Browsing by Author "García-Huidobro Munita, Diego Nicolás"

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    A cluster randomized trial of interferon ß-1a for the reduction of transmission of SARS-Cov-2: protocol for the Containing Coronavirus Disease 19 trial (ConCorD-19)
    (2021) Iturriaga, Carolina; Eiffler, Nat; Aniba, Rad; Pérez Mateluna, Guillermo; Meyer, Jessica K. V.; Severino Cuevas, Nicolás Felipe; Borzutzky Schachter, Arturo; Perret Pérez, Cecilia; Castro Rodríguez, José Antonio; García-Huidobro Munita, Diego Nicolás; Iturriaga, Carolina; Eiffler, Nat; Aniba, Rad; Pérez Mateluna, Guillermo; Meyer, Jessica K. V.; Severino Cuevas, Nicolás Felipe; Borzutzky Schachter, Arturo; Perret Pérez, Cecilia; Castro Rodríguez, José Antonio; García-Huidobro Munita, Diego Nicolás; Iturriaga, Carolina; Eiffler, Nat; Aniba, Rad; Pérez Mateluna, Guillermo; Meyer, Jessica K. V.; Severino Cuevas, Nicolás Felipe; Borzutzky Schachter, Arturo; Perret Pérez, Cecilia; Castro Rodríguez, José Antonio; García-Huidobro Munita, Diego Nicolás; Iturriaga, Carolina; Eiffler, Nat; Aniba, Rad; Pérez Mateluna, Guillermo; Meyer, Jessica K. V.; Severino Cuevas, Nicolás Felipe; Borzutzky Schachter, Arturo; Perret Pérez, Cecilia; Castro Rodríguez, José Antonio; García-Huidobro Munita, Diego Nicolás
    Abstract Background SARS-CoV-2 infection rapidly spreads in populations due to the high rates of community transmission. Interrupting the shedding of SARS-CoV-2 may reduce the incidence of Coronavirus Disease 19 (COVID-19). Herein we provide a protocol for a cluster randomized trial that will examine the effectiveness of treatment with interferon (IFN) ß-1a compared to standard of care in limiting the transmission of SARS-CoV-2. Co-primary objectives are to determine whether IFN therapy reduces (a) the proportion of infected cases shedding SARS-CoV-2 at day 11 post randomization and (b) the incidence of transmission of SARS-CoV-2 infection from index cases to treatment-eligible household post-exposure contacts at day 11 after randomization. Secondary objectives include assessing the impact of IFN treatment on duration of viral clearance, hospitalizations and fatalities, and evaluating the safety of IFN treatment. Methods Three hundred and ten households, each including an index case with a recent COVID-19 diagnosis and at least one asymptomatic treatment-eligible household contact, will be randomized to receive 3 doses of 125 μg IFN ß-1a by subcutaneous administration (days 1, 6, and 11), or standard of care. All participants will be followed until day 29. Discussion The results from this trial will identify whether IFN ß treatment of mild or moderate COVID-19 cases accelerates viral clearance and prevents disease progression and whether IFN ß treatment of post-exposure contacts of COVID-19 cases reduces transmission of infection. Trial Registration: This trial is registered at ClinicalTrials.gov NCT04552379; date of registration September 17, 2020.
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    Accidentes en pediatría: Oportunidades para la prevención
    (2005) García-Huidobro Munita, Diego Nicolás; Munita Valenzuela, María Del Pilar; Legarraga Raddatz, Paulette; Valenzuela Contreras, Patricia; Cano Cornejo, Carmen Cristina; Bedregal G., Paula; Cifuentes Águila, Lorena Isabel
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    Cuidar a los cuidadores: Un desafío para los profesionales de la salud
    (2008) García-Huidobro Munita, Diego Nicolás; Sprohnle Pozas, Carolina Andrea; Sapag Muñoz De La Peña, Jaime Camilo
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    Designing a mobile app to enhance parenting skills of latinx parents : a community-based participatory approach
    (2020) Doty, J. L.; Brady, S. S.; Popelka, J. M.; Rietveld, L.; García-Huidobro Munita, Diego Nicolás; Doty, M. J.; Linares, R.; Svetaz, M. V.; Allen, M. L.
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    Effect of Patient-Centered Medical Home on Preventive Services for Adolescents and Young Adults
    (2016) García-Huidobro Munita, Diego Nicolás; Shippee, Nathan; Dicaprio, Julia Joseph; O'Brian, Jenniffer; Svetaz, María Verónica
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    Effective Parenting Interventions to Reduce Youth Substance Use : A Systematic Review
    (2016) Allen, M.; García-Huidobro Munita, Diego Nicolás; Porta, C.; Curran, D.; Patel, R.; Miller, J.; Borowsky, I.
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    Expectativas de estudiantes de medicina de pregrado en relación al perfil de médico esperado
    (2006) García-Huidobro Munita, Diego Nicolás; Nuñez, Felipe; Vargas Innocenti, Paula Andrea; Astudillo Mihovilovic, Smiljan Osvaldo; Hitschfeld Arriagada, Mario Javier; Gennero Riganti, Rubén Carlo; Salvatierra López, Loreto Olivia; Benavente Carrasco, Angela María
    Background: During the last few years, multiple new medical schools have emerged in Chile, associated to the constant preoccupation to provide a good quality medical care. This created the need to evaluate medical training programs and to open a discussion about the attributes that a good physician should have. Aim: To evaluate the medical student's perception of the ideal medical doctor profile. Material and methods: An analytical, descriptive and cross sectional study was designed. Eleven second year, 11 third year, nine fourth year, 13 fifth year, 6 sixth year and 8 seventh year students were studied. Data collection was gathered by focus groups. Codes and triangulation were used for data analysis. Results: As attitudes and moral-ethical values, students valued the absence of discrimination a listening attitude and empathy. Among job related issues, they valued responsibility and punctuality. Emotional and legal self-care were valued as self related attitudes. Among skills, competences and capacities, a value was given to communicational skills, team work and professional easiness. Knowledge about medical and non medical topics was appraised. The valued attributes among duties and activities were patient diagnosis, treatment and education, team leadership and continuous medical training. Conclusions: These findings should help to design new curricula for medical schools.
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    Increased rates of parental separation and anxiety among Latinx youth
    (2020) Brown, C. R.; Shramko, M.; García-Huidobro Munita, Diego Nicolás; Miller, K. K.; Brar, P.; Ogugua, F.; Svetaz, M. V.
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    Learning Together to Work Together : Interprofessional Education for Students in a Primary Care Setting in Chile
    (2013) García-Huidobro Munita, Diego Nicolás; Skewes, S.; Barros, X.; Pizarro, C.; Gawinski, B.
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    Mixed-methods evaluation of the initial implementation of advanced home visits in Chile
    (2022) García-Huidobro Munita, Diego Nicolás; Vergés, Álvaro; Basualto, Patricia; Calvo Miranda, Carlos; Boetto Puebla, Carolina; Soto, Mauricio; Kopplin Ibáñez, Erika Blanca; Martínez Pérez, Mayra Alicia; Aracena Álvarez, Marcela
    Home visiting programs are evidence-based interventions that have a myriad outcomes for mothers and newborns. Chile offers these services as part of the Chile Crece Contigo, a nationwide program. However, implementing home visiting programs in community settings is difficult. In this study, we report clinic, provider, and participant engagement with the implementation of advanced home visits (ViDAs) in Chilean primary care clinics. ViDAs include a high number of visits, external supervision, and the use of technology. In this study, qualitative and quantitative data were collected to assess the initial implementation of the home visiting strategy. Qualitative data consisted of individual interviews and focus groups with directors of city health departments, clinic managers, and providers conducting home visits. Quantitative data included clinic, provider, and participant recruitment. City health departments were approached to authorize the participation of primary care clinics in the ViDAs program. Then, clinic directors were invited to approve the implementation of the home visiting program at their health centers. In total, 16 clinics, 42 practitioners, and 185 participants were recruited. A large amount of resources was needed to recruit clinics, providers, and participants. The intervention had low acceptability, low adoption, and a high implementation cost. Initial program implementation experienced several challenges. Identified facilitators and barriers both highlighted the need for community engagement at all levels for the successful implementation of an innovation in Chilean primary care clinics. In addition, this article provides recommendations for practitioners and researchers regarding the conduct of research in community-based settings.
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    Parents and Family Matter Strategies for Developing Family-Centered Adolescent Care Within Primary Care Practices
    (2014) Svetaz, M.; García-Huidobro Munita, Diego Nicolás; Allen, M.
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    Perceived importance and interest in research by Chilean primary care providers
    (2023) García-Huidobro Munita, Diego Nicolás; Aracena Álvarez, Marcela; Bravo Valenzuela, Paulina Fabiola; González, Karla; Soto, Mauricio; von Borries, Pamela; Sapag, Jaime C.
    Background: Primary care providers (PCPs) are relevant stakeholders for primary care research (PCR). Objective: We report the perceived importance and interest in PCR of a national sample of Chilean PCPs. Methods: We conducted a cross-sectional study targeting Chilean PCPs. An electronic survey assessing perceived relevance of PCR, research training and experience, training interests, and demographics was disseminated through emails and WhatsApp messages. Descriptive statistics were used to summarize data. Logistic regression models were used to estimate adjusted probabilities and 95% confidence intervals for high interest in PCR, high interest in using research methods, and high interest in receiving research training, and predictors of these outcomes. Results: A total of 387 providers completed the online survey. Only 26.4% of PCPs had research experience as a principal or co-investigator. However, most clinicians perceived PCR as very important (92.5%) and were interested in using research methods (90.7%) and receiving training (94.3%). There were no statistically significant differences in these perceptions between provider’s discipline, role, sex, age, and geographical location after adjusting for covariates. Conclusions: Despite few Chilean PCPs have research training, a large majority perceive it as important, are interested in using it in their practice and would like to receive training.
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    Research on Clinical Preventive Services for Adolescents and Young Adults: Where Are We and Where Do We Need to Go?
    (2017) Harris, Sion K.; Aalsma, Matthew C.; Weitzman, Elissa; García-Huidobro Munita, Diego Nicolás; Wong, Charlene; Hadland, Scott E.; Santelli, John; Park, M. Jane; Ozer, Elizabeth M.
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    Safety, Tolerability, Bioavailability, and Biological Activity of Inhaled Interferon-& alpha;2b in Healthy Adults: The (INCOVID)-C-2 Phase I Randomized Trial
    (2023) García-Huidobro Munita, Diego Nicolás; Iturriaga, Carolina; Perez-Mateluna, Guillermo; Fajuri, Paula; Severino Cuevas, Nicolás Felipe; Urzua, Marcela; Fraga, Juan Pablo; Cruz, Javiera de la; Poli, Cecilia; Castro Rodríguez, José Antonio; Fish, Eleanor; Borzutzky, Arturo
    Background and ObjectivesInterferons have been identified as a potential treatment alternative for coronavirus disease 2019. This study assessed the safety, tolerability, bioavailability, and biological activity of inhaled interferon-& alpha;2b (IFN)-& alpha;2b in healthy adults.MethodsA double-blind, randomized, phase I clinical trial was conducted with two cohorts of healthy subjects aged 18-50 years. The first cohort received 2.5 MIU of inhaled IFN-& alpha;2b twice daily for 10 days (n = 6) or placebo (n = 3); the second cohort received 5.0 MIU of inhaled IFN-& alpha;2b in a similar scheme (n = 6) or placebo (n = 3). The first two doses were administered in an emergency department, then participants completed their treatment at home. Safety was measured through vital signs, new symptoms, and laboratory tests. Tolerability was measured as participants' treatment acceptability. Bioavailability and biological activity were measured from serum IFN & alpha; concentrations and real-time quantitative polymerase chain reaction of interferon-induced genes in blood before and after treatments.ResultsExposure to inhaled IFN-& alpha;2b at 2.5-MIU or 5-MIU doses did not produce statistically significant changes in participant vital signs, or elicit new symptoms, and standard hematological and biochemical blood measurements were comparable to those recorded in individuals who received placebo. A total of 58 adverse events were observed. All were mild or moderate and did not require medical care. All participants reported very high tolerability towards a twice-daily nebulized treatment for 10 days (98.0, 97.0, and 97.0 in the placebo, 2.5-MIU, and 5-MIU groups, respectively, on a 0- to 100-mm visual analog scale). A dose-dependent mild increase in serum IFN-& alpha; concentrations and an increase in serum RNA expression of IFN-induced genes were observed 11 days after treatment (p < 0.05 for all between-group comparisons).ConclusionsInhaled IFN-& alpha;2b was preliminarily safe and well tolerated, and induced systemic biological activity in healthy subjects.
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    Squeezing observational data for better causal inference : methods and examples for prevention research
    (2016) García-Huidobro Munita, Diego Nicolás; Oakes, J. Michael
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    System-Wide Accelerated Implementation of Telemedicine in Response to COVID-19: Mixed Methods Evaluation (Preprint)
    (2020) García-Huidobro Munita, Diego Nicolás; Rivera, Solange; Valderrama Chang, Sebastián; Bravo, Paula; Capurro, Daniel
    Background: As the COVID-19 pandemic disrupted medical practice, telemedicine emerged as an alternative to outpatient visits. However, it is unknown how patients and physicians respond to an accelerated implementation of this model of medical care. Objective: To report the system-wide accelerated implementation of telemedicine, compare patient satisfaction between telemedicine and in-person visits, and report provider perceptions. Methods: A convergent parallel mixed-methods study design consisting of simultaneous use of both qualitative and quantitative methods. This study was conducted at the UC-Christus Health Network, a large private academic health network in Santiago, Chile. Satisfaction of patients receiving telemedicine care between March and April, 2020, was compared to those receiving in-person care during the same period (concurrent control group) and during March and April, 2019 (retrospective control group). Patient satisfaction with in-person care was measured using the Net Promoter Score (NPS) survey. Satisfaction with telemedicine was assessed by patients using an online survey assessing similar domains. Providers rated their satisfaction and responded to open-ended questions assessing challenges, strategies to address them, the diagnostic process, treatment, and the patient-provider relationship. Results: A total of 3,962 patients receiving telemedicine, 1,187 patients from the concurrent control group, and 1,848 from the retrospective control group completed the surveys. Satisfaction was very high with both telemedicine and in-person services. Overall, 263 physicians from over 41 specialties responded the survey. During telemedicine visits, most providers felt their clinical skills were challenged (61.8%). Female providers felt more challenged than male providers (70.7% vs 50.9%, P = .002). Surgeons, obstetricians and gynecologists felt their clinical skills were challenged the least, compared to providers from non-surgical specialties (P < .001). Challenges related to the delivery modality, diagnostic process, and patient-provider relationship differed according to the provider’s specialty (P = .046, P < .001, and P = .022, respectively). Conclusions: Telemedicine implemented in response to the COVID-19 pandemic produced high patient and provider satisfaction. Specialty groups perceive the impact of this new mode of clinical practice differently.
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    Tema Valorado Críticamente: Tratamiento Hipolipemiante con Estatinas para la Prevención Primaria de Eventos Cardiovasculares en Pacientes Diabéticos
    (2006) García-Huidobro Munita, Diego Nicolás; Pantoja Calderón, Tomás
    En pacientes diabéticos sin eventos cardiovasculares previos el uso de tratamiento hipolipemiante con estatinas reduce el riesgo relativo de eventos cardiovasculares en un 21%.
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