Browsing by Author "Viñuela Morales, Macarena Rocío"

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    Alteraciones de las vías centrales relacionadas con el utrículo en los pacientes con vértigo posicional paroxístico benigno
    (2024) Waissbluth Abarca, Sofía; Oyarzun Angulo Javier Andres; Novoa, Iván; Viñuela Morales, Macarena Rocío; Cordano Guajardo, Valentina Paz
    Introducción: Otoconias en los canales semicirculares, desprendidas de los órganos otolíticos, podría ser la causa del vértigo posicional paroxístico benigno (VPPB). Formas de evaluar el utrículo incluyen la subjetiva visual vertical (SVV) y el potencial miogénico evocado vestibular ocular (oVEMP). Objetivos: Evaluar SVV y oVEMP en pacientes con VPPB, antes y después de la maniobra de reposición (MRP). Materiales y Métodos: Estudio prospectivo, caso-control. Se reclutaron pacientes con VPPB (canal semicircular posterior), y controles pareados por edad y sexo. Se realizó SVV y oVEMP. Se ejecutó la MRP y se repitió SVV y oVEMP inmediatamente, y a la semana. Se evaluó el nivel de discapacidad con la escala Dizziness Handicap Inventory (DHI) y del mareo con la escalavisual analógica (EVA); ambos realizados pre- y post-MRP. Resultados: Trece pacientes completaron el estudio (48,8 años, 53,8% mujeres). El puntaje DHI y EVA bajaron postMRP. El 53,8% presentó alteración en SVV, 71,4% presentó mayor desviación hacia el lado contralateral al VPPB. A la semana post-MRP, 4/13 presentaron desviación, pero en menor grado y unilateral. Se observó una correlación positiva entre la SVV y DHI. Todos presentaron respuesta bilateral en oVEMP, 4/13 presentaron asimetría inicialmente, y ninguno post-tratamiento. No se observó correlación entre oVEMP y DHI o EVA.
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    Bilateral Vestibulopathy. What Can the Video Head Impulse Test Tell Us?
    (2025) Waissbluth Abarca, Sofía; Viñuela Morales, Macarena Rocío; Escobedo Durán, Emilia José; Pastore, Antonia; Novoa, Iván
    Bilateral vestibulopathy (BV) is a known cause of chronic vestibular syndrome. With the video head impulse test (VHIT), we can now evaluate all six semicircular canals independently and establish BV subgroups based on canal gain patterns. Background/objectives: To assess canal gain patterns for BV with VHIT, and evaluate subgroups with regard to sex, age, and hearing loss. Methods: A retrospective chart review was performed of all patients who underwent a VHIT between January 2021 and July 2024. Patients with decreased lateral canal gains, bilaterally, were included. Results of canal gains, VHIT patterns, audiometry, and videonystagmography (VNG) results were reviewed. Results: 101 cases were included. Patients were 75.5 ± 13.1 years old and 64.4% were women.Various VHIT patterns were observed; the most frequent being decreased canal gains across all six canals (44.6%), followed by a mix of canals with decreased gains with no clear pattern (34.7%). Decreased gains limited to the lateral canals were rare. We did not observe any significant difference between subgroups with regard to gender or age. Concomitant hearing loss was common (89.6%). A trend was noted, suggesting that severity of hearing loss increased with the number of affected canals. An abnormal VNG test was common (73.3%).
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    Bilateral Vestibulopathy. What Can the Video Head Impulse Test Tell Us?
    (2025) Waissbluth Abarca, Sofía; Viñuela Morales, Macarena Rocío; Escobedo Durán, Emilia José; Pastore, Antonia; Novoa, Iván
    Bilateral vestibulopathy (BV) is a known cause of chronic vestibular syndrome. With the video head impulse test (VHIT), we can now evaluate all six semicircular canals independently and establish BV subgroups based on canal gain patterns. Background/objectives: To assess canal gain patterns for BV with VHIT, and evaluate subgroups with regard to sex, age, and hearing loss. Methods: A retrospective chart review was performed of all patients who underwent a VHIT between January 2021 and July 2024. Patients with decreased lateral canal gains, bilaterally, were included. Results of canal gains, VHIT patterns, audiometry, and videonystagmography (VNG) results were reviewed. Results: 101 cases were included. Patients were 75.5 ± 13.1 years old and 64.4% were women.Various VHIT patterns were observed; the most frequent being decreased canal gains across all six canals (44.6%), followed by a mix of canals with decreased gains with no clear pattern (34.7%). Decreased gains limited to the lateral canals were rare. We did not observe any significant difference between subgroups with regard to gender or age. Concomitant hearing loss was common (89.6%). A trend was noted, suggesting that severity of hearing loss increased with the number of affected canals. An abnormal VNG test was common (73.3%).
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    Follow-up of gallbladder polyps in a high-risk population of gallbladder cancer: a cohort study and multivariate survival competing risk analysis
    (Elsevier B.V., 2021) Candia Balboa, Roberto Andrés; Viñuela Morales, Macarena Rocío; Chahuán Abde, Javier Nicolás; Díaz Piga, Luis Antonio; Gándara, Vicente; Errázuriz Gastellu, Pedro; Bustamante Herrera, Luis Felipe Alberto; Villalón Friedrich, Alejandro Andrés; Huete Garín, Alvaro; Crovari Eulufi, Fernando; Briceño Valenzuela, Eduardo Andrés
    The risk of neoplasia in gallbladder polyps seems to be low, but the evidence from populations at high-risk of gallbladder cancer is limited. We aimed to estimate the risk and to identify the factors associated with neoplastic polyps in a high-risk Hispanic population. Methods: A retrospective cohort was recruited between January 2010 and December 2019 at a Chilean university center. Multivariate survival analyses were conducted. Fine–Gray models were fitted to account for competing risks. Covariate adjustment was conducted using propensity scores. The main outcome was the development of gallbladder adenomas or adenocarcinoma. Results: Overall, 748 patients were included, 59.6% underwent cholecystectomy. The median follow-up of patients not subjected to cholecystectomy was 54.7 months (12–128.6 months). Seventeen patients (2.27%) developed the outcome. After adjustment by age, sex, intralesional blood flow, lithiasis and gallbladder wall thickening, only polyp size (≥10 mm, adjusted-HR: 15.01, 95%CI: 5.4–48.2) and number of polyps (≥3 polyps, adjusted-HR: 0.11, 95%CI: 0.01–0.55) were associated with neoplasia. Conclusion: In a Hispanic population at high-risk for gallbladder cancer, gallbladder polyps seem to have a low risk of neoplasia. Polyp size was the main risk factor, while having multiple polyps was associated with an underlying benign condition.
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    SARS-CoV-2 vaccine booster in solid organ transplant recipients previously immunised with inactivated versus mRNA vaccines: A prospective cohort study
    (2022) Dib Marambio, Martín Javier; Le Corre Pérez, Monique Nicole; Ortiz Koh, Catalina Alejandra; García, Daniel; Ferrés, Marcela; Martínez Valdebenito, Constanza; Ruiz-Tagle, Cinthya; Ojeda Valenzuela, María José; Espinoza Sepúlveda, Manuel Antonio; Jara Contreras, Aquiles; Arab Verdugo, Juan Pablo; Rabagliati B., Ricardo; Vizcaya Altamirano, Cecilia; Ceballos, María Elena; Sarmiento Maldonado, Mauricio; Mondaca Contreras, Sebastián Patricio; Viñuela Morales, Macarena Rocío; Pastore Thomson, Antonia; Szwarcfiter Neiman, Vania; Galdames Lavín, Elizabeth Alejandra; Barrera Vásquez, Aldo Vincent; Castro Gálvez, Pablo Federico; Gálvez Arriagada, Nicolás Marcelo Salvador; Soto Ramírez, Jorge Andrés; Bueno Ramírez, Susan; Kalergis Parra, Alexis Mikes; Nervi Nattero, Bruno; Balcells Marty, María Elvira
    Solid-organ transplant (SOT) recipients have worse COVID-19 outcomes than general population and effective immunisation in these patients is essential but more difficult to reach. We aimed to determine the immunogenicity of an mRNA SARS-CoV-2 vaccine booster in SOT recipients previously immunised with either inactivated or homologous SARS-CoV-2 mRNA vaccine. Methods: Prospective cohort study of SOT recipients under medical care at Red de Salud UC-CHRISTUS, Chile, previously vaccinated with either CoronaVac or BNT162b2. All participants received a BNT162b2 vaccine booster. The primary study end point was anti-SARS-CoV-2 total IgG antibodies (TAb) seropositivity at 8-12 weeks (56-84 days) post booster. Secondary end points included neutralising antibodies (NAb) and specific T-cell responses. Findings: A total of 140 (50% kidney, 38% liver, 6% heart) SOT recipients (mean age 54 [13.6] years; 64 [46%] women) were included. Of them, 62 had homologous (three doses of BNT162b2) and 78 heterologous vaccine schedules (two doses of CoronaVac followed by BNT162b2 booster). Boosters were received at a median of 21.3 weeks after primary vaccination. The proportion achieving TAb seropositivity (82.3% vs 65.4%, P = 0.035) and NAb positivity (77.4% vs 55.1%, P = 0.007) were higher for the homologous versus the heterologous group. On the other hand, the number of IFN-γ and IL-2 secreting SARS-CoV-2-specific T-cells did not differ significantly between groups. Interpretation: This cohort study shows that homologous mRNA vaccine priming plus boosting in SOT recipients, reaches a significantly higher humoral immune response than inactivated SARS-CoV-2 vaccine priming followed by heterologous mRNA booster.