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- ItemA nomogram for predicting serious complications in patients with solid tumors and apparently stable febrile neutropenia: prospective data on 781 consecutive episodes from the FINITE study(2014) Ghanem, Ismael; Rebollo, Maite Antonio; Garrido, Marcelo; Martínez, Jerónimo; Font, Carme; Ramchandani, Avinash; Biosca, Merce; Beato, Carmen; Martínez de Castro, Eva; Castanon, Eduardo; Virizuela Echaburu, Juan; Espinosa, Javier; Sevillano, Elena; Aragon Manrique, Isabel; Cardona, Merce; Mondejar, Rebeca; Baron, Francisco; Acevedo Claros, Francisco Nicolás; Jiménez-Fonseca, Paula; Carmona Bayonas, AlbertoBackground: An accurate estimate of the likelihood of serious complications in patients with otherwise apparently stable febrile neutropenia (FN) may assist in decision-making regarding individualized therapy. Our group has developed a prognostic score for predicting complications in patients with solid tumors and apparently stable episodes called CISNE (Clinical Index for Stable Febrile Neutropenia). The purpose of this study is to present a nomogram based on the previously mentioned index in a broader dataset of patients. Methods: FINITE is a prospective and multicenter study which aims to investigate prognostic factors and outcomes of FN episodes with clinical stability at first assessment, defined as events without acute organ dysfunction, vital signs abnormalities or major infections. We performed a nomogram based on the CISNE score which includes the following prognostic variables: ECOG PS≥2, chronic obstructive pulmonary disease, cardiovascular disease, mucositis NCI grade ≥2, monocytes <200/mm3 and stress-induced hyperglycemia. A calibration plot was used to analyze the accuracy of this multivariate nomogram. Results: From October 2012 to December 2013, 781 patients with apparently stable FN were recruited in 21 Spanish hospitals. The rate of infection-related complications and death was 15.6% (95% confidence interval [CI], 12.9-18.6%) and 1.7% (95% CI, 0.98%-3.01%). A nomogram was designed according to the CISNE score. The area under the ROC curve was 0.836 (95% CI, 0.808-0.861). The observed and predicted probabilities also matched closely. Conclusions: Our group has developed a user-friendly nomogram for predicting complications in patients with apparently stable FN. This nomogram may be particularly useful to prevent premature discharges of cancer patients starting inpatient management.
- ItemA preliminary study on aflatoxin exposure by urine biomonitoring in Chile(2022) Foerster, Claudia; Monsalve, Liliam; Maldonado, Carlos; Cortés Arancibia, Sandra; Ferreccio, Catterina; CEDEUS (Chile)We assessed the occurrence of aflatoxin M1 (AFM1) in urine in a sample of the MAUCO population-based cohort (n = 120) using an enzyme-linked immune sorbent assay (ELISA) kit specially designed for the analysis of AFM1 in urine. We found AFM1 in the urine of 59% of the participants (> limit of detection), with 12% of the samples being over the limit of quantification. The mean of the quantifiable samples was 0.66 (± 0.35) ng/mg adjusted creatinine, ranging from 0.31 to 1.39 ng/mg creatinine. The mean probable daily intake (PDI) of AFB1 was 0.23 (± 0.37) ng/kg bw according to the upper bound (UB), being significantly higher in women and 0.14 (± 0.23) ng/kg bw in the modified lower bound (mLB) approach, ranging from 0.01 to 1.98 ng/kg bw. The risk of AFB1 was assessed with the margin of exposure (MOE) approach estimated at 2800 in the mean mLB and 1733 in the mean UB. According to the MOE values obtained in this study, aflatoxin B1 exposure must be considered a public health concern and must be taken as a priority for food risk management.
- ItemA randomized controlled trial of mindfulness-based stress reduction (MBSR) in health workers (E-Poster Presentations)(Cambridge Univ. Press, 2020) Errazuriz Concha, Antonia; Figueroa Cabello, Rodrigo Andrés
- ItemAbstract PS6-37: Clinical stage is the only predictor of survival in breast cancer patients with a complete pathological response(2021) Acevedo, Francisco; Walbaum, Benjamin; Merino, Tomas; Petric, Militza; Sanchez, CesarINTRODUCTION In breast cancer (BC) patients, achieving a complete pathological response (pCR) after neoadjuvant chemotherapy (NCT) is associated with better prognosis. Despite this, some of these patients will experience recurrences of the disease and will eventually die of BC. We identified clinical factors that can affect recurrence and survival in BC patients who achieve pCR.METHODSRetrospective analysis of a Chilean BC database including patients treated in public and private hospitals in Santiago, Chile from 2010 to 2019. pCR was defined as the absence of residual invasive disease in the breast and in the axillary lymph nodes (ypT0/is N0) at the completion of the NCT. Invasive Disease-Free Survival (IDFS), Distant Disease-Free Survival (DDFS) and BC-specific survival (BCS) was measured from the time of diagnosis to the event or lost to follow-up. We performed Cox regression analysis to identify factors associated with prognosis.RESULTSFrom 855 patients who received NCT, 195 (22.8%) achieved pCR and were included in this study. Clinical characteristics are shown in table 1. 76 (37.9%) patients had hormone receptor positive (HR+) and 113 (57.4%) had Human epidermal growth factor 2 (HER2) positive tumors. 88.7% were treated with a regimen that included anthracyclines and taxanes. With a median follow-up of 36 months, three-year IDFS, DDFS and BCS and their 95% confidence intervals were 90.9% (84.7 - 94.6), 91.8% (86.0 - 95.3) and 93.8% (87.8 - 97.5); respectively. The stage at diagnosis was the only predictor associated with IDFS (Hazard ratio (HR) = 5.6; p = 0.02), DDFS (HR = 4.1, p = 0.07), and BCS (HR = 8.3, p = 0.04). Body mass index (BMI), age, hospital, HR or HER2 status, lymph node involvement, or the presence of an in-situ component, were not associated with prognosis in the multivariate analysis.CONCLUSIONThe clinical stage at diagnosis was the only predictor of survival in patients who achieved pCR after NCT. Short follow-up and few events may have affected these results. This data is consistent with previously published work. Table 1. Tumor and patient characteristicsMedian age49 (24 – 78)HospitalPublic57.4%Private43.6%BMIMedian27.2 (18.5 – 44.7)Overweight38.0%Obese31.9%Receptor StatusRH+/HER2-16.4%RH+/HER2+21.5%RH-/HER2+35.9%RH-/HER2-26.2%Clinical StageI2.1%II47.4%III50.5%Lymph Node +69.7%ypT0/N078.1%ChemotherapyAnthracycline5.1%Taxane6.2%Anthracycline-Taxane88.7% Citation Format: Francisco Acevedo, Benjamin Walbaum, Tomas Merino, Militza Petric, Cesar Sanchez. Clinical stage is the only predictor of survival in breast cancer patients with a complete pathological response [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS6-37.
- ItemAcute myeloblastic leukemia in Chile: treatment and outcomes in patients admitted at the Hospital Clinico de la Pontificia Universidad Católica de Chile between 2010–2014(2014) Fuentes Arismendi, Mónica Paulina; Rojas, Patricio; Ernst Díaz, Daniel Matías; Acevedo Claros, Francisco Nicolás; Sarmiento Maldonado, Mauricio; Ocqueteau Tacchini, Mauricio Esteban; Bertin Cortes-Monroy, Pablo Alfonso; Ramírez, PabloIntroduction: Acute Myeloblastic Leukemia (AML) is the most frequent acute leukemia in the adults and its incidence increases with age. There are few studies about the demography and outcomes of AML patients in Chile and the only report belongs to a public hospital from 2000. We discuss the results of patients treated in our institution with AML non promyelocytic. Patients and Methods: Retrospective analysis of the epidemiologic, clinical and laboratory characteristics of diagnosis (cytology and flow cytometry) and treatment of AML non promyelocytic patients between 2010-2014. Statistical analysis of the data was performed using SPSS Statistics v21 software. Results: 63 patients were diagnosed with AML non M3, 52 males (66%), with a median age of 55.4 years (range: 16 - 89). Diagnosis laboratory tests (mean values and ranges) were: WBC 45.989/mm3 (range: 700 - 405.000); hemoglobin 9,1 g/dl (range: 5,2 - 14,1); platelets 75.548/mm3 (range: 10.000 - 454.000); peripheral blood blasts 38% (range 0 - 100); bone marrow blasts 74% (range 25 - 100%). The cytogenetic risk groups were: favorable (n=5, 8%), intermediate (n=33, 52%), adverse (n=8, 13%) and unknown (n=17, 27%). Of all the patients, 75% (n=47) received induction chemotherapy (CT) and 25% (n=16) palliative care. The mean age of the group with cytogenetic analysis was 51.2 years and only 8.6% did not receive consolidation CT. On the other hand, the group of patients with unknown cytogenetics had a mean age of 68 years and 57% did not receive consolidation CT. The mean survival of the CT group was 27.3 month (range: 0 - 53). By contrast, the mean survival in the palliative care group was 1 month (range: 0 - 6). The mean follow up in all patients was 13 months, (range: 1 - 55) and 17 months (range: 1 - 54) in the group that received CT. 87% (n=41) of patients with CT had febrile neutropenia with respiratory and intestinal focus most commonly identified. The induction mortality was 4,2% (n=2). Complete cytologic remission was achieved in 70% (n=33). The 3-year relapse free survival (RFS) and overall survival (OS) in the CT group were 25% and 31%, respectively. The multivariate survival analysis using Cox’s regression demonstrated that the variables that had significant impact in RFS and OS were: age at diagnosis (<60 years), achievement of disease remission and the use of induction and consolidation CT (high dose cytarabine versus others). In this analysis the cytogenetic risk did not have any impact in OS. The patients that only had induction CT (but not consolidation) had significantly better survival rates compared to the group in palliative care (6 months vs. 1 month, respectively, p=0.001). The mortality during the follow up of patients who had survived the induction CT was 47% (n=22), 2/3 of leukemia and 1/3 of infections. Conclusions: Our study shows that in our center, CR rates and OS rates after induction and consolidation chemotherapy are similar to those reported in international series, and are better than the data that was previously reported in our country. Low induction CT mortality, and the efficacy of CT in patients younger than 60 years old stand out in our report and validate the efficacy of intensive CT.
- ItemAdaptación cultural y propiedades psicométricas de la versión en español-chileno del cuestionario Family Satisfaction in the Intensive Care Unit – 24(2022) Padilla Fortunatti, Cristóbal Felipe; Molina Muñoz, Yerko; Avendaño Jara, Stefany
- ItemAdaptación y análisis factorial del cuestionario de conducta de alimentación del adulto (AEBQ) en idioma español(2020) Morales, Eva María; Maghioros, María Ángeles; Obregón, Ana M.; Santos, José L.El Cuestionario de Conducta de Alimentación de Adultos (AEBQ, por su sigla en inglés derivada de Adult Eating Behavior Questionnaire) es una de las herramientas psicométricas más usadas para evaluar la conducta de alimentación. El objetivo de este estudio fue adaptar y analizar factorialmente la versión en idioma español del AEBQ. El cuestionario adaptado al idioma español se aplicó en un estudio piloto de 50 voluntarias universitarias entre 20 y 30 años de edad. Se utilizó la técnica de análisis factorial para reducir la dimensionalidad de los datos y evaluar preliminarmente su estructura. Se usó la estadística alfa de Cronbach para explorar la consistencia interna del cuestionario adaptado. El análisis factorial reveló una estructura de 8 factores que explican el 82,8 % de la variación de los datos, lo que es concordante con el número de dimensiones de la conducta de alimentación publicada para el AEBQ original. La consistencia interna fue alta, con valores de la estadística α de Cronbach entre 0,77 y 0,91 para las 8 dimensiones consideradas. En conclusión, la versión adaptada al idioma español del AEBQ presenta una razonable concordancia en su estructura de datos con el cuestionario publicado originalmente en inglés, así como una adecuada consistencia interna. Se deben realizar futuros estudios de mayor tamaño muestral que incluyan participantes de diferentes grupos de edad, sexo y estado nutricional.
- ItemAdvances in molecular imaging of atherosclerosis and myocardial infarction: shedding new light on in vivo cardiovascular biology(2012) Phinikaridou, Alkystis; Andía Kohnenkampf, Marcelo Edgardo; Shah, Ajay M.; Botnar, René M.Molecular imaging of the cardiovascular system heavily relies on the development of new imaging probes and technologies to facilitate visualization of biological processes underlying or preceding disease. Molecular imaging is a highly active research discipline that has seen tremendous growth over the past decade. It has broadened our understanding of oncologic, neurologic, and cardiovascular diseases by providing new insights into the in vivo biology of disease progression and therapeutic interventions. As it allows for the longitudinal evaluation of biological processes, it is ideally suited for monitoring treatment response. In this review, we will concentrate on the major accomplishments and advances in the field of molecular imaging of atherosclerosis and myocardial infarction with a special focus on magnetic resonance imaging.
- ItemAdverse childhood experiences and suicidal ideation among immigrants in Santiago, Chile(Cambridge Univ. Press, 2021) Errazuriz Concha, Antonia; Avello Sáez, Daniela Margot; Morales, S.; Pino, R.Introduction: Understanding suicidal ideation and its association with childhood adversity is crucial for preventing suicide. Although the “healthy immigrant effect”, whereby immigrants are healthier than the native-born population, has been well documented across studies, little research has examined the presence of such effect on lifetime suicidal ideation (LSI) and its association to early adversity.Objectives: The aim of this study was to compare the prevalence of LSI between the immigrant and native-born population in Chile and explore the association between childhood adversity and suicidal ideation in immigrants.Methods:Data from two cross-sectional health surveys: the Santiago Immigrant Wellbeing Study (STRING, n=1,091; 2019) and the Chilean National Health Survey (ENS2016, n=3,432) were used. Each study used multistage probability sampling and estimates were weighted to approximate the distribution of demographic variables in each population. Outcomes included LSI measured by WHO-CIDI and an adapted version of the Adverse Childhood Experience Questionnaire. Multivariate logistic regression was employed.Results:indicated that immigrants were less likely to report LSI compared with the native-born population. Moreover, male and female immigrants had lower risk of having SI than native-born counterparts. After controlling for socioeconomic status, social support, and health conditions, childhood adversities predicted an increased risk of LSI in immigrants. No gender differences were found in the effects of childhood adversity on suicidal thoughts.Conclusions: Findings confirm the presence of a healthy immigrant effect in LSI and support a life course perspective, highlighting the importance of assessing early life disadvantages to understand suicidal ideation among immigrants.
- ItemAir pollution and environmental epidemiological evidence in Chile: alerts for decision-makers and citizens(2023) Cortés Arancibia, Sandra; CEDEUS (Chile)Air pollution in Chile presents unique challenges, exacerbated by inequalities and geographical and climatic diversity. Current policies have not succeeded in aligning air quality with international and national standards, nor have they significantly mitigated public health impacts, despite being more advanced than those in other Latin American countries. The evidence on the health damages caused by air pollution is compelling, showing harmful acute and chronic effects across various life stages. Yet, current measures do not effectively reduce exposure to pollutants. The monitoring network, which reports data from stationary and mobile sources, does not always detect early fugitive emissions and is limited to regulated pollutants, leaving areas without adequate monitoring coverage and without management plans for critical episodes outside of autumn and winter and for a reduced number of pollutants. In the context of climate change, which increases the frequency of forest fires, Chile is experiencing a deterioration of air quality, highlighting the need to expand critical episode management beyond the current Air Pollution Prevention and/or Atmospheric Decontamination Plans. Integrated intersectoral plans need to be improved and extended to address the high exposure to pollutants, due to the large number of people exposed, and a broad population health risks, including quality of life. Decarbonisation by 2040 based on the Sustainable Development Goals is an important pillar of the strategy, but a public debate is needed to establish additional actions for addressing environmental injustice, improving equity and reducing current exposure to air pollutants.
- ItemAnálisis comparativo y perfil de publicaciones en la Revista Chilena de Pediatría 2001-2006(2007) Harris, Paul R.; Liebbe G., J.L.; Sotomayor A., J.; Ugarte P., F.; Cano Sch., F.Background: The Revista Chilena de Pediatría (Rev Chil Pediatr), official journal of Sociedad Chilena de Pediatría is index in SciELO, but not in the National Library of Medicine (NLM) of USA. Objectives: a) Determine the profile of published and visited articles of Rev Chil Ped, in order to compare them with the Jornal de Pediatria from Brazil (J Ped Br) and the Journal of Pediatrics (J Ped) from USA. b) Evaluate the visibility of Rev Chil Pediatr compared to Revista Medica de Chile (Rev Med Chil). Method: On line issues from the above mentioned journal were evaluated through SciELO database and PubMed database from 2001 - 2006. A random and representative subset of published articles was obtained from each one of the 3 journals during the referred period. The most visited articles from Rev Chil Pediatr were analyzed and classified as originals (clinical and basic research) and non originals (editorial, clinical case, reviews and others). The articles were classified according to thematic content in 25 medical specialties. In addition, the number of annual visits to Rev Chil Pediatr and Rev Med Chil were analyzed, including the most frequent citations given and received in that period of time. Results: Out of 512 articles in Rev Chil Pediatr, 220 were analyzed; 35% were originals and 65% non originals, with a significant lower percentage of original articles compared to J Ped Br and J Ped (p < 0.05). The thematic areas with more articles were respiratory disease, infectious diseases and nutrition with 9.1, 7.7 and 7.7%, respectively. Rev Chil Pediatr published twice as many nutrition articles and five times more public health articles compared to J Ped (p < 0.05). The most visited articles on line were of nutrition, infectious diseases, respiratory diseases and neonatology. Among the 10 most visited articles from Rev Chil Pediatr, 7 were review articles. Since 2005, an explosive growth is detected in the number of visits to articles from Rev Chil Pediatr in SciELO. When the number of visits was adjusted to the number of physicians belonging to the corresponding society, there was a higher number of visits to Rev Chil Pediatr from 2005 compared to Rev Med Chile. Conclusion: The thematic content of Rev Chil Pediatr is similar to regional journals, but different to international ones. There is an appropriate correlation between published and visited articles. SciELO has been an important tool that contributes to the diffusion of research published in Rev Chil Pediatr. © 2007 Sociedad Chilena de Pediatría.
- ItemAnálisis de la diferencia entre importancia y satisfacción de las necesidades de los familiares de pacientes críticos(2019) Padilla Fortunatti, Cristóbal Felipe
- ItemAnálisis de los fenotipos y genotipos de resistencia a eritromicina y clindamicina en cepas de Streptococcus pyogenes aisladas en Chile en un período de 10 años(2011) Rodríguez, Carlos; Rojas, Pablo; Wozniak, Aniela; Kalergis, Alexis M.; Cerón, Inés; Riedel, Ingrid; Román, Juan C.; Villarroel, Luis A.; Berríos, Ximena; Bavestrello, Luis; García, PatriciaBackground: Macrolide and lincosamide resistance in Streptococcus pyogenes is due to the acquisition of mef, ermB and ermA genes, which confer different resistance phenotypes, namely M, MLSBconstitutive and MLSBinducible respectively. The last report of resistance in Chile was done in the period 1990-1998, in which resistance to macrolides was 5.4%, with M phenotype as the predominant one. Aim: To characterize the evolution of erythromycin and clindamycin resistance and their associated genes in S. pyogenes strains isolated from patients with invasive and noninvasive infections in the period 1996 to 2005. Material and Methods: Resistance to erythromycin and clindamycin was determined in 1,282 clinical isolates using the disk diffusion test. Resistant isolates were analyzed by polymerase chain reaction (PCR) for the presence of the above mentioned resistance genes. Results: Global resistance to erythromycin and clindamycin was 3.5 and 0.7% respectively. Eighty percent of the resistant strains possessed the M. phenotype. Conclusions: Resistance levels of S. pyogenes have decreased in Chile in the last years. Most resistant strains have M phenotype in contrast to many countries in which the MLSB constitutive phenotype is the predominant one.
- ItemAnálisis del paladar oseo como zona dadora de injerto(2007) Martínez, Catalina; Inzunza, Oscar; Vargas Diaz, Alex PatricioThe palate bone could be a favorable zone as a graft donor site whenever there is certainty in determining its thickness. The aim of this study was to assess the correlation between the upper anterior facial heights with the hard palate thickness. In 29 dry skulls, we measured the upper anterior facial height after identifying the craniometric points nasion and prosthion. Then we measured the thickness of the hard palate of every sample at 6 and 9 mm dorsally from the incisive canal, in both paramedian regions (at 3 and 6 mm from the mid-palatal suture). A statistical analysis was done with Pearson correlation test to establish if the facial height could be a predictor of palate thickness. There exists a great variability in the hard palate's thickness ranging from 0.1 to 1.1 cm. The mean available was found to be best at 6 mm from the incisive canal with an average of 0,71 ± 0.20 cm. There was no significant correlation between the upper anterior facial height and the palate thickness. To rightly determine the hard palate thickness and, at the same time, its availability as a bone graft site, it would be necessary to confront craniometric methods with advanced imaging techniques.
- ItemAnálisis genético molecular en niños con fibrosis hepática congénita(2008) Harris, Paul R.; Cavagnaro, F.
- ItemAnalysis of Emergency Room Episodes Duration Through Process Mining(2019) Rojas, Eric; Cifuentes Soto, Andrés Alonso; Burattin, A.; Muñoz Gama, Jorge; Sepúlveda, Marcos; Capurro, DanielThis study presents the proposal of a performance analysis method for ER Processes through Process Mining. This method helps to determine which activities, sub-processes, interactions and characteristics of episodes explain why the process has long episode duration, besides providing decision makers with additional information that will help to decrease waiting times, reduce patient congestion and increment quality of provided care. By applying the exposed method to a case study, it was discovered that when a loop is formed between the Examination and Treatment sub-processes, the episode duration lengthens. Moreover, the relationship between case severity and the number of repetitions of the Examination-Treatment loop was also studied. As the case severity increases, the number of repetitions increases as well.
- ItemAnalyzing medical emergency processes with process mining: the stroke case(2019) Fernandez-Llatas, Carlos; Ibanez-Sanchez, Gema; Celda, Angeles; Mandingorra, Jesus; Aparici-Tortajada, Lucia; Martinez-Millana, Antonio; Munoz-Gama, Jorge; Sepúlveda, Marcos; Rojas, Eric; Gálvez, Víctor; Capurro, Daniel; Traver, VicenteMedical emergencies are one of the most critical processes that occurs in a hospital. The creation of adequate and timely triage protocols, can make the difference between the life and death of the patient. One of the most critical emergency care protocols is the stroke case. This disease demands an accurate and quick diagnosis for ensuring an immediate treatment in order to limit or even, avoid, the undesired cognitive decline. The aim of this paper is perform an analysis of how Process Mining techniques can support health professionals in the interactive analysis of emergency processes considering critical timing of Stroke, using a Question Driven methodology. To demonstrate the possibilities of Process Mining in the characterization of the emergency process, we have used a real log with 9046 emergency episodes from 2145 stroke patients that occurred from January of 2010 to June of 2017. Our results demonstrate how Process Mining technology can highlight the differences of the stroke patient flow in emergency, supporting professionals in the better understanding and improvement of quality of care.
- ItemAnatomía y Embriología General y Aplicada(2009) Inzunza, Oscar; Bravo Contreras, Hermes; Pontificia Universidad Católica de Chile. Escuela de medicina. Departamento de anatomía
- ItemAnatomía y neuroanatomía, disciplinas perjudicadas por la reforma curricular(2007) Inzunza H., Oscar; Vargas, A.; Bravo, H.En los últimos tiempos, la docencia en Morfología ha debido enfrentar un escenario cambiante, producto de: a) un cambio curricular que ha llevado a la reducción de las horas destinadas a los cursos de Anatomía y Neuroanatomía; b) la dificultad creciente de obtener material cadavérico para las actividades prácticas de dichos cursos; c) el incremento en el número de alumnos de los cursos de pregrado; y, d) la reducción alarmante de los cultores de estas ciencias básicas del currículo de Medicina. Como resultado de lo anterior, es dable esperar, que esta situación -que tiene un alcance mundial-, más temprano que tarde tenga un efecto en el conocimiento morfológico de los médicos recién formados. En este estudio se analiza el rendimiento obtenido en pruebas diagnósticas de reconocimiento de estructuras en Anatomía y Neuroanatomía, aplicadas a médicos residentes de primer año de la especialidad de Radiología, formados bajo este nuevo paradigma curricular. Los resultados mostraron que la nota promedio (escala 1 a 7) de la prueba diagnóstica fue 3,14 + 0,99. Es interesante notar que para una evaluación similar, los alumnos de primer año de la carrera de medicina obtienen una nota promedio de 5,75 + 0,55. Luego de aplicar a los mismos residentes del estudio un curso teórico-práctico de nivelación en Anatomía, se aprecia un mejoramiento en el reconocimiento de estructuras anatómicas, con nota promedio de 4,79 + 0,96; detectándose una mejora sustantiva en la identificación de elementos en secciones anatómicas de tronco. En las evaluaciones de temas neuroanatómicos, las diferencias son aún más notorias (1,53 v/s 3,97). Estos datos reposicionan a las actividades prácticas de Anatomía, en especial el trabajo con material cadavérico, como un quehacer central en el proceso de aprendizaje de estos temas. Esta situación de olvido y/o desconocimiento observada en los nuevos médicos, ha generado una gran demanda por cursos de apoyo morfológico para las distintas especialidades.
- ItemAplicación de tres modelos pronósticos en cáncer de mama precoz(2018) Sánchez R., César; Maldonado J., Daniela; Jans B., Jaime; Domínguez C., Francisco; Galindo A., Héctor; Camus A., Mauricio; Oddo B., David; Medina A., Lidia; Acevedo Claros, Francisco NicolásAplicar tres modelos pronósticos “online” (índice pronóstico de Nothingham (NPI), Adjuvantonline! (AO) y PREDICT utilizados en la práctica oncológica para estratificar a pacientes y definir el uso de terapias adyuvantes en pacientes con cáncer de mama (CM) precoz, para evaluar su correlación y predicción de sobrevida en nuestra población. Métodos: Obtuvimos datos clínicos de pacientes con CM invasor T1N0M0, tratados en el Centro de Cáncer de la Pontificia Universidad Católica de Chile, Santiago, Chile, desde enero de 1997 hasta diciembre de 2003. Resultados: Analizamos datos de 125 pacientes. Edad mediana fue 55 años (35-80). La mayoría de los tumores fueron carcinomas ductales infiltrantes (72,8%), receptor de estrógeno (RE) positivos (88,8%), 80% recibieron terapia endocrina (TE). El beneficio estimado de la TE y la quimioterapia (QT) en la sobrevida global (SG), determinadas según AO y PREDICT, no fueron significativamente diferentes (1,3% y 1% para QT, p = 0,13; 0,9% y 1% para TE, p = 0,8; respectivamente). El modelo NPI estimó una mediana de SG superior (96%) a la calculada por AO (90,9%) y PREDICT (92,5%). La mortalidad específica por CM fue de 3%, similar a lo observado (3,2%). La mediana de SG estimada por todos los modelos en el grupo de pacientes fallecidos no fue estadísticamente diferente al grupo de sobrevivientes (p = 0,85). Conclusión: Los modelos pronósticos predicen apropiadamente la SG en pacientes con CM precoz; sin embargo, en esta serie, no discriminaron pacientes de mal pronóstico.