Browsing by Author "Fuentes-Lopez E."

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    Association between the home-to-healthcare center distance and hearing aid abandonment among older adults
    (2024) Fuentes-Lopez E.; Galaz-Mella J.; Ayala S.; De la Fuente C.; Luna-Monsalve M.; Nieman C.; Marcotti A.
    Copyright © 2024 Fuentes-López, Galaz-Mella, Ayala, De la Fuente, Luna-Monsalve, Nieman and Marcotti.Background: Access to audiology services for older adults residing in sparsely populated regions is often limited compared to those in central urban areas. The geographic accessibility to follow-up care, particularly the influence of distance, may contribute to an increased risk of hearing aid abandonment. Objective: To assess the association between the home-to-healthcare-calibration-center distance and hearing aid abandonment among older adults fitted in the Chilean public health system. Methods: 455 patients who received hearing aids from two public hospitals in two regions were considered. Univariate and multivariate Poisson regression models with robust variance estimation were used to analyze the association between the geographical distance and hearing aid abandonment, accounting for confounding effects. Results: Approximately 18% of the sample abandoned the hearing aid, and around 50% reported using the hearing aid every day. A twofold increase in distance between home and the hearing center yielded a 35% (RR = 1.35; 95% CI: 1.04–1.74; p = 0.022) increased risk of hearing aid abandonment. Also, those in the second quintile had a 2.17 times the risk of abandoning the hearing aid compared to the first quintile (up to 2.3 km). Under the assumption that patients reside within the first quintile of distance, a potential reduction of 45% in the incidence of hearing aid abandonment would be observed. The observed risk remained consistent across different statistical models to assess sensitivity. Conclusion: A higher distance between the residence and the healthcare center increases hearing aid abandonment risk. The association may be explained by barriers in purchasing supplies required to maintain the device (batteries, cleaning elements, potential repairs, or maintenance).
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    Duration of Chilean Spanish voiceless stops in typically developed speakers and those with Parkinson's diseaseDuración de las oclusivas áfonas del español de Chile en personas normotípicas y con enfermedad de Parkinson
    (2024) Soto-Barba J.; Martinez-Cifuentes R.; Fuentes-Lopez E.
    © 2024 Universidad Austral de Chile. All rights reserved.The objective of this study was to compare the absolute duration, relative duration and the index relative to the duration of the syllable (IREDUS, by its acronym in Spanish) of /p-t-k/ between people with Parkinson's disease (PD) and typically developed people, and contrast these acoustic indices in the first three stages of this disease. Fifteen people with PD and fifteen typically developed people participated. The 30 participants, all Chilean Spanish speakers, were paired by age, sex and educational level. Although the absolute duration was systematically longer in people with PD, there was not a statistically significant difference with the group of typically developed people. In general, the measurement of the relative duration and IREDUS of /p-t-k/ were similar in both groups. Lastly, there were significant differences when comparing the relative duration of /t/ and IREDUS of /t/ and /k/ in the first three stages of PD.
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    Evaluation of trefoil factor 3 as a non-invasive biomarker of gastric intestinal metaplasia and gastric cancer in a high-risk populationEvaluación de Trefoil factor 3 como un biomarcador no invasivo para la detección de metaplasia intestinal y cáncer gástrico en una población de alto riesgo
    (2022) Latorre G.; Pizarro M.; Vargas J.I.; Espino A.; Aguero C.; Gonzalez R.; Riquelme A.; Gandara V.; Munoz G.; Ford J.S.; Araya J.C.; Bellolio E.; Villaseca M.; Fuentes-Lopez E.; Cortes P.; Rollan A.; Bufadel M.E.; Araya R.; Sharp A.; Donoso A.; Bresky G.; Pedrero P.; Rueda C.; Calvo A.; Parra-Blanco A.; Odagaki T.; Moriyama T.; Ishida T.; Camargo M.C.; Corvalan A.H.
    © 2022 Elsevier España, S.L.U.Background: Adenocarcinoma is preceded by chronic atrophic gastritis, gastric intestinal metaplasia and dysplasia. Trefoil factor 3 (TFF3) is a peptide secreted by goblet cells, which is abundantly present in intestinal metaplasia. Aim: To evaluate the utility of serum TFF3 as a non-invasive biomarker for the diagnosis of intestinal metaplasia and gastric cancer. Methods: Single-center, cross-sectional study of 274 patients who consecutively underwent upper gastrointestinal endoscopy with gastric biopsies (updated Sydney system). TFF3 levels were measured in serum by a commercial ELISA kit. Patients with normal histology or chronic atrophic gastritis without intestinal metaplasia comprised the control group. In addition, 14 patients with invasive gastric cancer were included as a reference group. The association between TFF3 levels and intestinal metaplasia was assessed by logistic regression. Results: Patients with intestinal metaplasia (n = 110) had a higher median TFF3 level as compared to controls (n = 164), 13.1 vs. 11.9 ng/mL, respectively (p = 0.024). Multivariable logistic regression showed a no significant association between TFF3 levels and intestinal metaplasia (OR = 1.20; 95%CI: 0.87–1.65; p-trend = 0.273). The gastric cancer group had a median TFF3 level of 20.5 ng/mL, and a significant association was found (OR = 3.26; 95%CI: 1.29–8.27; p-trend = 0.013). Conclusion: Serum levels of TFF3 do not discriminate intestinal metaplasia in this high-risk Latin American population. Nevertheless, we confirmed an association between TFF3 levels and invasive gastric cancer.
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    High prevalence of SARS-CoV-2 detection and prolonged viral shedding in stools: A systematic review and cohort studyElevada detección de SARS-CoV-2 y prolongada excreción viral en deposiciones: Estudio de cohorte y revisión sistemática
    (2022) Diaz L.A.; Chahuan J.; Alvarez M.; Pavez C.; Candia R.; Monrroy H.; Espino A.; Pizarro M.; Riquelme A.; Garcia-Salum T.; Levican J.; Almonacid L.I.; Valenzuela G.H.; Serrano E.; Ferres M.; Salinas E.; Medina R.A.; Fuentes-Lopez E.; Riquelme A.; Reyes D.; Ortiz J.; Rada G.; Valderrama S.; Budnik S.; Gandara V.; Gallardo A.; Seydewitz M.F.; Cofre C.; Rada G.; Ortiz L.; Rada G.; Toro A.; Ortega M.; Ortega M.
    © 2022 Elsevier España, S.L.U.Objectives: To: 1. Describe the frequency of viral RNA detection in stools in a cohort of patients infected with SARS-CoV-2, and 2. Perform a systematic review to assess the clearance time in stools of SARS-CoV-2. Methods: We conducted a prospective cohort study in two centers between March and May 2020. We included SARS-CoV-2 infected patients of any age and severity. We collected seriated nasopharyngeal swabs and stool samples to detect SARS-CoV-2. After, we performed a systematic review of the prevalence and clearance of SARS-CoV-2 in stools (PROSPERO-ID: CRD42020192490). We estimated prevalence using a random-effects model. We assessed clearance time by using Kaplan–Meier curves. Results: We included 32 patients; mean age was 43.7 ± 17.7 years, 43.8% were female, and 40.6% reported gastrointestinal symptoms. Twenty-five percent (8/32) of patients had detectable viral RNA in stools. The median clearance time in stools of the cohort was 11[10–15] days. Systematic review included 30 studies (1392 patients) with stool samples. Six studies were performed in children and 55% were male. The pooled prevalence of viral detection in stools was 34.6% (twenty-four studies, 1393 patients; 95%CI:25.4–45.1); heterogeneity was high (I2:91.2%, Q:208.6; p ≤ 0.001). A meta-regression demonstrates an association between female-gender and lower presence in stools (p = 0.004). The median clearance time in stools was 22 days (nineteen studies, 140 patients; 95%CI:19–25). After 34 days, 19.9% (95%CI:11.3–29.7) of patients have a persistent detection in stools. Conclusions: Detection of SARS-CoV-2 in stools is a frequent finding. The clearance of SARS-CoV-2 in stools is prolonged and it takes longer than nasopharyngeal secretions.
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    Impact of rifaximin use in infections and mortality in patients with decompensated cirrhosis and hepatic encephalopathy
    (2024) Idalsoaga F.; Robles C.; Ortiz A.; Corsi O.; Fuentes-Lopez E.; Diaz L.A.; Ayares G.; Arrese M.; Arab J.P.
    © The Author(s), 2024.Introduction: Infections in patients with cirrhosis are associated with high morbidity and mortality. Rifaximin is an antibiotic used to treat and prevent hepatic encephalopathy (HE); however, it has been suggested that it may play a crucial role in reducing infections in these populations. Aim: To evaluate the role of rifaximin in preventing frequent cirrhosis-related infections [spontaneous bacterial peritonitis, pneumonia, urinary tract infection (UTI), and bacteremia], Clostridioides difficile infection, and all-cause mortality, as well as determining adverse effects and adherence to the drug. Methods: A retrospective cohort study was conducted on decompensated cirrhotic patients with history of HE between January 2017 and November 2022 at a university center. Patients with cirrhosis, regardless of their etiology and severity, were included in the study, encompassing both hospitalized and outpatient cases. The statistical analysis included adjusted general linear models, Poisson regressions, and propensity score matching. Results: We included 153 patients. The mean age in the cohort was 60.2 ± 12.3 years and 67 (43.8%) were women. The main cause of cirrhosis was metabolic dysfunction-associated steatotic liver disease 52 (38%), and the median Model of End-Stage Liver Disease sodium was 16.5 (7–32). In the cohort, 65 (45%) patients used rifaximin. The mean follow-up was 32 months. Eighty-five patients with infectious events were recorded, and a total of 164 infectious events were registered. The main infectious events were UTIs (62, 37.8%) and pneumonia (38, 23.2%). The use of rifaximin was associated with lower infection rates, displaying an incidence rate ratio (IRR) of 0.64 [95% confidence interval (CI) (0.47–0.89); p = 0.008]. However, no discernible impact on mortality outcome was observed [IRR 1.9, 95% CI (0.9–4.0); p = 0.09]. There were no reported adverse effects, and no patient discontinued the therapy due to adverse effects. Conclusion: The use of rifaximin significantly reduces infections in patients with cirrhosis and HE. Despite rifaximin was associated with a decreased all-cause mortality, this impact was not statistically significant in the adjusted analysis.
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    Phonological and Semantic Fluency in Alzheimer's Disease: A Systematic Review and Meta-Analysis
    (2023) Olmos-Villasenor R.; Sepulveda-Silva C.; Julio-Ramos T.; Fuentes-Lopez E.; Toloza-Ramirez D.; Santibanez R.A.; Copland D.A.; Mendez-Orellana C.
    BACKGROUND: Semantic and Phonological fluency (SF and PF) are routinely evaluated in patients with Alzheimer's disease (AD). There are disagreements in the literature regarding which fluency task is more affected while developing AD. Most studies focus on SF assessment, given its connection with the temporoparietal amnesic system. PF is less reported, it is related to working memory, which is also impaired in probable and diagnosed AD. Differentiating between performance on these tasks might be informative in early AD diagnosis, providing an accurate linguistic profile. OBJECTIVE: Compare SF and PF performance in healthy volunteers, volunteers with probable AD, and patients with AD diagnosis, considering the heterogeneity of age, gender, and educational level variables. METHODS: A total of 8 studies were included for meta-analysis, reaching a sample size of 1,270 individuals (568 patients diagnosed with AD, 340 with probable AD diagnosis, and 362 healthy volunteers). RESULTS: The three groups consistently performed better on SF than PF. When progressing to a diagnosis of AD, we observed a significant difference in SF and PF performance across our 3 groups of interest (p = 0.04). The age variable explained a proportion of this difference in task performance across the groups, and as age increases, both tasks equally worsen. CONCLUSION: The performance of SF and PF might play a differential role in early AD diagnosis. These tasks rely on partially different neural bases of language processing. They are thus worth exploring independently in diagnosing normal aging and its transition to pathological stages, including probable and diagnosed AD.
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    Quadruple therapies are superior to standard triple therapy for Helicobacter pylori first-line eradication in ChileTerapias cuádruples son superiores a terapia triple estándar en primera línea de erradicación de Helicobacter pylori en Chile
    (2021) Candia R.; Vargas J.I.; Mansilla R.; Arenas A.; Chahuan J.; Espino A.; Pizarro M.; Riquelme A.; Reyes D.; Ortiz J.; Fuentes-Lopez E.; Riquelme A.; Budnik S.; Gandara V.; Gallardo A.; Seydewitz M.F.; Rollan A.; Rollan M.P.; Godoy J.; Mansilla R.; Vargas J.I.; Arenas A.
    © 2021 Elsevier España, S.L.U.Introduction: Helicobacter pylori infection affects approximately 70% of the Chilean population. It is a public health problem whose eradication treatment is part of the explicit health guarantees in Chile. Objectives: Characterize the most widely used H. pylori first-line eradication therapies in our environment and evaluate their efficacy. Methods: A retrospective observational study was carried out where, in patients with certified H. pylori infection, the eradication therapy indicated by the treating physician, its efficacy, adherence and adverse effects, in addition to the eradication certification method used, were evaluated. Results: 242 patients and 4 main therapies were analyzed: standard triple therapy, dual therapy, concomitant therapy, and bismuth quadruple therapy. Eradication rates of 81.9% (95% CI 74.44–87.63), 88.5% (95% CI 73.13–95.67), 93.7% (95% CI 78.07–98.44) and 97.6% (95% CI 84.81–99.67) were observed respectively, with concomitant therapy (RR: 1.14; 95% CI 1.01–1.29; p = .028) and quadruple therapy with bismuth (RR: 1.19; 95% CI 1.09–1.31; p < .001) being significantly more effective than standard triple therapy. Regarding the rate of reported adverse effects, it was 58.5% (95% CI 50.66–65.92), 35.4% (95% CI 24.6–48.11), 22.9% (95% CI 81–37.14) and 63.4% (95% CI 47.8–76.64), having the dual and concomitant therapy significantly fewer adverse effects compared with standard therapy. Conclusions: Quadruple therapies are superior to standard triple therapy and should be considered as first-line treatment in Chile. Dual therapy is promising. More studies will be required to determine which therapies are most cost-effective.
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    Reduction in Helicobacter pylori infection among patients referred for upper gastrointestinal endoscopy in Santiago, Chile, between 2010-2020Reducción de la infección por Helicobacter pylori en pacientes derivados a endoscopia digestiva alta en Santiago de Chile entre 2010-2020
    (2024) Silva F.; Latorre G.; Medel P.; Bustamante M.; Montero I.; Robles C.; Dukes E.; Martinez F.; Binder M.V.; Uribe J.; Reyes D.; Bittner M.; Sirhan M.; Espinoza M.; Fuentes-Lopez E.; Candia R.; Aguero C.; Vargas J.I.; Espino A.; Riquelme A.
    Latin America presents a high prevalence of Helicobacter pylori(Hp) infection. Between1996-2003, the prevalence in Santiago, Chile, was 70%; recent studies indicate a decreasein this infection. Updating the frequency of Hp is crucial due to its associated health impact. OBJECTIVE: Our objective was to describe the trend in Hp infection in patients undergoingambulatory esophagogastroduodenoscopy (EGD) in a Chilean population. MATERIALS AND METHODS: A retrospective observational study was conducted on patients over 18 years old who attended a first EGD with a rapid urease test between 2010-2020. Time trendswere described through time series analysis. A Poisson model was constructed to estimatethe risk of infection, adjusted for age and gender. RESULTS: 11,355 patients were included[66.9% females; mean age 52 years; Hp 41.6%]. Male gender presented a higher frequencyof Hp infection [RR 1.13; (95% CI: 1.08-1.18)].Hp frequency infection decreased significantlyfrom 45.1% in 2010 to 29% in 2020, with a 36% lower probability of Hp infection in 2020 compared to 2010 [RR 0.64;(95% CI: 0.55-0.74)]. A progressive decline in Hp infectiontrend was projected, reaching values close to 25% by year 2025. CONCLUSION: A significantreduction in Hpinfection was observed between 2010-2020. This decrease could be explained by the implementation of public health policies in the last decade associated with socio-sanitary changes.