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Differential Effects of a Telemonitoring Platform in the Development of Chemotherapy-Associated Toxicity: A Randomized Trial Protocol
Get PDFChemotherapy requires careful monitoring, but traditional follow-up approaches face significant challenges that were highlighted by the COVID-19 pandemic. Hence, exploration into telemonitoring as an alternative emerged. The objective is to assess the impact of a telemonitoring platform that provides clinical data to physicians overseeing solid tumor patients, aiming to enhance the care experience. The methodology outlines a parallel-group randomized clinical trial involving recently diagnosed patients with solid carcinomas preparing for curative intent chemotherapy. Eligible adult patients diagnosed with specific carcinoma types and proficient in Spanish, possessing smartphones, will be invited to participate. They will be randomized using concealed allocation sequences into two groups: one utilizing a specialized smartphone application called Contigo for monitoring chemotherapy toxicity symptoms and accessing educational content, while the other receives standard care. Primary outcome assessment involves patient experience during chemotherapy using a standardized questionnaire. Secondary outcomes include evaluating severe chemotherapy-associated toxicity, assessing quality of life, and determining user satisfaction with the application. The research will adhere to intention-to-treat principles. This study has been registered at ClinicalTrials.govVersión Publicad
Sistema productivo ganadero Kampenaike
No full textTesina presentada a la Facultad de Arquitectura y Arte de la Universidad del Desarrollo para optar al grado académico / título profesional de Arquitecta con mención en Innovación y Emprendimiento.En el sur de Chile, la creencia arraigada en la abundancia de agua se enfrenta a una amenazante crisis hídrica en la región de Magallanes y la Antártica chilena, socavando la confianza en esta percepción tradicional. Esta disparidad entre la creencia y la realidad plantea cuestionamientos acerca de la sostenibilidad del suministro de agua en una zona previamente considerada rica en recursos hídricos. Esta investigación explora los desafíos que esta crisis impone a las comunidades locales y destaca la importancia de la gestión sostenible de los recursos hídricos en una era de cambio climático y escasez de agua a nivel global, donde tiene graves repercusiones en sectores clave, especialmente en la agricultura y la ganadería.
De este modo, el principal objetivo de la investigación es comprender y analizar la implementación de una nueva manera de captar, distribuir y acumular el agua para regenerar espacios hídricos territoriales. En este caso se hablará sobre un sistema productivo ganadero para preservar los paisajes hídricos en riesgo y la ganadería del lugar. Estos prototipos son adaptables y que capturan diversas fuentes de agua, como lluvia, humedad atmosférica y aguas subterráneas, con el objetivo de regenerar y preservar el recurso hídrico. Este enfoque, inicialmente dirigido a Magallanes, podría extenderse a otras regiones, salvaguardando el agua como patrimonio territorial y proporcionando soluciones a largo plazo a la crisis hídrica y las consecuencias que esta conlleva a la ganadería ovina del lugar.
Para lograrlo, se realiza un análisis a cabalidad de diversas construcciones que se utilizaban en la antigüedad u hoy en día para preservar o capturar agua y que han funcionado, para así analizar sus características y soluciones constructivas y a la vez, se analizan distintas características y arquitecturas ganaderas para poder generar un espacio para el ovino. Estas se interpretan para obtener diferentes opciones de geometrización que briden soluciones a la problemática abordada en esta investigación
ANALYSIS OF THE INTERNATIONAL EPIDEMIOLOGICAL SITUATION OF BLADDER CANCER
No full textIntroducción: El Cáncer de Vejiga es de las diez neoplasias más frecuentes del mundo. Se clasifica en no músculo invasor, músculo invasor y metastásico. Posee una alta prevalencia y tasa de recurrencia, generando un alto costo para la población. Objetivo: Describir la incidencia y mortalidad internacional del Cáncer Vesical durante 2000-2019. Metodología: Estudio observacional descriptivo, sobre la base de datos epidemiológicos del Institute for Health Metrics and Evaluation, sobre Cáncer de Vejiga entre 2000-2019. Se recolectó datos de magnitud, mortalidad y años de vida ajustados por discapacidad. Resultados: Durante el período, la incidencia se mantuvo y la mortalidad disminuyó un 11,7%. Se observó tres veces mayor probabilidad de desarrollar Cáncer Vesical y 2,8 veces más mortalidad en hombres que mujeres. Mayores de 70 años presentan 34,7 veces más riesgo de morir en comparación a personas menores. Países de alto ingreso tienen mayor incidencia y mortalidad, aunque su letalidad es menor en relación a regiones de bajo ingreso. Discusión: El 80% del diagnóstico de Cáncer de Vejiga es sobre los 65 años. La incidencia y mortalidad a nivel mundial es mayor en hombres, sobre 70 años y en países con alto ingreso. Aunque la mortalidad de este cáncer va en disminución, los pacientes viven con más años de discapacidad, por su alta tasa de recurrencia. Conclusión: El Cáncer vesical varía según sexo, edad y geografía. Los pacientes tienen más años de discapacidad influyendo en un alto costo económico y calidad de vida de las personas.
Introduction: Bladder Cancer is one of the ten most frequent neoplasms in the world. It is classified as non-muscle invasive, muscle invasive, and metastatic. It has a high prevalence and recurrence rate, generating a high cost for the population. Objective: To describe the international incidence and mortality of Bladder Cancer during 2000- 2019. Methodology: Descriptive observational study, based on epidemiological data from the Institute for Health Metrics and Evaluation, on Bladder Cancer between 2000-2019. Data on magnitude, mortality and disabilityadjusted life years were collected. Results: During the period, incidence was maintained and mortality decreased by 11,7%. Men were three times more likely to develop bladder cancer and 2,8 times more likely to die in men than in women. People over 70 years of age have 34,7 times more risk of dying compared to younger people. High-income countries have higher incidence and mortality, although their lethality is lower in relation to lowincome regions. Discussion: 80% of the diagnosis of Bladder Cancer is over 65 years of age. Incidence and mortality worldwide are higher in men, over 70 years of age and in high-income countries. Although the mortality of this cancer is decreasing, patients live with more years of disability, due to its high recurrence rate. Conclusion: Bladder Cancer varies according to sex, age and geography. Patients have more years of disability influencing a high economic cost and quality of life of people
LINC00662 Promotes Aggressive Traits by Modulating OCT4 Expression through miR-335-5p in Gallbladder Cancer Cells
Get PDFLong non-coding RNAs (lncRNAs) are nucleotide sequences that participate in different biological processes and are associated with different pathologies, including cancer. Long intergenic non-protein-coding RNA 662 (LINC00662) has been reported to be involved in different cancers, including colorectal, prostate, and breast cancer. However, its role in gallbladder cancer has not yet been described. In this article, we hypothesize that LINC00662 has an important role in the acquisition of aggressiveness traits such as a stem-like phenotype, invasion, and chemoresistance in gallbladder cancer. Here, we show that LINC00662 is associated with larger tumor size and lymph node metastasis in patients with gallbladder cancer. Furthermore, we show that the overexpression of LINC00662 promotes an increase in CD133+/CD44+ cell populations and the expression of stemness-associated genes. LINC00662 promotes greater invasive capacity and the expression of genes associated with epithelial-mesenchymal transition. In addition, the expression of LINC00662 promotes resistance to cisplatin and 5-fluorouracil, associated with increased expression of chemoresistance-related ATP-binding cassette (ABC) transporters in gallbladder cancer (GBC) cell lines. Finally, we show that the mechanism by which LINC00662 exerts its function is through a decrease in microRNA 335-5p (miR-335-5p) and an increase in octamer-binding transcription factor 4 (OCT4) in GBC cells. Thus, our data allow us to propose LINC00662 as a biomarker of poor prognosis and a potential therapeutic target for patients with GBC.Versión Publicad
Methadone directly impairs central nervous system cells in vitro
Get PDFMethadone is a synthetic long-acting opioid that is increasingly used in the replacement therapy of opioid-addicted patients, including pregnant women. However, methadone therapy in this population poses challenges, as it induces cognitive and behavioral impairments in infants exposed to this opioid during prenatal development. In animal models, prenatal methadone exposure results in detrimental consequences to the central nervous system, such as: (i) increased neuronal apoptosis; (ii) disruption of oligodendrocyte maturation and increased apoptosis and (iii) increased microglia and astrocyte activation. However, it remains unclear whether these deleterious effects result from a direct effect of methadone on brain cells. Therefore, our goal was to uncover the impact of methadone on single brain cell types in vitro. Primary cultures of rat neurons, oligodendrocytes, microglia, and astrocytes were treated for three days with 10 µM methadone to emulate a chronic administration. Apoptotic neurons were identified by cleaved caspase-3 detection, and synaptic density was assessed by the juxtaposition of presynaptic and postsynaptic markers. Apoptosis of oligodendrocyte precursors was determined by cleaved caspase-3 detection. Oligodendrocyte myelination was assessed by immunofluorescence, while microglia and astrocyte proinflammatory activation were assessed by both immunofluorescence and RT-qPCR. Methadone treatment increased neuronal apoptosis and reduced synaptic density. Furthermore, it led to increased oligodendrocyte apoptosis and a reduction in the myelinating capacity of these cells, and promoted the proinflammatory activation of microglia and astrocytes. We showed that methadone, the most widely used drug in opioid replacement therapy for pregnant women with opioid addiction, directly impairs brain cells in vitro, highlighting the need for developing alternative therapies to address opioid addiction in this population.Versión Publicad
Discovery of novel genetic syndromes in Latin America: Opportunities and challenges
Get PDFLatin America (LatAm) has a rich and historically significant role in delineating both novel and well-documented genetic disorders. However, the ongoing advancements in the field of human genetics pose challenges to the relatively slow adaption of LatAm in the field. Here, we describe past and present contributions of LatAm to the discovery of novel genetic disorders, often referred as novel gene-disease associations (NGDA). We also describe the current methodologies for discovery of NGDA, taking into account the latest developments in genomics. We provide an overview of opportunities and challenges for NGDA research in LatAm considering the steps currently performed to identify and validate such associations. Given the multiple and diverse needs of populations and countries in LatAm, it is imperative to foster collaborations amongst patients, indigenous people, clinicians and scientists. Such collaborative effort is essential for sustaining and enhancing the LatAm´s contributions to the field of NGDA.Versión Aceptad
Masificación de la educación superior en Chile: rol del estado y de las instituciones de educación superior sobre la pertinencia de la oferta académica. Caso de una Universidad privada
No full textTesina presentada a la Facultad de Gobierno de la Universidad del Desarrollo
para optar al grado académico de Magíster en Políticas Públicas, mención gestión y Políticas EducativasLa presente investigación se centra a nivel general en la masificación de la educación superior en Chile, para en particular hacer un análisis de la oferta
académica desde el rol del Estado y de las Instituciones de Educación Superior y si ésta es pertinente con la demanda laboral existente en el país. Se analizará la oferta académica de dos áreas del conocimiento a nivel nacional y en particular se observará la oferta académica de una Institución
de Educación Superior privada.
Esta investigación se realizará a través de una metodología cuantitativa, focalizándose en las áreas de Administración y Pedagogía, siendo abordada
desde tres ámbitos: masificación de la educación superior y sus efectos sobre el mérito en el ideario occidental, políticas de educación superior y oferta
académica.
De esta manera este trabajo busca conocer la pertinencia de la oferta académica de las Instituciones de Educación Superior y si esta oferta, de estas áreas específicas, cubre eficazmente la demanda de profesionales del mercado laboral chileno
Availability and barriers to access post-stroke rehabilitation in Latin America
No full textObjectives: To describe the availability and barriers to access post-stroke rehabilitation services in Latin America.
Materials and methods: We conducted a multi-national survey in Latin American countries. The survey consisted of three sections: (1) the national state of post-stroke rehabilitation; (2) the local state of post-stroke rehabilitation; and (3) the coverage and financing of post-stroke services. Stroke leaders from the surveyed countries were involved in developing and disseminating the survey.
Results: 261 responses were collected from 17 countries. The mean age of respondents was 42.4 ± 10.1 years, and 139 (54.5 %) of the respondents were male. National clinical guidelines for post-stroke rehabilitation were reported by 67 (25.7 %) of the respondents. However, there were discrepancies between respondents within the same country. Stroke units, physiotherapy, occupational therapy, speech therapy, and neuropsychological therapy services were less common in public than private settings. The main barriers for inpatient and outpatient services included limited rehabilitation facilities, coverage, and rehabilitation personnel. The main source of financing for the inpatient and outpatient services was the national health insurance, followed by out-of-pocket payments. Private and out-of-pocket costs were more frequently reported in outpatient services.
Conclusions: Post-stroke rehabilitation services in Latin American countries are restricted due to a lack of coverage by the public health system and private insurers, human resources, and financial aid. Public settings offer fewer post-stroke rehabilitation services compared to private settings. Developing consensus guidelines, increasing coverage, and using innovative approaches to deliver post-stroke rehabilitation is paramount to increase access without posing a financial burden.Versión Aceptad
Niveles de dialogicidad y narratividad en el discurso docente y su relación con el aprendizaje alcanzado por estudiantes de enseñanza media en la asignatura de Lenguaje
No full textThis study sought to ascertain the relationship between the varying levels of dialogicity and narrativity found in the discourse of different teachers when teaching, as well as their students’ learning of the same curricular content. A multilevel, correlational quantitative design was used, with the data collection technique of classroom teacher observation, to determine the teachers’ levels of dialogicity and narrativity. Questionnaires were also administered to students to assess their learning and the quality of their recall of the content taught in the classes. The participants were 13 teachers with proven pedagogical excellence in language and communication who taught classes in 13 Chilean schools, as well as their 350 students in their last year of high school education. Using a linear hierarchical model, we concluded that there is a positive, significant relationship between the narrativity of the teacher discourse and student learning. We also found that males learned better with more narrative teachers, while females learned better with more dialogic teachers
Impact on the quality of life of sinus endoscopic surgery in the treatment of chronic rhinosinusitis
No full textLa cirugía endoscópica nasosinusal (CEN) de cavidades paranasales es un tratamiento ampliamente utilizado para la rinosinusitis crónica, con un impacto
significativo en mejorar la calidad de vida de los pacientes. Objetivo: Evaluar el impacto de la CEN en la calidad de vida en pacientes con diagnóstico de rinosinusitis crónica en una cohorte nacional y a largo plazo (1 año). Material y Método: Se realizó un estudio de cohorte prospectiva. Se incluyó 95 pacientes con diagnóstico de RSC operados en el servicio de otorrinolaringología del hospital del Salvador en el período 2017-2021.
Se compararon síntomas como obstrucción nasal, rinorrea, descarga posterior, algia facial e hiposmia, además de la encuesta SNOT-22 pre y post cirugía utilizando como medidas la escala visual análoga (EVA) de sintomatología cardinal de RSC y SNOT-22. Resultados: Los resultados mostraron una mejoría significativa en todos los síntomas evaluados. La obstrucción nasal, rinorrea, descarga posterior, hiposmia y algia facial presentaron una disminución estadísticamente significativa después de la CEN.
Además, la encuesta de calidad de vida SNOT-22 reveló una mejora significativa en la calidad de vida de los pacientes después de la cirugía. Conclusión: Este estudio sugiere que la CEN podría tener un impacto significativo en la mejora de los síntomas y la calidad de vida de los pacientes con rinosinusitis crónica. Los resultados de esta cohorte nacional respaldan la efectividad de la CEN como tratamiento para esta enfermedad a largo plazo (1 año) y destacan la importancia de considerar esta opción terapéutica en el manejo de la RSCVersión publicad