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Duodenal hematoma: multiple etiologies for an underestimated diagnosis. Case series
Get PDFEl hematoma duodenal corresponde a la acumulación de sangre en la pared del duodeno debido a una rotura vascular de la capa subserosa. Las etiologías más frecuentes son traumas abdominales cerrados, trastornos de coagulación, pancreatitis, iatrogenia y vasculitis, entre otros. Se puede manifestar como abdomen agudo, obstrucción intestinal o con síntomas inespecíficos. Para el diagnóstico es fundamental considerar factores de riesgos y apoyo en estudios imagenológicos. En este trabajo se describen tres casos de hematoma duodenal en pacientes de distintas edades, con registro ecográfico y/o tomográfico.
Duodenal hematoma refers to the accumulation of blood in the wall of the duodenum due to a vascular rupture of the subserosa layer. The most common etiologies are closed abdominal trauma, coagulation disorders, pancreatitis, iatrogenesis, and vasculitis, among others. It can manifest as acute abdomen, intestinal obstruction, or with non-spe-cific symptoms. For diagnosis, it is essential to consider risk factors and support with imaging studies. In this paper, three cases of duodenal hematoma in patients of different ages are described with ultrasound and/or tomographic recordsVersión Aceptad
Knockdown of Antisense Noncoding Mitochondrial RNA Reduces Tumorigenicity of Patient-Derived Clear Cell Renal Carcinoma Cells in an Orthotopic Xenograft Mouse Model
Get PDFClear cell renal cell carcinoma (ccRCC) is the most prevalent form of renal cancer and its treatment is hindered by a resistance to targeted therapies, immunotherapies and combinations of both. We have reported that the knockdown of the antisense noncoding mitochondrial RNAs (ASncmtRNAs) with chemically modified antisense oligonucleotides induces proliferative arrest and apoptotic death in tumor cells from many human and mouse cancer types. These studies have been mostly performed in vitro and in vivo on commercially available cancer cell lines and have shown that in mouse models tumor growth is stunted by the treatment. The present work was performed on cells derived from primary and metastatic ccRCC tumors. We established primary cultures from primary and metastatic ccRCC tumors, which were subjected to knockdown of ASncmtRNAs in vitro and in vivo in an orthotopic xenograft model in NOD/SCID mice. We found that these primary ccRCC cells are affected in the same way as tumor cell lines and in the orthotopic model tumor growth was significantly reduced by the treatment. This study on patient-derived ccRCC tumor cells represents a model closer to actual patient ccRCC tumors and shows that knockdown of ASncmtRNAs poses a potential treatment option for these patients.Publicad
Adequate housing as a social determinant of the health of international migrants and locals in Chile between 2013 and 2022
No full textBackground: Adequate housing is a fundamental right and a social determinant of health. It also represents a historically contentious topic in Latin America. Migratory flows to Chile have become increasingly precarious in the past few years, limiting opportunities for adequate housing, with potential repercussions on the health of international migrants and the general population. This study aims to analyse adequate housing as a social determinant of health among international migrants and locals between 2013 and 2022 in Chile.
Methods: Observational cross-sectional study based on repeated versions of the nationally representative Socioeconomic Characterization Survey in Chile. Adequate housing indicators adapted from the United Nations Housing Rights Programme guidelines were analyzed with relation to individual health, distinguishing between the local and international migrant populations. Logistic regression models were fitted for housing indicators with migration as the main independent variable and for short-term and long-term healthcare needs in locals and immigrants with housing as the main dependent variables. Models were adjusted for sociodemographic variables and considered the complex sample design.
Results: Descriptive findings indicated higher availability of services and infrastructure among international migrants, and a disadvantage for habitability, location, and affordability by quintiles compared to locals. Logistic regression models, adjusting for demographic variables, revealed significant associations between migration status and overcrowding (OR 6.14, 2022), poor housing materiality (OR 5.65, 2022) and proximity to healthcare centres (OR 1.4, 2022) compared to locals. Experiencing hazardous situations consistently predicted short-term healthcare needs in both migrants (OR = 1.4, 2022) and locals (OR = 2.8, 2022). Overcrowding predicted both long and short-term healthcare needs among locals across the years and long term needs among migrants in 2013 and 2015.
Conclusions: We found significant inequities in adequate housing between migrant populations and locals in Chile, and some inequities among both populations based on structural socioeconomic deprivation. Experiencing hazardous situations emerged as a social determinant of health among international migrants in 2022, potentially suggesting growing challenges related to social exclusion in urban areas. However, limitations such as exclusion criteria of the survey and sample sizes for data on the migrant population potentially suggest that housing challenges and their impact on health are underestimated.Versión publicad
Capacitación básica en Bioética clínica y de investigación a Profesionales del Hospital Policial del Uruguay
No full textTrabajo de Grado presentado a la Facultad de Medicina de la Universidad del Desarrollo para optar al grado académico de Magister en Bioétic
Complex externalities: introduction to the special issue
Get PDFcollection of essays extends analytical bridges between public choice, property rights economics, and new institutional economics. The essays question many of our prevailing assumptions behind the standard conceptualization of externalities. They also offer pragmatic and theoretical alternatives and apply these insights to analyze radio spectrum, environmental pollution, intellectual property, and public health issues. These essays demonstrate the ongoing significance of public choice in addressing society’s most pressing challengesVersión publicad
Meta-Neuropsy Salud mental y metacognición: análisis desde una perspectiva transdiagnóstica
No full textEn los procesos de toma de decisiones la metacognición tiene un rol fundamental, en tanto un proceso asociado al monitoreo y control de los propios procesos cognitivos.
Existen diversos elementos que influyen sobre los procesos metacognitivos, siendo relevante considerar, entre otras cosas, la característica del estímulo, la experiencia y la información que tiene el sujeto, e incluso su contexto de salud mental.
Respecto de la relación entre metacognición y salud mental, la evidencia muestra diferencias significativas en medidas de sensibilidad y sesgo metacognitivo, particularmente desde líneas de investigación que se enmarcan en una clasificación transdiagnóstica de los cuadros de salud mental
Distinct Driver Pathway Enrichments and a High Prevalence of TSC2 Mutations in Right Colon Cancer in Chile: A Preliminary Comparative Analysis
Get PDFColorectal cancer (CRC) is the second leading cause of cancer deaths globally. While ethnic differences in driver gene mutations have been documented, the South American population remains understudied at the genomic level, despite facing a rising burden of CRC. We analyzed tumors of 40 Chilean CRC patients (Chp) using next-generation sequencing and compared them to data from mainly Caucasian cohorts (TCGA and MSK-IMPACT). We identified 388 mutations in 96 out of 135 genes, with TP53 (45%), KRAS (30%), PIK3CA (22.5%), ATM (20%), and POLE (20%) being the most frequently mutated. TSC2 mutations were associated with right colon cancer (44.44% in RCRC vs. 6.45% in LCRC, p-value = 0.016), and overall frequency was higher compared to TCGA (p-value = 1.847 × 10-5) and MSK-IMPACT cohorts (p-value = 3.062 × 10-2). Limited sample size restricts definitive conclusions, but our data suggest potential differences in driver mutations for Chilean patients, being that the RTK-RAS oncogenic pathway is less affected and the PI3K pathway is more altered in Chp compared to TCGA (45% vs. 25.56%, respectively). The prevalence of actionable pathways and driver mutations can guide therapeutic choices, but can also impact treatment effectiveness. Thus, these findings warrant further investigation in larger Chilean cohorts to confirm these initial observations. Understanding population-specific driver mutations can guide the development of precision medicine programs for CRC patients.Versión Publicad
Reconceptualising Franchisee Performance: A configurational approach in a base-of-the-pyramid context
Get PDFThis paper proposes and tests a new conceptual framing for franchisee performance that draws on institutional complexity to explore the interaction of corporate, market and relational logics of performance. Extant research draws on corporate and market logics to explain performance, however, this does not explain individual franchisee performance in complex institutional environments such as Base-of-the-Pyramid (BoP) markets where
relational logics may be more important, limiting explanations of how franchisee outlets perform. Drawing on data from a network of 58 franchise outlets in the context of Kenya, we conduct a configurational analysis related to sales outcomes. We leverage fsQCA to map out the conditions under which franchisees exhibit higher sales performance. Results show that three different configurations can lead to increased sales performance. Our results paint a nuanced picture of combinations of factors that result in franchisee success with relevance to the BoP context and beyond
Neural basis of speech and grammar symptoms in non-fluent variant primary progressive aphasia spectrum
Get PDFThe nonfluent/agrammatic variant of primary progressive aphasia (nfvPPA) is a neurodegenerative syndrome primarily defined by the presence of apraxia of speech (AoS) and/or expressive agrammatism. In addition, many patients exhibit dysarthria and/or receptive agrammatism. This leads to substantial phenotypic variation within the speech-language domain across individuals and time, in terms of both the specific combination of symptoms as well as their severity. How to resolve such phenotypic heterogeneity in nfvPPA is a matter of debate. “Splitting” views propose separate clinical entities: “primary progressive apraxia of speech” (PPAOS) when AoS occurs in the absence of expressive agrammatism, “progressive agrammatic aphasia” (PAA) in the opposite case, and “AOS + PAA” when mixed motor speech and language symptoms are clearly present.
While therapeutic interventions typically vary depending on the predominant symptom (e.g., AoS vs expressive agrammatism), the existence of behavioral, anatomical, and pathological overlap across these phenotypes argues against drawing such clear-cut boundaries. In the current study, we contribute to this debate by mapping behavior to brain in a large, prospective cohort of well characterized patients with nfvPPA (n = 104). We sought to advance scientific understanding of nfvPPA and the neural basis of speech-language by uncovering where in the brain the degree of MRI-based atrophy is associated with inter-patient variability in the presence and severity of AoS, dysarthria, expressive agrammatism, or receptive agrammatism. Our cross-sectional examination
of brain-behavior relationships revealed three main observations. First, we found that the neural correlates of AoS and expressive agrammatism in nfvPPA lie side by side in the left posterior inferior frontal lobe, explaining their behavioral dissociation/association in previous reports.
Second, we identified a “left-right” and “ventral-dorsal” neuroanatomical distinction between AoS versus dysarthria, highlighting (i) that dysarthria, but not AoS, is significantly influenced by tissue loss in right-hemisphere motor-speech regions and (ii) that, within the left hemisphere, dysarthria and AoS map onto dorsally versus ventrally located motor-speech regions, respectively. Third, we confirmed that, within the large-scale grammar network, left frontal tissue loss is preferentially involved in expressive agrammatism and left temporal tissue loss in receptive agrammatism. Our findings thus contribute to define the function and location of the epicenters within the large-scale neural networks vulnerable to neurodegenerative changes in nfvPPA. We propose that nfvPPA be redefined as an umbrella term subsuming a spectrum of speech and/or language phenotypes that are closely linked by the underlying neuroanatomy and neuropathology.Versión enviad
Conexión entre las ONG y personas naturales para el desarrollo sostenible
Get PDFTesis presentada a la facultad de Diseño de la Universidad del Desarrollo para optar al grado de Magíster en Diseño e Innovación SostenibleLa colaboración y el apoyo entre personas y grupos de personas ha sido un componente fundamental para el origen, desarrollo y subsistencia de las sociedades y su capacidad para superar desafíos. Este espíritu evolucionado constantemente y adopta nuevas formas o enfoques. Una de sus manifestaciones es la creación de organizaciones de la sociedad civil u organizaciones no gubernamentales (ONG). Pero ¿qué es una ONG?
Una ONG es un grupo de ciudadanos voluntarios sin fines de lucro que se organiza a nivel internacional, nacional o local, con la misión de abordar causas o necesidades, específicas o amplias de la sociedad. Las ONG han jugado un rol muy importante en abordar los problemas que los distintos gobiernos, o el estado por su propia cuenta, no han logrado resolver por completo, trabajando en soluciones necesarias y en oportunidades contingentes, promoviendo la participación ciudadana y defendiendo distintos tipos de derechos.
Hoy en día, se estima que existen alrededor de 10 millones de ONG alrededor del mundo (AQUAE Fundación, 2020) y en Chile al 2020, se cuenta con la información que existían alrededor de 215 mil organizaciones de este tipo (Centro UC, 2020).
Este tipo de organizaciones a lo largo de su historia han estado enfrentados a distintos desafíos para mantenerse operativas y seguir trabajando para cumplir con sus objetivos.
Dentro de las dificultades que tienen las ONG para subsistir y trabajar sus principales desafíos han estado asociados a la captación de recursos, la gestión eficiente de estos y el relacionamiento con las personas. Entendiendo que los recursos son limitados, que a pesar de las diversas fuentes de financiamiento no existe una costumbre de involucramientos y el alto número de organizaciones, la necesidad de una gestión eficaz son dificultades contantes que se deben superar.
A nivel nacional, uno de los mayores desafíos que han tenido las ONG ha sido el relacionamiento con las personas para motivarlos ayudar tanto de forma económica como también en la participación de voluntariados. Dentro de los principales desafíos han estado en comprender e impulsar las motivaciones que generan que las personas participen y adicionalmente los casos de corrupción que se han presentado en el último tiempo que han generado desconfianza por parte de la sociedad.
Para poder abordar los desafíos de las ONG y fomentar la participación ciudadana, se desarrolló “Match for Good”. Este proyecto nace de la utilización del modelo de doble diamante de British Design Council dado que está centrada en el usuario, permitiendo comprender de manera profunda las necesidades y motivaciones para generar soluciones innovadoras y efectivas.
Luego de un proceso de descubrimiento, definición y desarrollo de las principales problemáticas de confianza y transparencia, se desarrolla “Match For Good” que inspirada en la dinámica de Tinder permite conectar a las personas con las ONG a través de un sistema de deslizamientos, donde los usuarios puedes mostrar su interés en distintos tipos de organizaciones, fomentando una conexión rápida y significativa.
Match for Good busca ofrecer perfiles detallados de las ONG, permitiendo a los usuarios filtros de búsqueda personalizada, actualización de proyectos disponibles a aportar y un sistema de recompensa. Esta plataforma no solo se enfoca en mejorar la transparencia y la confianza, sino que también empodera a los donantes y voluntarios, asegurando que su apoyo tenga un impacto real, significativo y que permita perdurar en el tiempo en búsqueda de la sostenibilidad