I2 = 0%). Among the inpatient studies, children who received OCS needed fewer additional OCS courses than those on placebo (RR: 0.57 [0.40–0.81], I2 = 0%). Conclusions: Treatment with OCS in the ED or hospital may be beneficial in toddlers and preschoolers with frequent asthma/wheezing exacerbations. However, more studies are needed before OCS can be broadly recommended for this age group. Future trials should be carefully designed to avoid bias and according to our findings regarding administration setting.
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    Epigenética en enfermedades alérgicas y asma
    (2016) Castro Rodríguez, José Antonio; Krause Leyton, Bernardo; Uauy, Ricardo; Casanello Toledo, Paola Cecilia
    Las enfermedades alérgicas y el asma son el resultado de complejas interacciones entre la predisposición genética y factores ambientales. El asma es una de las enfermedades crónicas más prevalentes en niños. En este artículo se revisan algunos factores ambientales como la exposición a alérgenos, tabaco, bacterias, componentes microbianos, dieta, obesidad y estrés, que intervienen durante la vida intrauterina y la infancia en la regulación epigenética de las enfermedades alérgicas y el asma. La revisión se realiza en tres tipos de modelos: in-vitro, animales y humanos.