Artículos de conferencia
Permanent URI for this collection
Browse
Recent Submissions
- ItemAri-Test: Set the Focus on the User Experience in the Design of a Self-Sampling Device for HPV Detection in Women(2024) Silva, Macarena; Gonzalez, Alberto; Caro Pinto, IvánHuman Papillomavirus (HPV) is regarded as the main cause of Cervical Cancer (CC), affectingover 440 million people worldwide (UC Christus Healthcare Network, s.f.), diagnosing over 600 thousand women each year, from which half of them die (WHO, 2023). In Chile, this outlook worsens, where 70% of over a thousand women who are diagnosed yearly die (Urrutia, 2015).It constitutes a global public problem, which has among its causes the inequality of access to healthcare services, refusal on the part of women to attend their gynecological check-ups, and other socioeconomic determinants (WHO, 2023) that complicate the situation. In the research, different critical interactions were raised, the most relevant is the lack of time and the discomfort generated by the PAP test (Papanicolau) experience, which distances women from the examination and, therefore, the early detection as well. These diseases are asymptomatic and don’t show obvious signs until they are in an advanced state and treatment becomes limited. However, its effects can be treated when detected in time. This implies that we’re facing a design problem that was not addressed as such. A healthcare and well-being concern that’s affecting people’s quality of life, so setting the view in the user’s experience is something that wasn’t being contemplated in these types of exams. The project proceeded considering the multiple aspects of the challenge but taking as priority those that directly influence the promotion of early detection. The research started as an undergraduate thesis in 2022 at the School of Design of Pontificia Universidad Católica de Chile, and it is currently financed by the National Research and Development Agency, Chile’s main funding state institution in research matters. Ari-test eases vaginal self-sampling for HPV detection, allowing women to regain agency over their gynecological experience and self-care by granting the possibility of access to the exam in a simple way from the comfort and privacy of their homes. The design process was approached from the iterative methodology of Health Design Thinking, which focuses on the real needs and behaviors of users instead of seeing them as patients defined by illness (Ku and Lupton, 2018). Including users in the process through co-designing tools and considering their gynecological experiences was crucial and challenged us to go beyond designing only for their bodies but working for and with them.
- ItemP008 Why do so many men who are potential candidates for a penile implant do not receive one? Understanding the reasons in a middle-income country(2024) Marconi Toro, Marcelo Carlos; Gonzalez, A.; Caro Pinto, Iván; Campillo, M.; Duarte, S.
- ItemPhysiologic Effects of High Flow Nasal Cannula Compared to Conventional Oxygen Therapy Postextubation: A Randomized Crossover Study(2022) Basoalto Escobar, Roque Ignacio; Damiani Rebolledo, Luis Felipe; Jalil Contreras, Yorschua Frederick; Garcia, P.; Carpio Cordero, David Bernardo; Bachmann Barron, María Consuelo; Alegria Aguirre, Luz Katiushka; Oviedo Álvarez, Vanessa Andrea; Bugedo Tarraza, Guillermo Jaime; Retamal, J.; Bruhn Cruz, Alejandro RodrigoRationale: High flow nasal cannula (HFNC) has been shown to generate several physiological which would be responsible forreducing weaning failure rates. However, there are not many physiological studies focused on the post-extubationstage.Objective: To determine the physiological effects of HFNC in the post-extubation period.Methods:Prospective randomizedcrossover study in the post-extubation period of patients with acute respiratory failure (ARF), which was approved by the HealthSciences Scientific Ethics Committee of Pontificia Universidad Católica de Chile. Critically ill patients connected to mechanicalventilation (MV) more than 48 hours, with PaO2/FiO2 <300 mmHg, and in whom the physician planned to perform a spontaneousventilation test (SBT) were included. After obtaining consent informed a catheter with an esophageal and gastric balloon andelectrodes to record the electrical activity of the diaphragm (EAdi) were installed. Moreover, an electrical impedance tomography(EIT) around the chest was connected, arterial and venous blood gases were recorded, in addition to the usual clinical signs.After extubation, the patients were connected to HFNC set at 50 L/min for one hour and conventional oxygen therapy (venturimask) for one hour in a random sequence.Results:Nine patients (6 men) aged 60.7 ± 10.0 years were included. Patients wereconnected to MV for 6.6 ± 3.2 days. Compared with conventional oxygen therapy, HFNC significantly reduces the respiratoryeffort observed by a reduction of esophageal pressure swings (ΔPes)(p= 0.006) and pressure-time product (PTPes) (p= 0.047)of 30% and 27%, respectively. In the HFNC period, the end-expiratory lung impedance (p< 0.001) and dynamic lung compliance(VT/ΔPes) (p= 0.041) was significantly higher. However, no differences were observed in tidal volume (p= 0.255), electricalactivity of the diaphragm (ΔEAdi) (p= 0.104), Neuro-ventilatory efficiency (p= 0.262), and respiratory rate (RR) (p= 0.299)compared to the period of conventional oxygen therapy. Finally, the PaO2 / FiO2 ratio was also higher in the HFNC period (p =0.029).Conclusion:The use of HFNC in the post-extubation period in patients with acute respiratory failure reduces work ofbreathing and is capable of increasing end-expiratory lung volume, dynamic compliance, and gas exchange.
- ItemImpact of Decreasing Respiratory Rate While Tolerating Moderate Hypercapnia on Lung Injury Markers in Patients with Covid-19 Related Acute Respiratory Distress Syndrome(2021) Damiani Rebolledo, Luis Felipe; Oviedo Álvarez, Vanessa Andrea; Alegria Aguirre, Luz Katiushka; Basoalto Escobar, Roque Ignacio; Bachmann Barron, María Consuelo; Jalil Contreras, Yorschua Frederick; Bruhn Cruz, Alejandro Rodrigo; Retamal Montes, A.; Santis Fuentes, César Antonio; Vera, M.; Bugedo Tarraza, Guillermo JaimeRationale: Acute respiratory distress syndrome (ARDS) secondary to SARS-CoV-2 pneumonia is associated with a high mortality rate. Protective ventilationstrategies, by decreasing ventilator induced lung injury (VILI), have reduced mortality in patients with ARDS. However, the role of respiratory rate (RR), a centraldeterminant of the energy applied to the lung parenchyma remains uncertain. Objective: To evaluate the role of respiratory rate on systemic pro-inflammatory mediators, as markers of VILI, in patients with Covid-19-associated ARDS (CARDS) Methods: Prospective, randomized crossover trial in patients with CARDS,PaO2:FIO2 ratio less than 200 mmHg, and requiring deep sedation and neuromuscular blockade. All patients were ventilated with a tidal volume of 6 ml/kg IBW,and PEEP and FiO2 according to the ARDSNet table. If PaO2:FIO2 ratio was less than 150 mmHg, patients were positioned in the prone position.Two 12 hoursperiods with a low RR and a high RR, randomly selected, was conducted. Low RR and high RR periods were set to obtain an 8-10 breaths/min difference betweengroups while maintaining pH and PaCO2 within recommended limits. I:E ratio was held constant during the study.Hemodynamic and respiratory mechanics wereregistered, and arterial blood samples drawn for gas exchange and quantification of inflammatory biomarkers at baseline and repeated at 12 and 24 hours. Results: We enrolled 11 patients (10 males, median age 54 [51-66] years, PaO2:FIO2 108 [86-132]), and all of them were in prone position. The low RR (20 [16-23]) vs the high RR (28 [26-32]) was associated with a significantly lower energy applied to the lung (16 [12-19] vs 23 [20-32] J / min, respectively). PaCO2 and pH were kept within the recommended limits (pH 7.30 [7.25-7.35] vs 7.46 [7.43-7.50]; PaCO2 48 (45-63) vs 36 (32-38) mmHg for low and high RR, respectively).There were no significant changes in any of the respiratory mechanics parameters.The change in RR did not induce differences in any inflammatory marker (IL-6,IL-8, TNF-R1) or in the markers of epithelial (receptor for advanced glycation end products, s-RAGE; Surfactant protein D, SP-D), endothelial damage (Angiopoietin2) or the marker of profibrotic activity (transforming growth factor ß, TGF-ß) (table 1). Conclusion: These preliminary results reveal that a decrease in respiratoryrate, tolerating moderate hypercapnia, does not modify the biomarkers of lung damage compared to a strategy of high respiratory rate in patients with CARDS.
- ItemTransferring knowledge on patient-centered care – experiences and evaluations from a workshop series in Chile(2024) Lages, Nadine; Scholl, Isabelle; Quezada, Constanza; Hahlweg, Pola; Zeh, Stefan; Dois C., Angelina M.; Bravo, Paulina; Härter, MartinIntroduction Patient-centered care (PCC) is a key principle of high-quality health care. Chile has declared PCC as a fundamental pillar of its health care system. However, PCC implementation in the Chilean health care system still lags behind. In order to promote PCC, a series of workshops was held in Santiago de Chile that aimed to transfer knowledge on PCC and shared decision-making (SDM). Methods Fifty-one participants (representatives of the Chilean Ministry of Health or clinicians in Chile) took part in this workshop series. It included four main topics: (1) concepts and practices of PCC and SDM, (2) clinician-patient communication, 3) assessment of PCC and SDM and 4) implementation and adoption of SDM. These workshops were evaluated via a questionnaire, including both closed and open- ended questions, analyzed by descriptive statistics and qualitative content analysis. Results Overall, participants were satisfied with the workshop series (M = 3.8, SD = 0.37). They rated both PCC (M = 4.0, SD = 0.15) and SDM (M = 3.9, SD = 0.28) as relevant for their work, and were able to follow the presentations easily (M = 3.8, SD = 0.39). Analysis of the open questions revealed that participants particularly appreciated the implementation tools presented during the workshops. Participants suggested that didactic methods could be improved. Discussion Exchanging thoughts and views on PCC and SDM with workshop participants has enriched the understanding of how to promote the implementation of PCC in Chile. By developing the key topics in close exchange with stakeholders, the workshops have been tailored to the needs and interests of the target group. Conclusions Addressing stakeholders to give them hands-on ideas on how to put the legal PCC promotion framework into practice may pave the way to implement PCC and SDM more thoroughly and thus improve health care.