Examinando por Autor "Martínez, Felipe"

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    A Technological Framework to Support Asthma Patient Adherence Using Pictograms
    (Multidisciplinary Digital Publishing Institute (MDPI), 2024-08) Figueroa, Rosa; Taramasco, Carla; Lagos, María Elena; Martínez, Felipe; Rimassa, Carla; Godoy, Julio; Pino, Esteban; Navarrete, Jean; Pinto, Jose; Nazar, Gabriela; Pérez, Cristhian; Herrera, Daniel
    Background: Low comprehension and adherence to medical treatment among the elderly directly and negatively affect their health. Many elderly patients forget medical instructions immediately after their appointments, misunderstand them, or fail to recall them altogether. Some identified causes include the short time slots allocated for appointments in the public health system in Chile, the complex terminology used by healthcare professionals, and the stress experienced by patients during appointments. One approach to improving patients’ adherence to medical treatment is to combine written and oral instructions with graphical elements such as pictograms. However, several challenges arise due to the ambiguity of natural language and the need for pictograms to accurately represent various medication combinations, doses, and frequencies. Objective: This study introduces SIMAP (System for Integrating Medical Instructions with Pictograms), a technological framework aimed at enhancing adherence among asthma patients through the delivery of pictograms via a computational system. SIMAP utilizes a collaborative and user-centered methodology, involving health professionals and patients in the construction and validation of its components. Methods: The technological framework presented in this study is composed of three parts. The first two are medical indications and pictograms related to the treatment of the disease. Both components were developed through a comprehensive and iterative methodology that incorporates both qualitative and quantitative approaches. This methodology includes the utilization of focus groups, interviews, paper and online surveys, as well as expert validation, ensuring a robust and thorough development. The core of SIMAP is the technological component that leveraged artificial intelligence methods for natural language processing to analyze, tokenize, and associate words and their context to a set of one or more pictograms, addressing issues such as the ambiguity in the text, the cultural factor that involves many ways of expressing the same indication, and typographical errors in the indications. Results: Firstly, we successfully validated 18 clinical indications along with their respective pictograms. Some of the pictograms were redesigned based on the validation results. However, in the final validation, the comprehension percentages of the pictograms exceeded 70%. Furthermore, we developed a software called SIMAP, which translates medical indications into previously validated pictograms. Our proposed software, SIMAP, achieves a correct mapping rate of 96.69%. Conclusions: SIMAP demonstrates great potential as a technological component for supplementing medical instructions with pictograms when tested in a laboratory setting. The use of artificial intelligence for natural language processing can successfully map medical instructions, both structured and unstructured, into pictograms. This integration of textual instructions and pictograms holds promise for enhancing the comprehension and adherence of elderly patients to their medical indications, thereby improving their long-term health.
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    Comparative Efficacy of a High-Dose vs Standard-Dose Hepatitis B Revaccination Schedule Among Patients With HIV A Randomized Clinical Trial
    (American Medical Association, 2021-08-23) Vargas, Jose Ignacio; Jensen, Daniela; Martínez, Felipe; Sarmiento, Valeska; Peirano, Felipe; Acuña, Pedro; Provoste, Felipe; Bustos, Valentina; Cornejo, Francisca; Fuster, Antonieta; Acuña, Martin; Fuster, Felipe; Soto, Sabrina; Estay, Denisse; Jensen, Werner; Ahumada, Rodrigo; Arab, Juan Pablo; Soza, Alejandro; Fuster, Francisco
    IMPORTANCE Active immunization for hepatitis B virus (HBV) infection is recommended in patients living with HIV. Limited evidence is available about the most appropriate regimen of HBV vaccination among those who have not responded to an initial schedule. OBJECTIVE To determine the efficacy of a high-dose schedule compared with a standard dose of HBV vaccination. DESIGN, SETTING, AND PARTICIPANTS This double-masked, parallel-group, randomized controlled trial included patients living with HIV at a single outpatient HIV and hepatology clinic in Chile for whom previous HBV vaccination had failed. Patients with hepatitis B surface antibody (anti-HBs) titers less than 10 IU/L after an initial HBV vaccination regimen were included. Consecutive patients were recruited between December 2013 and March 2018. Data were analyzed in June 2018 using intention-to-treat analysis. INTERVENTION The high-dose HBV vaccination group consisted of 3 doses of 40 μg recombinant hepatitis B vaccine at 0, 1, and 2 months. The standard-dose group received 3 doses 20 μg each at 0, 1, and 2 months. MAIN OUTCOMES AND MEASURES Primary outcome was the serologic response to HBV vaccination (anti-HBs greater than 10 IU/L) 4 to 8 weeks after completion of the schedule. Secondary outcomes were anti-HBs greater than 100 IU/L and seroprotective anti-HBs at 1 year follow up. RESULTS A total of 107 patients underwent randomization (55 to the standard-dose group, 52 to the high-dose group); 81 (75.7%) were men, and the mean (SD) patient age was 47.0 (13.3) years. Nearly all patients were receiving antiretroviral therapy (105 patients [98%]) and 92 patients (86%) had an undetectable HIV viral load. Mean (SD) CD4 count was 418 (205) cells/mm3. There were no differences in baseline characteristics between groups. Serological response in the high-dose group was found in 36 of 50 patients (72%; 95% CI, 56.9%-82.9%) compared with 28 of 55 patients in the standard-dose group (51%; 95% CI, 37.1%-64.6%) (odds ratio, 2.48; 95% CI, 1.02-6.10; P = .03). Mean (SD) anti-HB levels were 398.0 (433.4) IU/L in the high-dose group and 158.5 (301.4) IU/L in the standard-dose group (P < .001). Of patients with a serological response in the high-dose group, 29 of 36 (80.6%) had anti-HBs titers greater than 100 IU/L compared with 14 of 28 responders (50.0%) in the standard-dose group (P = .02). At 1-year follow-up, 20 of 25 patients (80.0%) with a serological response in the high-dose group had protective anti-HBs vs 9 of 23 patients (39.1%) in the standard-dose group (P = .01). CONCLUSIONS AND RELEVANCE The results of this randomized clinical trial suggest that use of a high-dose regimen for HBV revaccination for patients with HIV achieves a higher and longer-lasting serological response as compared with a standard-dose regimen. © 2021 American Medical Association. All rights reserved.
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    Effects of internet-based telemonitoring platforms on the quality of life of oncologic patients: A systematic literature review protocol
    (Public Library of Science, 2023) Martínez, Felipe; Tobar, Catalina; Taramasco, Carla
    Introduction Telemonitoring involves the transmission of clinical information through digital means, including internet-connected devices such as smartphones, health tracking apps and video conferencing platforms. This strategy could provide a viable alternative to facilitate follow-up in several conditions, including cancer. Objectives To synthesise the available evidence on the effectiveness of internet-based telemonitoring platforms amongst oncological patients. Relevant endpoints include overall quality of life, the ability to detect postoperative complications, severe toxicity reactions attributable to chemotherapy, reducing the frequency of hospitalisations, emergency department visits and mortality. Methods A systematic review of published and unpublished randomised and controlled studies will be carried out. Iterative searches in PubMED/MEDLINE, EMBASE, Epistemonikos, LILACS, and Cochrane CENTRAL repositories from January 2000 to January 2023 will be conducted. Grey literature repositories, such as Clinicaltrials, BioRxiv and MedRxiv will be searched as well. The Cochrane risk of bias tool will be used to assess the quality of the eligible studies. If possible, a meta-analysis based on the random-effects model will be conducted to evaluate changes in any of the aforementioned outcomes. Heterogeneity will be assessed with Cochrane’s Q and I2 statistics. Its exploration will be carried out using subgroup and sensitivity analyses. Relevant subgroups include the proportion of elderly patients in each study, characteristics of each platform, study type, type of funding and moment of conduction (i.e. before or after the COVID-19 pandemic). Publication bias will be assessed using funnel plots and Egger’s test. Copyright: © 2023 Martínez et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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    Effects on Quality of Life of a Telemonitoring Platform amongst Patients with Cancer (EQUALITE): A Randomized Trial Protocol
    (Multidisciplinary Digital Publishing Institute (MDPI), 2024-04) Martínez, Felipe; Taramasco, Carla; Espinoza, Manuel; Acevedo, Johanna; Goic, Carolina; Nervi, Bruno
    Cancer, a pervasive global health challenge, necessitates chemotherapy or radiotherapy treatments for many prevalent forms. However, traditional follow-up approaches encounter limitations, exacerbated by the recent COVID-19 pandemic. Consequently, telemonitoring has emerged as a promising solution, although its clinical implementation lacks comprehensive evidence. This report depicts the methodology of a randomized trial which aims to investigate whether leveraging a smartphone app called Contigo for disease monitoring enhances self-reported quality of life among patients with various solid cancers compared to standard care. Secondary objectives encompass evaluating the app’s impact on depressive symptoms and assessing adherence to in-person appointments. Randomization will be performed independently using an allocation sequence that will be kept concealed from clinical investigators. Contigo offers two primary functions: monitoring cancer patients’ progress and providing educational content to assist patients in managing common clinical situations related to their disease. The study will assess outcomes such as quality of life changes and depressive symptom development using validated scales, and adherence to in-person appointments. Specific scales include the EuroQol Group’s EQ-5D questionnaire and the Patient Health Questionnaire (PHQ-9). We hypothesize that the use of Contigo will assist and empower patients receiving cancer treatment, which will translate to better quality of life scores and a reduced incidence of depressive symptoms. All analyses will be undertaken with the intention-to-treat principle by a statistician unaware of treatment allocation. This trial is registered in ClinicalTrials under the registration number NCT06086990. © 2024 by the authors.
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    Proyecto periodístico : Soluciones & Comunicación : comunicación estratégica
    (Universidad Andrés Bello, 2007) Martínez, Felipe; Bechan, Deborah; Facultad de Humanidades y Ciencias Sociales; Escuela de Comunicación
    Soluciones y Comunicación (S&C) es una empresa dedicada a la comunícaci0n estratégica de entidades de orden publico y administrativo formada por tres estudiantes de periodismo de la Universidad Andrés Bello. En particular, S&C busca asesorar a las diversas municipalidades de la Región Metropolitana, pues se tuvo en consideración la poca y casi nula exploración de este nicho por parte de otras organizaciones que trabajan en el ámbito publico. La idea del negocio consiste en orientar comunicacionalmente municipios debido a su importante labor dentro de la comunidad y la trascendencia de su existencia en la sociedad. La idea es que la comuna a la que representan sienta que las organizaciones en cuestión están completamente involucradas con los procesos vecinales y que trabaja en conjunto con los pobladores para incrementar la calidad de vida de estos.
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    Relación neutrófilo a linfocito, recuento linfocitario e índices de actividad inflamatoria como factores pronóstico en infecciones por SARS-CoV-2: Un estudio de cohorte prospectiva
    (Sociedad de Anestesiologia de Chile, 2022) Martínez, Felipe; Boisier, Dominique; Vergara, Constanza; Vidal, Jaime
    Introduction: Patients with COVID-19 can develop respiratory failure requiring treatment with invasive mechanical ventilation (IMV) and death. It is important to have clinical predictors of these outcomes. Objetives: To establish the diagnostic accuracy of neutrophil to lymphocyte ratios (NLr) in predicting the need of IMV and survival amongst patients with COVID-19 and to compare this accuracy with other laboratory tests. Methodology: Prospective cohort study of hospitalized patients with a SArS-CoV-2 infection confirmed by rT-PCr. Clinical, demographic and laboratory predictors were assessed, including LDH, C-reactive protein, absolute lymphocyte counts, serum ferritin and NLr. Statistical analyses were undertaken using receiver-operator characteristics (rOC) curves, which were in turn compared using the method described by Hanley and McNeal. Results: One hundred and twelve patients were studied, most were male (60.7%) with a mean age of 63.4 ± 18.3 years. Twenty-two patients required IMV during their stay and 28 died. The NLr showed a good diagnostic accuracy in detecting patients that would require IMV (AUC 0.70, 95% CI 0.57-0.86) or died during the hospitalization (AUC 0.83, 95%CI 0.75-0.91). A cutoff point of 5.5 or higher had an 80.8% sensitivity and 73.1% specificity in detecting patients that died during their stay. Conclusions. NLr showed favorable diagnostic properties in detecting patients with COVID-19 at risk of adverse outcomes. Its wide availability and low cost are desirable features that might facilitate its implementation in routine clinical practice. © 2022 Sociedad de Anestesiologia de Chile. All rights reserved.
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    Spread of epidemic disease on edge-weighted graphs from a database: A case study of covid-19
    (MDPI, 2021-04) Manríquez, Ronald; Guerrero-Nancuante, Camilo; Martínez, Felipe; Taramasco, Carla
    The understanding of infectious diseases is a priority in the field of public health. This has generated the inclusion of several disciplines and tools that allow for analyzing the dissemination of infectious diseases. The aim of this manuscript is to model the spreading of a disease in a population that is registered in a database. From this database, we obtain an edge-weighted graph. The spreading was modeled with the classic SIR model. The model proposed with edge-weighted graph allows for identifying the most important variables in the dissemination of epidemics. More-over, a deterministic approximation is provided. With database COVID-19 from a city in Chile, we analyzed our model with relationship variables between people. We obtained a graph with 3866 vertices and 6,841,470 edges. We fitted the curve of the real data and we have done some simulations on the obtained graph. Our model is adjusted to the spread of the disease. The model proposed with edge-weighted graph allows for identifying the most important variables in the dissemination of epidemics, in this case with real data of COVID-19. This valuable information allows us to also include/understand the networks of dissemination of epidemics diseases as well as the implementation of preventive measures of public health. These findings are important in COVID-19’s pandemic context. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.