Browsing by Author "Viviani, Paola"

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    Antecolic versus retrocolic alimentary limb in laparoscopic Roux-en-Y gastric bypass: a comparative study
    (2007) Escalona, Alex; Devaud, Nicolas; Perez, Gustavo; Crovari, Fernando; Boza, Carnilo; Viviani, Paola; Ibanez, Luis; Guzman, Sergio
    Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) has become the most common surgical treatment for morbid obesity. Intestinal obstruction and internal hernias are cornplications more commonly observed after LRYGB than after open RYGB. The aim of this study was to evaluate the incidence of these cornplications in patients who had undergone LRYGB using an antecolic versus a retrocolic technique.
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    Epidemiological characterization of bites on people, as emergency care record. Province of Los Andes, Chile
    (SOC CHILENA INFECTOLOGIA, 2017) Villagra, Vania; Caceres, Dante; Alvarado, Sergio; Salinas, Elizabeth; Loreto Caldera, M.; Lucero, Erick; Viviani, Paola; Torres, Marisa
    Background: Bites constitute a public health problem worldwide. Aim: To characterize epidemiologically bites by animals happened in the province of Los Andes (2005-2007). Method: Descriptive, retrospective epidemiological study. Studied variables: Bitten person (BP), accident by bite, biting animal and bite. It was not feasible to obtain more updated information by law of patient protection. Results: 2,360 BP were assisted in the emergency unit of San Juan de Dios Hospital and Rio Blanco clinic. An annual average rate of 729 BP/100,000 inhabitants and 1.99 daily average was recorded. The male gender was most affected (53.5%) and the age group from 6 to 10 years old. (Rate:.521/100,000). Most frequent topographic location was the lower limb, except in children under 5 year olds in whom predominated head and neck. The biting animal according to frequency was: the dog (67.1%) spider (7.1%) and cat (3.9%). The animal property was 35.6% known and 30.7% own. The most frequent problems were: nonspecific allergy; toxic effect by spider bites and among the infections, the disease made by cat's scratch stands out. Regarding the record system, the biting animal complaint was applied to 47.6% of the BP and the 92.8% of the recorded information was incomplete. Conclusions: Bites reported higher rates in the province of Los Andes than the average of the country (729 versus 188/100,000), standing out the higher magnitude in 6 to 10 year-old-children. It is noticed that the record is low and incomplete. In this province, no bite control programs or updated studies have been carried out.
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    Features associated with the development of non-motor manifestations in Parkinson's disease
    (ASSOC ARQUIVOS NEURO- PSIQUIATRIA, 2008) Juri, Carlos; Viviani, Paola; Chana, Pedro
    Parkinson's disease (PD) is a neurodegenerative disorder, predominantly characterized by the presence of motor symptoms. However, the non motor manifestations (NMM) are a frequent complaint in the PD patients. There is a lack of information about the risk factors associated with the NMM in these patients. The aim of this study is to evaluate the prevalence of the more common NMM in a population of PD patients and to determine the features associated with its development. We! studied 124 ambulatory PD patients. NMM were defined by the presence of neuropsychiatric manifestations, cognitive disorder, autonomic dysfunction or sleep related problems. In a multivariate analysis we found that the years of evolution of the PD and the presence of cognitive dysfunction are the risk factors for the neuropsychiatric and autonomic manifestations, whereas axial impairment is a risk factor for cognitive disorders and dyskinesias is for sleep related problems. In conclusion, this study shows that the features related to the PD progression appear as the main risk factors associated with NMM.
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    Gallbladder polyps
    (2006) Escalona, Alex; Leon, Francisca; Bellolio, Felipe; Pimentel, Fernando; Guajardo, Matias; Gennero, Ruben; Cruz, Juan Pablo; Viviani, Paola; Ibanez, Luis
    Background: Gallbladder polyps are becoming a common finding. The management of these polyps is complicated considering that they can bear malignant lesions. Aim: To analyze the ultrasonographic and histopatbologic findings of patients operated due to gallbladder polyps. Patients and methods: The records of patients with ultrasonograpbic diagnosis of gallbladder polyp and that underwent cholecystectomy in a thirteen years period were reviewed, collecting their demographic, ultrasonograpbic and histopathological data. Results: One hundred and twenty three patients were operated. Tbe mean age was 44 +/- 13 years, and 69% were women. The mean size of polyps in ultrasonography was 7.3 +/- 5 mm. Histopathology confirmed the presence of polyps in 79% of patients, with a mean size and number of lesions of 5.1 +/- 3.8 mm and 2.1 +/- 2, respectively. Nine percent of polyps were greater than 10 mm, and single polyps were significantly larger than the multiple ones (p = 0.003). Four cases of adenoma (3.2%) were diagnosed; one of them had in situ carcinoma. All were single and larger than 10 mm. We found a significant correlation between ultrasonograpbic and histopathological polyp size determination (r = 0.47; p = 0.002). Polyp size was also a predictor of the presence of adenoma (p = 0.043; confidence intervals., 1.006-1.424). Conclusions: There is a good correlation between the size of the gallbladder polyp in ultrasonography and the size in the histopathology report. Gallbladder adenoma is uncommon and it correlates with the size of the polyp. In this series, size was the only predictor of the presence of adenoma.
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    HPV16/18 genotyping for the triage of HPV positive women in primary cervical cancer screening in Chile
    (2015) Lagos Lucero, Marcela; Van De Wyngard, Vanessa; Poggi, Helena; Cook, María Paz; Viviani García, Paola; Barriga Cosmelli, María Isabel; Ferreccio Readi, Catterina; Pruyas, Martha; Lagos Lucero, Marcela; Van De Wyngard, Vanessa; Poggi, Helena; Cook, María Paz; Viviani, Paola; Barriga, María I.; Ferreccio Readi, Catterina; Pruyas, Martha
    Abstract Background We previously conducted a population-based screening trial of high-risk human papillomavirus (hrHPV) testing and conventional cytology, demonstrating higher sensitivity (92.7 % vs 22.1 % for CIN2+) but lower positive predictive value (10.5 % vs 23.9 %) of hrHPV testing. Here we report the performance of HPV16/18 genotyping to triage the hrHPV positive participants. Methods Women aged 25 years and older received hrHPV (Hybrid Capture 2) and Papanicolaou testing; positives by either test underwent colposcopy and directed biopsy, as did a sample of double-negatives. hrHPV positive women were reflex-tested with HPV16/18 genotyping (Digene HPV Genotyping PS Test). Results Among the 8,265 participants, 10.7 % were hrHPV positive, 1.7 % had ASCUS+ cytology, 1.2 % had CIN2+; 776 (88 %) hrHPV positive women had complete results, of whom 38.8 % were positive for HPV16 (24.0 %), HPV18 (9.7 %) or both (5.1 %). CIN2+ prevalence in HPV16/18 positive women (16.3 %, 95 % CI 12.3-20.9) was twice that of HPV16/18 negative women (8.0 %, 95 % CI 5.7-10.8). HPV16/18 genotyping identified 40.5 % of CIN2, 66.7 % of CIN3 and 75.0 % of cancers. Compared to hrHPV screening alone, HPV16/18 triage significantly reduced the referral rate (10.7 % vs 3.7 %) and the number of colposcopies required to detect one CIN2+ (9 vs 6). When HPV16/18 negative women with baseline ASCUS+ cytology were also colposcopied, an additional 14 % of CIN2+ was identified; referral increased slightly to 4.2 %. Conclusions HPV16/18 triage effectively stratified hrHPV positive women by their risk of high-grade lesions. HPV16/18 positive women must be referred immediately; referral could be deferred in HPV16/18 negative women given the slower progression of non-HPV16/18 lesions, however, they will require active follow-up.Abstract Background We previously conducted a population-based screening trial of high-risk human papillomavirus (hrHPV) testing and conventional cytology, demonstrating higher sensitivity (92.7 % vs 22.1 % for CIN2+) but lower positive predictive value (10.5 % vs 23.9 %) of hrHPV testing. Here we report the performance of HPV16/18 genotyping to triage the hrHPV positive participants. Methods Women aged 25 years and older received hrHPV (Hybrid Capture 2) and Papanicolaou testing; positives by either test underwent colposcopy and directed biopsy, as did a sample of double-negatives. hrHPV positive women were reflex-tested with HPV16/18 genotyping (Digene HPV Genotyping PS Test). Results Among the 8,265 participants, 10.7 % were hrHPV positive, 1.7 % had ASCUS+ cytology, 1.2 % had CIN2+; 776 (88 %) hrHPV positive women had complete results, of whom 38.8 % were positive for HPV16 (24.0 %), HPV18 (9.7 %) or both (5.1 %). CIN2+ prevalence in HPV16/18 positive women (16.3 %, 95 % CI 12.3-20.9) was twice that of HPV16/18 negative women (8.0 %, 95 % CI 5.7-10.8). HPV16/18 genotyping identified 40.5 % of CIN2, 66.7 % of CIN3 and 75.0 % of cancers. Compared to hrHPV screening alone, HPV16/18 triage significantly reduced the referral rate (10.7 % vs 3.7 %) and the number of colposcopies required to detect one CIN2+ (9 vs 6). When HPV16/18 negative women with baseline ASCUS+ cytology were also colposcopied, an additional 14 % of CIN2+ was identified; referral increased slightly to 4.2 %. Conclusions HPV16/18 triage effectively stratified hrHPV positive women by their risk of high-grade lesions. HPV16/18 positive women must be referred immediately; referral could be deferred in HPV16/18 negative women given the slower progression of non-HPV16/18 lesions, however, they will require active follow-up.
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    Increase in maternal mortality and prematurity during the COVID-19 pandemic in Chile
    (2023) Gonzalez, Rogelio; Viviani, Paola; Merialdi, Mario; Rubio, Gonzalo; Pons, Andres; Gutierrez, Jorge
    Introduction: At the third year of the pandemic in Chile, the reported cases of COVID-19 reached 4,769,638 and 61,725 deaths (1.4%), with 93% of the population with a complete vaccination schedule (17,686,528). Aim: The purpose of this study is a brief communication on the impact of the SARS-CoV-2 pandemic on maternal, perinatal and prematurity mortality in Chile. Method: The national database of the Informatics Department of the Ministry of Health of Chile (DEIS), and the information reported from the official WHO website were used. All births, general and fetal deaths from January 1990 to September 2022 were included. A comparison is made between the basic maternal and perinatal indicators of the last 30 years and those of the years of the pandemic. Results: From March 2020 to September 2022, approximately 61,000 people died in Chile with a diagnosis associated with COVID-19, 17% of the general mortality for the period (approx. 364.000 deaths). An acceleration in the historical trend towards a decrease in the overall birth/death ratio was observed from 1.9 pre-pandemic to 1.4 during the third year of the pandemic. Maternal Mortality Ratio in 2020 (28.1 x 100,000) increased compared to 2019 pre-pandemic (19.1) or the simple historical trend line projected for 2020 (18.0) by 56%. Prematurity under 37 weeks of gestation increased from 8.5% (2019) to 9.5% for the years 2021 and 2022. Neonatal mortality in the first 28 days remained stable at 9 per thousand births during the 3 years of the pandemic and fetal mortality (>21 weeks) had a slight increase to 4.7 per thousand (year 2020) in relation to 3.4 in 2019. Conclusions: In Chile, an increase of approximately 56% in maternal mortality occurred in the first year of the SARS-CoV-2 pandemic. In the second year, a significant increase in late prematurity and a slight increase in fetal mortality were observed. These findings have been reported in the reviews and latest updates of the year 2022.
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    Increase of Bone Resorption and the Parathyroid Hormone in Postmenopausal Women in the Long-term after Roux-en-Y Gastric Bypass
    (2009) Valderas, Juan P.; Velasco, Soledad; Solari, Sandra; Liberona, Yessica; Viviani, Paola; Maiz, Alberto; Escalona, Alex; Gonzalez, Gilberto
    The effects of Roux-en-Y Gastric Bypass (RYGB) on bone in the long-term remains unclear. We assessed bone metabolism and bone mineral density (BMD) 1 to 5 years after RYGB.
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    Inverse correlation between allergy markers and Helicobacter pylori infection in children is associated with elevated levels of TGF-beta
    (LIPPINCOTT WILLIAMS & WILKINS, 2011) Serrano, Carolina A.; Talesnik, Eduardo; Pena, Alfredo; Rollan, Antonio; Duarte, Ignacio; Torres, Javiera; Majerson, Daniela; Einisman, Helly; Viviani, Paola; Harris, Paul R.
    Objectives We evaluated allergy/hypersensitivity clinical markers and their correlation with Helicobactor pylori infection in children and adults to analyze how early acquisition of H. pylori could modulate allergic disorder expression.
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    Platelet count/spleen diameter ratio for non-invasive prediction of high risk esophageal varices in cirrhotic patients
    (ELSEVIER ESPANA, 2009) Barrera, Francisco; Riquelme, Arnoldo; Soza, Alejandro; Contreras, Alvaro; Barrios, Gerty; Padilla, Oslando; Viviani, Paola; Maria Perez Ayuso, Rosa
    Background and objective. Prophylaxis therapy is indicated in cirrhotic patients with large esophageal varices or small varices with red wale signs (high risk esophageal varices; HREV). Endoscopic surveillance to detect HREV is currently recommended. The objective of this study is to identify non-invasive predictors of HREV in cirrhotic patients. Design and methods. Adult cirrhotic patients without previous variceal bleeding were prospectively included. All patients underwent a complete biochemical workup, upper digestive endoscopy, and ultrasonographic measurement of spleen bipolar diameter. Platelet count/spleen diameter ratio (PC/SD) was calculated for all patients. The association of these variables with the presence of HREV in upper endoscopy was tested using univariate and multivariate analysis. Receiver operating characteristic (ROC) curves were constructed for variables associated with HREV. Results. Sixty-seven patients were included. The prevalence rate of HREV was 50%. Age, gender (female), platetet count, spleen diameter, PC/SD ratio, total bilirrubin, prothrombin activity (INR), Childl-Pugh score, clinical and ultrasonographic ascites were significantly associated with presence of HREV in univariate analysis. Age and PC/SD ratio were the parameters independently associated with HREV in a multivariate analysis, with OR 8.81 (CI 95%: 1.7-44.9) and OR 11.21 (CI 95%: 2.8-44.6) respectively. A PC/SD ratio cut-off value under 830.8 predicted HREV with 76.9% sensitivity, 74.2% specificity and 77.8% negative predictive value (ROC curve area: 0.78). Conclusions. The PC/SD ratio was significantly associated with HREV, but with suboptimal sensitivity and specificity. Therefore, the results of this study do not support the routine clinical use of PC/SD ratio for screening of HREV.
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    Risk factors associated with higher scores in internalizing and externalizing behaviors in Chilean preschoolers
    (2023) Bedregal, Paula; Lermanda, Victoria; Sierra, Rodrigo; Viviani, Paola
    Early detection of behavioral disorders in children is necessary for intervention. Available data show a high prevalence of child and adolescent psychiatric disorders in Chile (22.5%), but behavioral problems in younger children have not been evaluated. This work assesses behavioral disorders in preschoolers and their association with sociodemographic variables of the family and the child. The data was collected during the impact assessment of the Biopsychosocial Development Support Program "Chile Crece Contigo", using a multistage and representative random sample of 1377 preschoolers, aged between 30 and 48 months, who attended public health services. Homes were visited to apply a questionnaire and the Child Behavior Checklist (CBCL, 1.5-5 years). Results: Multivariable regression model for total raw scores shows that child's age, the number of chronic diseases in the child, and history of exposure to mother's alcohol consumption in pregnancy, remain significant when adjusted for all variables included (R-2 of 17.8% and & eta;(2) of .19 (95% CI: .14-.22)). In externalizing and internalizing explanatory models, child's chronic diseases and a higher score of authoritarian beliefs about parenting show the two largest effect sizes. These results add to the evidence of urgent problems in preschool mental health.
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    Value of adenosine deaminase (ADA) in ascitic fluid for the diagnosis of tuberculous peritonitis - A meta-analysis
    (LIPPINCOTT WILLIAMS & WILKINS, 2006) Riquelme, Arnoldo; Calvo, Mario; Salech, Felipe; Valderrama, Sebastian; Pattillo, Alejandro; Arellano, Marco; Arrese, Marco; Soza, Alejandro; Viviani, Paola; Letelier, Luz Maria
    Background and Goals: Adenosine deaminase (ADA) levels are used for diagnosing tuberculosis in several locations and although many studies have evaluated ADA levels in ascitic fluid. These studies have defined arbitrary cut-off points creating difficulties in the clinical application of the results. The goals of this study are: to determine the usefulness of ADA levels in ascitic fluid as a diagnostic test for peritoneal tuberculosis (PTB) and define the best cut-off point.