Browsing by Author "Carvajal Cabrera, Jorge Andrés"

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    2-Methoxyestradiol mediates apoptosis through caspase-dependent and independent mechanisms in ovarian cancer cells but not in normal counterparts
    (2008) Kato Cardemil, Sumie Rode; Sadarangani, Anil; Lange Smith, María Soledad; Delpiano, Ana M.; Vargas, Macarena; Brañes, Jorge; Carvajal Cabrera, Jorge Andrés; Lipkowitz, Stanley; Owen, Gareth Ivor; Cuello Fredes, Mauricio Arturo
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    Barriers for research activities in residency programs: A mix-methods study
    (2023) Merino Lara, Tomas Rodrigo; Rojas Donoso, Viviana Isabel; Fuentes López, Eduardo; Sanchez Rojel, Cesar Giovanni; Pizarro Rojas, Margarita Alicia; Fuentes Cimma, Javiera Carolina; Cifuentes Aguila, Lorena Isabel; Cuello Fredes Mauricio Arturo; Carvajal Cabrera, Jorge Andrés; Balcells Marty, Maria Elvira; Riquelme Pérez, Arnoldo
    Introduction: Research activities have a positive impact on the performance of residents. However, information on research conducted by residents from developing countries is scarce. Our study sought to identify the barriers and facilitators for developing research in medical residency programs in a Latin-American faculty of medicine. Methods: A mixed methodology study design was carried out. We used a grounded theory approach for the qualitative phase, collecting data through semi-structured interviews and focus groups with faculty and residents. For the quantitative phase, surveys were administered to residents and teachers. We used factor analysis and scree plot (validity), Cronbach's alpha, and Intraclass correlation coefficient (reliability) to evaluate the surveys' psychometric properties. Results: Focus groups involving ten faculty members and 15 residents were conducted, and the following domains were identified: a) facilitators for resident participation, b) barriers, c) strategies for introducing research into the curriculum, d) arguments supporting research activities throughout medical residency, and e) profile of research-motivated residents. Both residents and faculty members identified a lack of protected time and adequate mentoring as the major barriers. A gender gap was found related to international publications (34% vs. 66% women/men); women perceived that research activities 'compete with other activities' (OR: 2.04, 95% CI 1.03 to 4.07). Conclusions: Research is highly valued by both residents and faculty members at a Latin-American university with a strong academic output. Major barriers to promoting research in this context include lack of protected time and effective mentoring, and gender gaps. Strategies proposed to improve research within medical residency programs include: establishing an interdisciplinary mentoring program between residents and researchers, promoting elective rotations, and rewarding proposals that consider gender equity.
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    Current concepts on the use of the partogram to monitor labor progression
    (2024) Rojas Cedeño, Luis; Carvajal Cabrera, Jorge Andrés
    The partogram is a graphic tool used to monitor labor progression. This article reviews the recent literature on the use of the partogram, aiming to evaluate whether its implementation reduces cesarean section rates and to determine which model is more appropriate. Studies that compared using the partogram with not using it were analyzed, as well as studies that contrasted different partogram models. The results indicate that partogram use is not associated with a significant reduction in cesarean section rate, particularly in countries with low cesarean section rates. However, the modified World Health Organization partogram, which eliminates the latent phase, appears to have advantages over the classic 1994 model, with significantly lower cesarean section rates. Although the partogram has not shown significant benefits in reducing cesarean sections, it is still a useful tool for graphically documenting the progress of labor, which could improve clinical decision-making. In Chile, the high cesarean section rates, close to 45%, suggest that implementing the WHO 2000 partogram could be beneficial. However, local studies are needed to confirm the potential benefits of reducing cesarean sections.El partograma es una herramienta gráfica utilizada para monitorear el progreso del trabajo de parto. Este artículo revisa la literatura reciente sobre el uso del partograma, con el objetivo de evaluar si su implementación reduce la tasa de cesáreas y determinar qué modelo es más adecuado. Se analizaron estudios que compararon el uso de partograma con su no utilización, así como estudios que contrastaron distintos modelos de partograma. Los resultados indican que el uso del partograma no se asocia con una reducción significativa de la tasa de cesáreas, particularmente en países con tasas bajas de cesárea. Sin embargo, el partograma modificado de la Organización Mundial de la Salud, que elimina la fase latente, parece tener ventajas sobre el modelo clásico de 1994, presentando una tasa significativamente menor de cesáreas. Aunque el partograma no ha mostrado beneficios significativos en la reducción de cesáreas, sigue siendo una herramienta útil para documentar gráficamente el progreso del trabajo de parto, lo cual podría mejorar la toma de decisiones clínicas. En Chile, la elevada tasa de cesáreas, cercana al 45%, sugiere que la implementación del partograma OMS 2000 podría ser beneficiosa. Sin embargo, es necesario realizar estudios locales para confirmar estos posibles beneficios en la reducción de cesáreas.
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    The role of the RHOA/ROCK pathway in the regulation of myometrial stages throughout pregnancy
    (2024) Carvajal Cabrera, Jorge Andrés; Galaz, José; Villagran Essmann, Sofía Paz; Astudillo, Rocío; Garmendia, Liliana; Delpiano, Ana María
    Background: Controlling uterine contractile activity is essential to regulate the duration of pregnancy. During most of the pregnancy, the uterus does not contract (i.e., myometrial quiescence). The myometrium recovers its contractile phenotype at around 36 weeks (i.e., myometrial activation) through several mechanisms. The RHOA/ROCK pathway plays a vital role in facilitating muscular contractions by calcium sensitization in humans. Yet, the role of this pathway during different myometrial stages, including quiescence, has not been elucidated. Objective: we aimed to study the role of the RHOA/ROCK pathway in the regulation of the different myometrial stages throughout pregnancy. Specifically, we hypothesized that the inhibition of the components of the RHOA/ROCK pathway play an important role in maintaining uterine quiescence. Study design: Myometrial samples were obtained from pregnant individuals who underwent cesarean section. Pregnant individuals who delivered preterm without labor (myometrial quiescence), preterm with labor (nonphysiological myometrial stimulation), term not in labor (activation), and term in labor (physiological myometrial stimulation) were included. The mRNA and protein expression of RHOA, ROCK I, ROCK II, RND1-3, and ROCK activity through pMYTP1 were evaluated. Results: We found that the human myometrium constitutively expressed RHOA/ROCK pathway components throughout pregnancy. No changes in the components of the RHOA/ROCK pathway were found during quiescence. Moreover, the RHOA protein and ROCK activity increased in the myometrium during labor, supporting the hypothesis that this pathway participates in maintaining the contractile activity of the myometrium. This study provides insight into the role of the RHOA/ROCK pathway in controlling myometrial contractile activity during pregnancy.