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Correlación entre los Estilos de Aprendizaje Según el Modelo de Felder-Silverman y el Rendimiento Académico de la Asignatura de Morfología y Función en Estudiantes Universitarios
(Universidad de la Frontera, 2023-10) Gutiérrez-Espinoza, Héctor; Araya-Quintanilla, Felipe; Valenzuela-Fuenzalida, Juan José; Nova, Pablo; Aviles-Walles, Maickel
El objetivo del estudio fue determinar la relación existente entre la tendencia predominante del estilo de aprendizaje, según el modelo de Felder-Silverman, evaluando el rendimiento académico parcial y final de los estudiantes que cursan la asignatura Morfología y Función I. Se realizó un estudio transversal en 231 estudiantes universitarios que ingresaron a las Facultades de Salud y Educación en el primer semestre del año 2019. Para poder evaluar el rendimiento, a los estudiantes se les aplicó el cuestionario de Índice de Estilos de Aprendizaje y se correlacionó con la nota de la prueba teórica 1, la evaluación práctica 1 y el promedio final de la asignatura. Los resultados muestran que el 53,4 % del total de estudiantes evaluados son visuales, para estos estudiantes el coeficiente de correlación de Spearman fue de -0,378 para prueba teórica (p<0,001), -0.467 para evaluación práctica (p<0,001) y -0.500 para el promedio final (p<0,001). Los estudiantes visuales tienen promedio de notas más altos en la prueba teórica y el promedio final comparado con los activos (p<0,05). Se concluyó que la tendencia predominante es el visual, para estos estudiantes existe una correlación inversa y estadísticamente significativa con el rendimiento académico. Además, presentan un promedio de notas significativamente más alto que las otras tendencias.
Primer caso de transmisión de mpox mediante toma de muestra por desteche en Chile
(Sociedad Chilena de Infectologia, 2023-11) Zacur, Militza; Barrientos, Victor; Carreño, Pablo; Segovia, Jorge
Mpox es una zoonosis vírica que causa síntomas similares a la viruela, aunque menos graves. La infección fue descrita inicialmente en África central y occidental. Luego del brote multinacional ocurrido el año 2022, ya no es considerada una emergencia de salud pública de importancia internacional. El mecanismo de transmisión es por contacto físico estrecho o directo con lesiones cutáneas de individuos infectados. Presentamos el caso clínico de una enfermera que se infectó por mpox tras un accidente cortopunzante durante la toma de muestra de una lesión por desteche con bisturí en un paciente con VIH. La transmisión percutánea tuvo un período de incubación corto, seguido de una lesión cutánea y síntomas sistémicos. Aunque infrecuente, se destaca el riesgo de transmisión ocupacional de mpox en la atención clínica. Es importante que el personal sanitario adhiera estrictamente a las medidas de prevención, como el uso de equipo de protección personal y la práctica segura en la toma de muestra.
Perioperative Factors Associated with Postoperative Delirium in Patients Undergoing Noncardiac Surgery: An Individual Patient Data Meta-Analysis
(American Medical Association, 2023-11) Sadeghirad, Behnam; Dodsworth, Benjamin T.; Schmutz Gelsomino, Nayeli; Goettel, Nicolai; Spence, Jessica; Buchan, Tayler A.; Crandon, Holly N.; Baneshi, Mohammad R.; Pol, Robert A.; Brattinga, Baukje; Park, Ui Jun; Terashima, Masanori; Banning, Louise B. D.; Van Leeuwen, Barbara L.; Neerland, Bjørn E.; Chuan, Alwin; Martinez, Felipe T.; Van Vugt, Jeroen L. A.; Rampersaud, Y. Raja; Hatakeyama, Shingo; Di Stasio, Enrico; Milisen, Koen; Van Grootven, Bastiaan; Van Der Laan, Lijckle; Thomson Mangnall, Linda; Goodlin, Sarah J.; Lungeanu, Diana; Denhaerynck, Kris; Dhakharia, Vibhawari; Sampson, Elizabeth L.; Zywiel, Michael G.; Falco, Lisa; Nguyen, Anna-Lisa V.; Moss, Stephana J.; Krewulak, Karla D.; Jaworska, Natalia; Plotnikoff, Kara; Kotteduwa-Jayawarden, Supun; Sandarage, Ryan; Busse, Jason W.; Mbuagbaw, Lawrence
Importance: Postoperative delirium (POD) is a common and serious complication after surgery. Various predisposing factors are associated with POD, but their magnitude and importance using an individual patient data (IPD) meta-analysis have not been assessed. Objective: To identify perioperative factors associated with POD and assess their relative prognostic value among adults undergoing noncardiac surgery. Data Sources: MEDLINE, EMBASE, and CINAHL from inception to May 2020. Study Selection: Studies were included that (1) enrolled adult patients undergoing noncardiac surgery, (2) assessed perioperative risk factors for POD, and (3) measured the incidence of delirium (measured using a validated approach). Data were analyzed in 2020. Data Extraction and Synthesis: Individual patient data were pooled from 21 studies and 1-stage meta-analysis was performed using multilevel mixed-effects logistic regression after a multivariable imputation via chained equations model to impute missing data. Main Outcomes and Measures: The end point of interest was POD diagnosed up to 10 days after a procedure. A wide range of perioperative risk factors was considered as potentially associated with POD. Results: A total of 192 studies met the eligibility criteria, and IPD were acquired from 21 studies that enrolled 8382 patients. Almost 1 in 5 patients developed POD (18%), and an increased risk of POD was associated with American Society of Anesthesiologists (ASA) status 4 (odds ratio [OR], 2.43; 95% CI, 1.42-4.14), older age (OR for 65-85 years, 2.67; 95% CI, 2.16-3.29; OR for >85 years, 6.24; 95% CI, 4.65-8.37), low body mass index (OR for body mass index <18.5, 2.25; 95% CI, 1.64-3.09), history of delirium (OR, 3.9; 95% CI, 2.69-5.66), preoperative cognitive impairment (OR, 3.99; 95% CI, 2.94-5.43), and preoperative C-reactive protein levels (OR for 5-10 mg/dL, 2.35; 95% CI, 1.59-3.50; OR for >10 mg/dL, 3.56; 95% CI, 2.46-5.17). Completing a college degree or higher was associated with a decreased likelihood of developing POD (OR 0.45; 95% CI, 0.28-0.72). Conclusions and Relevance: In this systematic review and meta-analysis of individual patient data, several important factors associated with POD were found that may help identify patients at high risk and may have utility in clinical practice to inform patients and caregivers about the expected risk of developing delirium after surgery. Future studies should explore strategies to reduce delirium after surgery.. © 2023 American Medical Association. All rights reserved.
Assessment of the physicochemical quality indicators and microbiological effects of Brazilian ozonized vegetable oils
(Journal of the Brazilian Chemical Society, Volume 32, Issue 1, Pages 216 - 224 January 2021, 2021) Díaz, Maritza F.; Veloso, Márcia C.; Pereira, Pedro A.; Sánchez, Yaima; Fernández, Iran; De Andrade, Jailson B.
The study of quality indicators in the process of obtaining ozonized vegetable oils is useful for monitoring the ozonation reaction. The Brazilian oils "dendê", soy, corn, rice and sunflower were studied, all of them were ozonated applying different doses of ozone. Ozonized oils were evaluated by determining the physicochemical indexes of peroxide, acidity, iodine and density in addition viscosity, fatty acid composition and microbiological activity were determined. The results showed that of the five ozonized oils evaluated, "dendê" oil exhibited a higher peroxide index, approximately 1746 mmol-equiv kg-1, using an applied ozone dose of 97 mg g-1, during an hour and a half of the ozonation reaction. This result could be explained by its chemical composition, rich in oleic acid that facilitates the reaction with ozone due to its spatial conformation. It was also demonstrated that "dendê" oil exhibits a greater antibacterial activity with minimum inhibitory concentration (MIC) values ranging from 1.9 to 4.75 mg mL-1against Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli. It is suggested that the ozonated "dendê" oil presents greater possibilities to be used in the preparation of pharmaceutical or cosmetic formulations. © 2021 Sociedade Brasileira de Quimica. All rights reserved.
Rates and Classification of Variants of Uncertain Significance in Hereditary Disease Genetic Testing
(American Medical Association, 2023-10) Chen, Elaine; Facio, Flavia M.; Aradhya, Kerry W.; Rojahn, Susan; Hatchell, Kathryn E.; Aguilar, Sienna; Ouyang, Karen; Saitta, Sulagna; Hanson-Kwan, Andrea K.; Capurro, Nicole Nakousi; Takamine, Eriko; Jamuar, Saumya Shekhar; McKnight, Dianalee; Johnson, Britt; Aradhya, Swaroop
Importance: Variants of uncertain significance (VUSs) are rampant in clinical genetic testing, frustrating clinicians, patients, and laboratories because the uncertainty hinders diagnoses and clinical management. A comprehensive assessment of VUSs across many disease genes is needed to guide efforts to reduce uncertainty. Objective: To describe the sources, gene distribution, and population-level attributes of VUSs and to evaluate the impact of the different types of evidence used to reclassify them. Design, Setting, and Participants: This cohort study used germline DNA variant data from individuals referred by clinicians for diagnostic genetic testing for hereditary disorders. Participants included individuals for whom gene panel testing was conducted between September 9, 2014, and September 7, 2022. Data were analyzed from September 1, 2022, to April 1, 2023. Main Outcomes and Measures: The outcomes of interest were VUS rates (stratified by age; clinician-reported race, ethnicity, and ancestry groups; types of gene panels; and variant attributes), percentage of VUSs reclassified as benign or likely benign vs pathogenic or likely pathogenic, and enrichment of evidence types used for reclassifying VUSs. Results: The study cohort included 1689845 individuals ranging in age from 0 to 89 years at time of testing (median age, 50 years), with 1203210 (71.2%) female individuals. There were 39150 Ashkenazi Jewish individuals (2.3%), 64730 Asian individuals (3.8%), 126739 Black individuals (7.5%), 5539 French Canadian individuals (0.3%), 169714 Hispanic individuals (10.0%), 5058 Native American individuals (0.3%), 2696 Pacific Islander individuals (0.2%), 4842 Sephardic Jewish individuals (0.3%), and 974383 White individuals (57.7%). Among all individuals tested, 692227 (41.0%) had at least 1 VUS and 535385 (31.7%) had only VUS results. The number of VUSs per individual increased as more genes were tested, and most VUSs were missense changes (86.6%). More VUSs were observed per sequenced gene in individuals who were not from a European White population, in middle-aged and older adults, and in individuals who underwent testing for disorders with incomplete penetrance. Of 37699 unique VUSs that were reclassified, 30239 (80.2%) were ultimately categorized as benign or likely benign. A mean (SD) of 30.7 (20.0) months elapsed for VUSs to be reclassified to benign or likely benign, and a mean (SD) of 22.4 (18.9) months elapsed for VUSs to be reclassified to pathogenic or likely pathogenic. Clinical evidence contributed most to reclassification. Conclusions and Relevance: This cohort study of approximately 1.6 million individuals highlighted the need for better methods for interpreting missense variants, increased availability of clinical and experimental evidence for variant classification, and more diverse representation of race, ethnicity, and ancestry groups in genomic databases. Data from this study could provide a sound basis for understanding the sources and resolution of VUSs and navigating appropriate next steps in patient care. © 2023 American Medical Association. All rights reserved.
Centuries of genome instability and evolution in soft-shell clam, Mya arenaria, bivalve transmissible neoplasia
(Nature Research, 2023-11) Hart, Samuel F. M.; Yonemitsu, Marisa A.; Giersch, Rachael M.; Garrett, Fiona E. S.; Beal, Brian F.; Arriagada, Gloria; Davis, Brian W.; Ostrander, Elaine A.; Goff, Stephen P.; Metzger, Michael J.
Transmissible cancers are infectious parasitic clones that metastasize to new hosts, living past the death of the founder animal in which the cancer initiated. We investigated the evolutionary history of a cancer lineage that has spread though the soft-shell clam (Mya arenaria) population by assembling a chromosome-scale soft-shell clam reference genome and characterizing somatic mutations in transmissible cancer. We observe high mutation density, widespread copy-number gain, structural rearrangement, loss of heterozygosity, variable telomere lengths, mitochondrial genome expansion and transposable element activity, all indicative of an unstable cancer genome. We also discover a previously unreported mutational signature associated with overexpression of an error-prone polymerase and use this to estimate the lineage to be >200 years old. Our study reveals the ability for an invertebrate cancer lineage to survive for centuries while its genome continues to structurally mutate, likely contributing to the evolution of this lineage as a parasitic cancer. © 2023, The Author(s)
c-Abl Phosphorylates MFN2 to Regulate Mitochondrial Morphology in Cells under Endoplasmic Reticulum and Oxidative Stress, Impacting Cell Survival and Neurodegeneration
(Multidisciplinary Digital Publishing Institute (MDPI), 2023-11) Martinez, Alexis; Lamaizon, Cristian M.; Valls, Cristian; Llambi, Fabien; Leal, Nancy; Fitzgerald, Patrick; Guy, Cliff; Kamiński, Marcin M.; Inestrosa, Nibaldo C.; van Zundert, Brigitte; Cancino, Gonzalo I.; Dulcey, Andrés E.; Zanlungo, Silvana; Marugan, Juan J.; Hetz, Claudio; Green, Douglas R.; Alvarez, Alejandra R.
The endoplasmic reticulum is a subcellular organelle key in the control of synthesis, folding, and sorting of proteins. Under endoplasmic reticulum stress, an adaptative unfolded protein response is activated; however, if this activation is prolonged, cells can undergo cell death, in part due to oxidative stress and mitochondrial fragmentation. Here, we report that endoplasmic reticulum stress activates c-Abl tyrosine kinase, inducing its translocation to mitochondria. We found that endoplasmic reticulum stress-activated c-Abl interacts with and phosphorylates the mitochondrial fusion protein MFN2, resulting in mitochondrial fragmentation and apoptosis. Moreover, the pharmacological or genetic inhibition of c-Abl prevents MFN2 phosphorylation, mitochondrial fragmentation, and apoptosis in cells under endoplasmic reticulum stress. Finally, in the amyotrophic lateral sclerosis mouse model, where endoplasmic reticulum and oxidative stress has been linked to neuronal cell death, we demonstrated that the administration of c-Abl inhibitor neurotinib delays the onset of symptoms. Our results uncovered a function of c-Abl in the crosstalk between endoplasmic reticulum stress and mitochondrial dynamics via MFN2 phosphorylation. © 2023 by the authors.
Effectiveness of alpha-lipoic acid in patients with neuropathic pain associated with type i and type II diabetes mellitus: A systematic review and meta-Analysis
(Lippincott Williams and Wilkins, 2023-11) Orellana-Donoso, Mathias; López-Chaparro, Michelle; Barahona-Vásquez, Marisol; Santana-Machuca, Andrés; Bruna-Mejias, Alejandro; Nova-Baeza, Pablo; Valenzuela-Fuenzalida, Juan José
Background: This systematic review explores the most current evidence regarding the mechanisms of neuropathic pain in patients with different types of diabetes and how this pain affects different functional and structural components of the neuroanatomical pain pathways. The review also seeks to provide guidelines for the best approach and treatment for patients experiencing this type of pain. The objective is to determine the effectiveness of alpha-lipoic acid (ALA) in improving functional and symptomatic outcomes in patients with diabetes mellitus type I and type II. Objective: To determine the effectiveness of alpha-lipoic acid (ALA) in improving functional and symptomatic outcomes in patients with diabetes mellitus type I and type II. Methods: We systematically search MEDLINE (via PubMed), EMBASE, SCOPUS, the Cochrane Central Register of Controlled Trials, the Cumulative Index to Nursing and Allied Health Literature, and Web of Science databases. Results: The findings of this review show that different forms of ALA do not present statistically significant changes for any of the scales included, including total symptom score (standardized mean difference [SMD] =-3.59, confidence interval [CI] =-4.16 to-3.02, and P <.00001), neuropathy impairment score (SMD =-1.42, CI =-3.68 to 0.84, and P =.22), and neuropathy symptom checklist (SMD =-0.09, CI =-0.15 to-0.02, and P =.01). Conclusion: In comparison to the use of a placebo, the findings suggest that ALA does not exhibit significant differences in terms of pain reduction and different functional scales. Moreover, no specific dosages are identified to support the use of ALA for the reduction of neuropathic pain. © 2023 Lippincott Williams and Wilkins. All rights reserved.
Clinical Characteristics of Neuropathic Pain and Its Relationship with Cancer in Different Corporal Areas—A Systematic Review
(Multidisciplinary Digital Publishing Institute (MDPI), 0025-01) Danés-López, Fernanda; Diaz-Palominos, Cristóbal; Ortiz Domínguez, Anggie; Silva Rodriguez, Alanna; Astorga, Constanza; Martínez-Hernández, Daniela; Valenzuela-Fuenzalida, Juan Jose; Sanchis-Gimeno, Juan; Nova-Baeza, Pablo; Suazo-Santibáñez, Alejandra; Oyanedel-Amaro, Gustavo; Orellana-Donoso, Mathias
Background: Neuropathic pain (NP) and cancer are caused by nerve damage due to cancer or treatments such as chemotherapy, radiotherapy, and surgery, with a prevalence that can reach up to 40%. Causes of neuropathic cancer pain (NCP) include direct nerve invasion or compression by the tumor, as well as neural toxicity associated with treatments. This type of pain is classified into several categories, such as plexopathy, radiculopathy, and peripheral neuropathies. Methods: Medline, Web of Science, Google Scholar, CINAHL, and LILACS databases were searched until October 2024. Two authors independently performed the search, study selection, and data extraction. Methodological quality was analyzed using the Robins-I tool. Results: The main findings of this review indicate that, depending on the cancer type, neuropathic pain will exhibit different characteristics, as well as identifying which types of cancer have a higher probability of presenting neuropathic pain. Additionally, there is a direct relationship whereby the more advanced the cancer, the greater the likelihood of experiencing neuropathic pain. Finally, although chemotherapy is employed as a cancer treatment, this therapy is quite invasive, and one of its adverse effects is that treated patients have a higher probability of developing neuropathic pain. Conclusions: Neuropathic pain is a condition that adversely affects patients with cancer. A detailed understanding of the relationships and triggers that produce this condition is present in only a small percentage of patients with cancer and is necessary to provide better treatment and gain a more comprehensive understanding of the characteristics of neuropathic pain. The objective of this study is to describe the relationship between different types of cancer or various treatments and the presence of NP. © 2025 by the authors.
Documentary Analysis of Hypericum perforatum (St. John’s Wort) and Its Effect on Depressive Disorders
(Multidisciplinary Digital Publishing Institute (MDPI), 0024-12) Otero, María Carolina; Ceric, Francisco; Miranda-Rojas, Sebastián; Carreño, Carolina; Escares, Rachelly; Escobar, María José; Saracini, Chiara; Atala, Cristian; Ramírez-Barrantes, Ricardo; Gordillo-Fuenzalida, Felipe
Hypericum perforatum, also known as St. John’s Wort, pericon, or yellow grass, is known for its antidepressant potential. It could represent a natural alternative to current pharmacological antidepressant treatments, which have a high incidence of side effects in patients and therefore lead to early dropouts. Through a bibliographic revision of clinical trials and information collected from scientific articles during the first period of 2020, we aimed to evaluate whether its administration could be beneficial in the treatment of mild-to-moderate depression, with fewer side effects compared to synthetic drugs. Among the main components, hypericin and hyperforin have been related to the observed antidepressant activity; therefore, their possible mechanism of action was reviewed and highlighted. Furthermore, patients receiving Hypericum extracts were less likely to withdraw from studies because of adverse effects compared to those receiving older standard antidepressants. This review aims to provide suggestions for an alternative treatment of mild-to-moderate depression disorder under the supervision of a medical doctor, since, although it appears to be a potentially efficient treatment with a low presence of adverse effects in comparison to synthetic antidepressants, it might also interact with other medications and lead to therapeutic failures if misused for self-medication. © 2024 by the authors.
Dietary Counseling: An Option to Malnutrition and Masticatory Deficiency in Patients with Total Protheses? A Scoping Review
(Multidisciplinary Digital Publishing Institute (MDPI), 0025-01) Cifuentes-Suazo, Gloria; Alarcón-Apablaza, Josefa; Jarpa-Parra, Marcela; Venegas, Camila; Marinelli, Franco; Fuentes, Ramón
Given the rising global population of older adults and their association with edentulism and the use of complete removable prostheses [CRP], it is imperative to pursue solutions for issues such as the relationship between poor diets and masticatory deficiency. Objective: To examine the research on the efficacy of dietary counseling in enhancing mastication and nutrition in older adults with CRP. Methods: A systematic literature review was performed in the PubMed, Trip, and Web of Science databases. Results: 812 results were retrieved from the databases, from which 6 clinical studies that fulfilled the qualifying criteria were selected. The selected studies reported reduced nutrition in patients with CRP due to impaired masticatory function. Research suggests that employing basic dietary guidelines or simplified nutritional recommendations enhances the masticatory function of patients with CRP, thereby ensuring sufficient nutritional intake. Conclusion: Dietary counseling improves nutritional intake and masticatory function in patients with CRP. This would allow simple dietary advice to be given to patients with total prostheses in clinical practice. Further randomized clinical trials are recommended to increase the available evidence. © 2024 by the authors.
Clinical Characteristics of Neuropathic Pain and Its Relationship with Cancer in Different Corporal Areas—A Systematic Review
(Multidisciplinary Digital Publishing Institute (MDPI), 0025-01) Danés-López, Fernanda; Diaz-Palominos, Cristóbal; Ortiz Domínguez, Anggie; Silva Rodriguez, Alanna; Astorga, Constanza; Martínez-Hernández, Daniela; Valenzuela-Fuenzalida, Juan Jose; Sanchis-Gimeno, Juan; Nova-Baeza, Pablo; Suazo-Santibáñez, Alejandra; Oyanedel-Amaro, Gustavo; Orellana-Donoso, Mathias
Background: Neuropathic pain (NP) and cancer are caused by nerve damage due to cancer or treatments such as chemotherapy, radiotherapy, and surgery, with a prevalence that can reach up to 40%. Causes of neuropathic cancer pain (NCP) include direct nerve invasion or compression by the tumor, as well as neural toxicity associated with treatments. This type of pain is classified into several categories, such as plexopathy, radiculopathy, and peripheral neuropathies. Methods: Medline, Web of Science, Google Scholar, CINAHL, and LILACS databases were searched until October 2024. Two authors independently performed the search, study selection, and data extraction. Methodological quality was analyzed using the Robins-I tool. Results: The main findings of this review indicate that, depending on the cancer type, neuropathic pain will exhibit different characteristics, as well as identifying which types of cancer have a higher probability of presenting neuropathic pain. Additionally, there is a direct relationship whereby the more advanced the cancer, the greater the likelihood of experiencing neuropathic pain. Finally, although chemotherapy is employed as a cancer treatment, this therapy is quite invasive, and one of its adverse effects is that treated patients have a higher probability of developing neuropathic pain. Conclusions: Neuropathic pain is a condition that adversely affects patients with cancer. A detailed understanding of the relationships and triggers that produce this condition is present in only a small percentage of patients with cancer and is necessary to provide better treatment and gain a more comprehensive understanding of the characteristics of neuropathic pain. The objective of this study is to describe the relationship between different types of cancer or various treatments and the presence of NP. © 2025 by the authors.
Hepatic Hilum Variations and Their Clinical Considerations in the Liver: A Systematic Review and Meta-Analysis
(Multidisciplinary Digital Publishing Institute (MDPI), 0024-10) Valenzuela-Fuenzalida, Juan Jose; Pena-Santibañez, Fernanda; Vergara Salinas, Ayline; Meneses Caroca, Trinidad; Rojo-Gonzalez, Javiera; Orellana-Donoso, Mathias Ignacio; Nova-Baeza, Pablo; Suazo-Santibañez, Alejandra; Sanchis-Gimeno, Juan; Gutierrez-Espinoza, Hector
Background: The liver has a region called the hepatic hilum (HH) where structures enter and exit: anteriorly, the left and right hepatic ducts; posteriorly, the portal vein; and between these, the left and right hepatic arteries. The objective of this review is to know how variants in structures of the hepatic hilum are associated with clinical alterations of the liver. Methods: The databases Medline, Scopus, Web of Science, Google Scholar, CINAHL, and LILACS were researched until January 2024. The methodological quality was evaluated with an assurance tool for anatomical studies (AQUA). The pooled prevalence was estimated using a random effects model. Results: A total of six studies met the selection criteria established in this study for meta-analysis. The prevalence of hepatic hilus variants was 9% (CI = 5% to 13%), and the heterogeneity was 83%. The other studies were analyzed descriptively and with their respective clinical considerations in the presence of the variant, such as the high incidence of the Michels type III variant; among the portal vein variants, the type III variant of the Cheng classification stands out and in biliary anatomy, and the IIIa variant stands out according to the Choi classification. Conclusions: This review allowed us to know in detail the anatomical variants of HH; the structure with which the greatest care should be taken is the hepatic artery because of the probability of metastatic processes due to increased blood distribution in the hepatic lobules. Finally, we believe that new anatomical and clinical studies are needed to improve our knowledge of the relationship between HH variants and liver alterations or surgeries. © 2024 by the authors.
Bioactive Lichen Secondary Metabolites and Their Presence in Species from Chile
(Multidisciplinary Digital Publishing Institute (MDPI), 2023-07) Poulsen-Silva, Erick; Gordillo-Fuenzalida, Felipe; Atala, Cristian; Moreno, Adrián A.; Otero, María Carolina
Lichens are symbiotic organisms composed of at least one fungal and one algal species. They are found in different environments around the world, even in the poles and deserts. Some species can withstand extreme abiotic conditions, including radiation and the vacuum of space. Their chemistry is mainly due to the fungal metabolism and the production of several secondary metabolites with biological activity, which have been isolated due to an increasing interest from the pharmaceutical community. However, beyond the experimental data, little is known about their mechanisms of action and the potential pharmaceutical use of these kinds of molecules, especially the ones isolated from lesser-known species and/or lesser-studied countries. The main objective of this review is to analyze the bibliographical data of the biological activity of secondary metabolites from lichens, identifying the possible mechanisms of action and lichen species from Chile. We carried out a bibliographic revision of different scientific articles in order to collect all necessary information on the biological activity of the metabolites of these lichen species. For this, validated databases were used. We found the most recent reports where in vitro and in vivo studies have demonstrated the biological properties of these metabolites. The biological activity, namely anticancer, antioxidant, and anti-inflammatory activity, of 26 secondary metabolites are described, as well as their reported molecular mechanisms. The most notable metabolites found in this review were usnic acid, atranorin, protolichesterinic acid, and lobaric acid. Usnic acid was the most investigated metabolite, in addition to undergoing toxicological and pharmacological studies, where a hepatotoxicity effect was reported due to uncoupling oxidative phosphorylation. Additionally, no major studies have been made to validate the pharmacological application of these metabolites, and few advancements have been made in their artificial growth in bioreactors. Despite the described biological activities, there is little support to consider these metabolites in pharmaceutical formulations or to evaluate them in clinical trials. Nevertheless, it is important to carry out further studies regarding their possible human health effects. These lichen secondary metabolites present a promising research opportunity to find new pharmaceutical molecules due to their bioactive properties. © 2023 by the authors.
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.
Epigenetic regulators controlling osteogenic lineage commitment and bone formation
(Elsevier Inc., 2024) Dashti, Parisa; Lewallen, Eric A.; Gordon, Jonathan A.R.; Montecino, Martin A.; Davie, James R.; Davie J.R.; Stein, Gary S.; van Leeuwen, Johannes P.T.M.; van der Eerden, Bram C.J.; van Wijnen, Andre J.
Bone formation and homeostasis are controlled by environmental factors and endocrine regulatory cues that initiate intracellular signaling pathways capable of modulating gene expression in the nucleus. Bone-related gene expression is controlled by nucleosome-based chromatin architecture that limits the accessibility of lineagespecific gene regulatory DNA sequences and sequence-specific transcription factors. From a developmental perspective, bone-specific gene expression must be suppressed during the early stages of embryogenesis to prevent the premature mineralization of skeletal elements during fetal growth in utero. Hence, bone formation is initially inhibited by gene suppressive epigenetic regulators, while other epigenetic regulators actively support osteoblast differentiation. Prominent epigenetic regulators that stimulate or attenuate osteogenesis include lysine methyl transferases (e.g., EZH2, SMYD2, SUV420H2), lysine deacetylases (e.g., HDAC1, HDAC3, HDAC4, HDAC7, SIRT1, SIRT3), arginine methyl transferases (e.g., PRMT1, PRMT4/CARM1, PRMT5), dioxygenases (e.g., TET2), bromodomain proteins (e.g., BRD2, BRD4) and chromodomain proteins (e.g., CBX1, CBX2, CBX5). Thisnarrative review provides a broad overview of the covalent modifications of DNA and histone proteins that involve hundreds of enzymes that add, read, or delete these epigenetic modifications that are relevant for selfrenewal and differentiation of mesenchymal stem cells, skeletal stem cells and osteoblasts during osteogenesis
Mascarillas para oxigenoterapia de alto flujo: ¿Son realmente Venturi?
(Sociedad de Anestesiologia de Chile, 2022) Fajardo Campoverdi, Aurio; Adasme Jeria, Rodrigo; Maturana Quinones, Michael; Roncalli Rocha, Angelo; Cristancho Gomez, William
Oxygen therapy is the mainstay for the treatment of hypoxia. The use of devices capable of satisfying the necessary flow demanded by the patient also offers stable and predictable oxygen concentrations, which is why they are currently considered a reliable and safe therapeutic tool. The physical mechanism for the operation of these devices is based on a modification of Bernoulli's principle. The supply of a constant flow of oxygen, when its pressure drops, increases its velocity and consequently allows the incorporation of ambient air into the system. However, in order to be granted the Venturi designation, structural requirements in geometrical, physical and thermodynamic terms must be met. The ISO standard specifies a Venturi tube by three fundamental parts: a contraction zone (inlet of a continuous flow of a gas), a constriction zone (smaller in radius than the contraction zone, so as to increase the fluid velocity) and a diffusion zone (outlet of a gas mixture with ambient air). In conclusion, the designation of Venturi to high-flow oxygen therapy masks is at least questionable. © 2022 Sociedad de Anestesiologia de Chile. All rights reserved.
Dynamic changes of hepatic vein Doppler velocities predict preload responsiveness in mechanically ventilated critically ill patients
(Intensive Care Medicine Experimental, Volume 12, Issue 1 December 2024 Article number 46, 2024-12) Bruna, Mario; Alfaro, Sebastian; Muñoz, Felipe; Cisternas, Liliana; Gonzalez, Cecilia; Conlledo, Rodrigo; Ulloa-Morrison, Rodrigo; Huilcaman, Marcos; Retamal, Jaime; Castro, Ricardo; Rola, Philippe; Wong, Adrian
Background: Assessment of dynamic parameters to guide fluid administration is one of the mainstays of current resuscitation strategies. Each test has its own limitations, but passive leg raising (PLR) has emerged as one of the most versatile preload responsiveness tests. However, it requires real-time cardiac output (CO) measurement either through advanced monitoring devices, which are not routinely available, or echocardiography, which is not always feasible. Analysis of the hepatic vein Doppler waveform change, a simpler ultrasound-based assessment, during a dynamic test such as PLR could be useful in predicting preload responsiveness. The objective of this study was to assess the diagnostic accuracy of hepatic vein Doppler S and D-wave velocities during PLR as a predictor of preload responsiveness. Methods: Prospective observational study conducted in two medical–surgical ICUs in Chile. Patients in circulatory failure and connected to controlled mechanical ventilation were included from August to December 2023. A baseline ultrasound assessment of cardiac function was performed. Then, simultaneously, ultrasound measurements of hepatic vein Doppler S and D waves and cardiac output by continuous pulse contour analysis device were performed during a PLR maneuver. Results: Thirty-seven patients were analyzed. 63% of the patients were preload responsive defined by a 10% increase in CO after passive leg raising. A 20% increase in the maximum S wave velocity after PLR showed the best diagnostic accuracy with a sensitivity of 69.6% (49.1–84.4) and specificity of 92.8 (68.5–99.6) to detect preload responsiveness, with an area under curve of receiving operator characteristic (AUC–ROC) of 0.82 ± 0.07 (p = 0.001 vs. AUC–ROC of 0.5). D-wave velocities showed worse diagnostic accuracy. Conclusions: Hepatic vein Doppler assessment emerges as a novel complementary technique with adequate predictive capacity to identify preload responsiveness in patients in mechanical ventilation and circulatory failure. This technique could become valuable in scenarios of basic hemodynamic monitoring and when echocardiography is not feasible. Future studies should confirm these results. © The Author(s) 2024.
La reparación aislada presenta mayor altura patelar postoperatoria según el índice de Insall-Salvati en comparación con la aumentación biológica en roturas agudas del tendón rotuliano
(Ediciones Doyma, S.L., 2024-10) R. Olivieri; J.T. Munoz; J.I. Laso; J. Ugarte; N. Franulic; P. Innocenti
Antecedentes y objetivo: Las roturas del tendón rotuliano (RTR) son lesiones infrecuentes pero altamente incapacitantes. El tratamiento quirúrgico es el estándar. La altura patelar (AP) postoperatoria es utilizada para determinar el éxito de la intervención, existiendo varios índices descritos en la literatura. El objetivo del estudio fue determinar si existen diferencias en la AP según el índice Insall-Salvati en el postoperatorio inmediato y a los 4 meses, entre 2 grupos de pacientes operados de RTR aguda: el primero, resuelto con técnicas de reparación aislada (RATR), y el segundo, en el que se agregó aumento biológico con auto o aloinjerto a la reparación (ABTR). Nuestra hipótesis fue que el grupo ABTR tuvo una menor AP en el postoperatorio inmediato y a los 4 meses. Materiales y métodos: Todos los pacientes con RTR aguda intervenidos en nuestro centro entre 2016 y 2022 fueron revisados retrospectivamente. Se excluyeron pacientes con re-rotura del tendón operado y con aumentación no biológica. La AP según el índice de Insall-Salvati fue medida en las radiografías tomadas al día siguiente de la cirugía y a los 4 meses de evolución por 3 ortopedistas con subespecialidad en cirugía de rodilla, de forma independiente. Un cuarto evaluador, ciego, analizó los resultados de las mediciones, determinando el promedio de AP y el índice de correlación intraclase de acuerdo absoluto para la media entre los 3 evaluadores. El resultado primario fue la diferencia de AP entre ambos grupos al día siguiente de la cirugía y a los 4 meses. El secundario fue la diferencia de AP entre la medición postoperatoria inmediata y a los 4 meses en ambos grupos.
Perception of the Virtualization of the Subject of Normal Human Anatomy and Embriology in a Pandemic
(Universidad de la Frontera, 2023-06) Rodríguez Luengo, Macarena; Águila Camacho, José; Pallauta Torres, Luis; Pérez Cárdenas, Nury; Luengo Mai, Diego; Niklander Ebensperger, Sven
As a result of the pandemic and the restrictions regarding in person attendance, different learning methodologies had to be explored and implemented to virtualize the contents in the Anatomy subject. The objective of this study was to evaluate the perception of teachers and students regarding the methodologies used in the virtualization of this subject. An observational-descriptive study with a quantitative approach was carried out. The study population was a convenience sample made up of 57 students and 4 teachers of the Normal Human Anatomy and Embryology subject of the Dentistry degree, Universidad Andrés Bello, Viña del Mar campus during 2021. These participants answered a validated questionnaire that included closed questions with a 5-level Likert scale, considering learning dimensions, motivation and performance, and qualifying questions to find out the perception of the strategies and resources used. Students positively perceive all digital resources, highlighting the Normal Human Anatomy Manual, with learning being the best evaluated dimension. The best perceived active strategy in terms of the 3 dimensions corresponds to the case method. In contrast, the inverted classes were perceived negatively in all dimensions. In relation to teachers, the best perceived digital resource was videos and capsules, highlighting the motivation dimension. The best evaluated active strategies were the case method and inverted classes. Despite having a positive perception regarding virtualization, there is no agreement between the best evaluated active strategies and digital resources among teachers and students. © 2023, Universidad de la Frontera. All rights reserved.

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