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Análisis de la distribución de la mortalidad por cirrosis hepática en las comunas del Área Metropolitana de Santiago, en los períodos 2001-2005 y 2007-2011, bajo el enfoque de Determinantes Sociales de la Salud
(Universidad de Chile, 2023)
El presente trabajo analiza el impacto de las desigualdades sociales en la salud, mediante un análisis evolutivo de la distribución de la mortalidad por cirrosis hepática en el Área Metropolitana de Santiago, entre los períodos comprendidos por los...
This work analyzes the impact of social inequalities on health, through an evolutionary analysis of the distribution of mortality due to liver cirrhosis in the Metropolitan Area of Santiago (AMS, in its Spanish acronym), between the periods from 2001 to 2005 and 2007 to 2011, in addition to address the differences between the population of the thirty-four communes that compose it, measuring the relative risk between them to develop liver cirrhosis, making use of information belonging to the national database of deaths of the Department of Statistics and Health Information of the Ministry of Health (DEIS-MINSAL in its Spanish acronym), as well as various demographic variables and socioeconomic indicators, based on the approaches of Medical Geography and Social Determinants of Health (SDH). Liver cirrhosis belongs to the set of chronic or non-communicable diseases (NCDs), which have gradual and long-term development, and whose cost of treatment is excessively high, progressively and severely affecting the quality of life of patients, mainly elderly people. NCDs originate from multiple causes and are associated with various risk factors, having a strong relationship with social inequality and poverty. They also include neoplasms (cancers), diabetes, as well as coronary and cerebrovascular diseases. The changes at the social, economic, demographic and technological level that took place since the Industrial Revolution gave rise to an epidemiological transition process, which was radicalized as unprecedented advances took place in fields such as medicine and the food industry, from milestones such as the invention of the vaccine, the development of public health infrastructure or the discovery of penicillin; thus, in the twentieth century, the setback and eradication of multiple infectious diseases was reached, increasing life expectancy in much of the countries of the world, where NCDs are positioned as the main causes of death, so which currently kill 41 million people at year worldwide, that being 71% of deaths (WHO, 2018). Chile, currently one of the most unequal countries in the world, follows the previously mentioned global tendency, so that in the results presented in the First Atlas of Mortality in Chile 2001-2008 (Icaza et al., 2013), NCDs are listed as the main causes of death both among men and women. However, in said period, liver cirrhosis, a disease that constitutes the final stage of chronic liver diseases, is one of the main causes of death, something that distinguishes the Chilean reality from that of the rest of the countries that compose the western hemisphere. The results of this work show evident spatial inequalities, associated to historical and social processes, regarding mortality rates and the relative risk of developing liver cirrhosis between the most affluent communities of Greater Santiago (located as a cluster in the north-eastern extreme of the city and the calls affected the cone of high income), and the peripheral communes of Santiago, characterized by having a more disadvantaged state in terms of their socioeconomic indicators, and which are part of a "crescent of higher mortality". The relationship of the development of liver cirrhosis with risk factors linked to diet and daily behaviours affects the present extremely unequal evolutionary rates and trends between different age ranges, as well as between men and women, showing a higher overall mortality among the male population of the 34 municipalities of the Metropolitan Area of Santiago, although with a gradual tendency to decrease; and a much lower level of mortality, but with a sustained increase, among the female population....
This work analyzes the impact of social inequalities on health, through an evolutionary analysis of the distribution of mortality due to liver cirrhosis in the Metropolitan Area of Santiago (AMS, in its Spanish acronym), between the periods from 2001 to 2005 and 2007 to 2011, in addition to address the differences between the population of the thirty-four communes that compose it, measuring the relative risk between them to develop liver cirrhosis, making use of information belonging to the national database of deaths of the Department of Statistics and Health Information of the Ministry of Health (DEIS-MINSAL in its Spanish acronym), as well as various demographic variables and socioeconomic indicators, based on the approaches of Medical Geography and Social Determinants of Health (SDH). Liver cirrhosis belongs to the set of chronic or non-communicable diseases (NCDs), which have gradual and long-term development, and whose cost of treatment is excessively high, progressively and severely affecting the quality of life of patients, mainly elderly people. NCDs originate from multiple causes and are associated with various risk factors, having a strong relationship with social inequality and poverty. They also include neoplasms (cancers), diabetes, as well as coronary and cerebrovascular diseases. The changes at the social, economic, demographic and technological level that took place since the Industrial Revolution gave rise to an epidemiological transition process, which was radicalized as unprecedented advances took place in fields such as medicine and the food industry, from milestones such as the invention of the vaccine, the development of public health infrastructure or the discovery of penicillin; thus, in the twentieth century, the setback and eradication of multiple infectious diseases was reached, increasing life expectancy in much of the countries of the world, where NCDs are positioned as the main causes of death, so which currently kill 41 million people at year worldwide, that being 71% of deaths (WHO, 2018). Chile, currently one of the most unequal countries in the world, follows the previously mentioned global tendency, so that in the results presented in the First Atlas of Mortality in Chile 2001-2008 (Icaza et al., 2013), NCDs are listed as the main causes of death both among men and women. However, in said period, liver cirrhosis, a disease that constitutes the final stage of chronic liver diseases, is one of the main causes of death, something that distinguishes the Chilean reality from that of the rest of the countries that compose the western hemisphere. The results of this work show evident spatial inequalities, associated to historical and social processes, regarding mortality rates and the relative risk of developing liver cirrhosis between the most affluent communities of Greater Santiago (located as a cluster in the north-eastern extreme of the city and the calls affected the cone of high income), and the peripheral communes of Santiago, characterized by having a more disadvantaged state in terms of their socioeconomic indicators, and which are part of a "crescent of higher mortality". The relationship of the development of liver cirrhosis with risk factors linked to diet and daily behaviours affects the present extremely unequal evolutionary rates and trends between different age ranges, as well as between men and women, showing a higher overall mortality among the male population of the 34 municipalities of the Metropolitan Area of Santiago, although with a gradual tendency to decrease; and a much lower level of mortality, but with a sustained increase, among the female population....
Epidemiological profile of liver cirrhosis in Chile 1970-1992 Perfil epidemiológico de la cirrosis hepática en Chile 1970-1992.
(1995)
Epidemiological profile of liver cirrhosis in Chile 1970-1992 Perfil epidemiológico
de la cirrosis hepática en Chile 1970-1992.
Serra,
Araneda,
Decinti,
BACKGROUND: Liver cirrhosis is an important public health...
Morphology of the myenteric plexus of the small intestine in patients with liver cirrhosis Morfologia de los plexos mientericos del intestino delgado en pacientes con cirrosis hepática.
(1993)
Morphology of the myenteric plexus of the small intestine in patients with liver
cirrhosis Morfologia de los plexos mientericos del intestino delgado en
pacientes con cirrosis hepática.
Chesta,
Smok,
BACKGROUND...
Liver cirrhosis in Chile: epidemiologic considerations Cirrosis hepática en Chile: consideraciones epidemiológicas.
(1993)
Liver cirrhosis in Chile: epidemiologic considerations Cirrosis hepática en Chile:
consideraciones epidemiológicas.
Medina,
Kaempffer,
Liver cirrhosis is an important public health problem in Chile, accounting for 5...
Influencia de la funcionalidad familiar en la adherencia al tratamiento de pacientes con cirrosis hepática
(Universidad de Chile, 2023)
La cirrosis es la etapa final del daño hepático crónico y corresponde a un proceso de inflamación, destrucción y regeneración del parénquima hepático que conduce a fibrosis, provocada por diferentes agentes1. Para impedir el avance de la enfermedad...
Cirrhosis is the final stage of chronic liver disease. It’s an inflammatory process of destruction and regeneration of the hepatic parenchyma which in turn leads to fibrosis, and it is caused by different type agents1. To prevent the progression of this disease there are several strategies. Among them is the pharmacological treatment, which can be effective if the patient correctly adheres to it. There are several factors that can affect the adherence of a patient to the treatment. Among them are the amount of family and societal support that he receives during the process of chronic illness. The objective of this study was to determine the degree of adherence to the treatment by patients with chronic liver disease and the relation with the functionality of the family core in patients treated at the Polyclinic Service of Gastroenterology at the Clinical Hospital of the University of Chile. The study had a cross-sectional and analytical design and it consisted of 61 patients with chronic liver disease that were receiving pharmacological treatment for the disease. Sociodemographic and therapeutic data were collected and adherence was assesed using the the Morisky-Green. Family functionality was also analyzed using the Family APGAR test. The sample was composed of 52,5% (32) men and 29% (47,5) women with a median age of 64 (IQR 54 - 69) years. 73,8% (45) of the patients were non-adherent to the treatment, and of this group, 91,1% (41) corresponded to patients with high functionality families. A statistical analysis was performed to examine the relationship between family functionality and treatment adherence. No statistically significant relationship was found (p=0,288). However, a significant relationship was observed between the numer of medications for cirrhosis and treatment adherence (p=0,042). Based on the above, it was concluded that, from a statistical point of view, family functionality did not have a significant influence on treatment adherence....
Cirrhosis is the final stage of chronic liver disease. It’s an inflammatory process of destruction and regeneration of the hepatic parenchyma which in turn leads to fibrosis, and it is caused by different type agents1. To prevent the progression of this disease there are several strategies. Among them is the pharmacological treatment, which can be effective if the patient correctly adheres to it. There are several factors that can affect the adherence of a patient to the treatment. Among them are the amount of family and societal support that he receives during the process of chronic illness. The objective of this study was to determine the degree of adherence to the treatment by patients with chronic liver disease and the relation with the functionality of the family core in patients treated at the Polyclinic Service of Gastroenterology at the Clinical Hospital of the University of Chile. The study had a cross-sectional and analytical design and it consisted of 61 patients with chronic liver disease that were receiving pharmacological treatment for the disease. Sociodemographic and therapeutic data were collected and adherence was assesed using the the Morisky-Green. Family functionality was also analyzed using the Family APGAR test. The sample was composed of 52,5% (32) men and 29% (47,5) women with a median age of 64 (IQR 54 - 69) years. 73,8% (45) of the patients were non-adherent to the treatment, and of this group, 91,1% (41) corresponded to patients with high functionality families. A statistical analysis was performed to examine the relationship between family functionality and treatment adherence. No statistically significant relationship was found (p=0,288). However, a significant relationship was observed between the numer of medications for cirrhosis and treatment adherence (p=0,042). Based on the above, it was concluded that, from a statistical point of view, family functionality did not have a significant influence on treatment adherence....
Mortality trend from liver cirrhosis in Chile from 1990 to 2007 Análisis de la tendencia de la mortalidad por cirrosis hepática en Chile: Años 1990 a 2007
(2010)
Mortality trend from liver cirrhosis in Chile from 1990 to 2007 Análisis de la
tendencia de la mortalidad por cirrosis hepática en Chile: Años 1990 a 2007
Alonso, Faustino Tomás
Garmendia, María Luisa
de Aguirre...
Comparative evaluation of survival prognosis using MELD or child-pugh scores in patients with liver cirrhosis in chile Evaluación comparativa entre MELD y Child-Pugh como escalas pronósticas de sobrevida en pacientes con cirrosis hepática en Chile
(Sociedad Medica de Santiago, 2017)
con cirrosis
hepática en Chile
Sanhueza, Edgar
Contreras, Jorge
Zapata, Rodrigo
Sanhueza, Matías
Elgueta, Fabián
López, Constanza
Jerez, Sigrid
Jerez, Verónica
Delgado, Iris
© 2017, Sociedad Medica de Santiago. All rights reserved.Background: Currently...
Asociación entre la adherencia terapéutica y las complicaciones clínicas en pacientes cirróticos que se atienden de forma ambulatoria en un centro de alta complejidad
(Universidad de Chile, 2022)
, el 31,7% (33) presentaba ascitis, el 12,5% (13) encefalopatía hepática, el 29,8% (31) antecedentes de sangrado de varices esofágicas y el 51,9% (54) presentaba hospitalizaciones previas relacionadas a la cirrosis. Respecto a las pruebas de hipótesis...
Cirrhosis is the final stage of chronic liver damage, which is associated with high morbidity and mortality. The clinical expression of cirrhosis encompasses the appearance of several complications and its treatment includes numerous drugs, which hinders patients' therapeutic adherence, worsening their prognosis and quality of life. The available evidence is insufficient to study the adherence of cirrhotic patients in Chile and its relationship with the complications of the pathology. The aim of this report was to study the association of coexistence between therapeutic adherence, measured with the eight-item Morisky Medication Adherence Scale (MMAS-8) and clinical complications in cirrhotic patients who are treated on an outpatient basis in a high complexity center. The type of study carried out was an analytical cross-sectional study that included a population of 104 cirrhotic patients treated on an outpatient basis at the Hospital Clínico de la Universidad de Chile José Joaquín Aguirre, recruited during the period July - November 2021, to whom a sociodemographic and clinical survey was applied with the aim of characterizing the population. The MMAS-8 scale was used to evaluate adherence and the information collected was complemented with data from the clinical records. Subsequently, statistical analysis was performed using the chi-square (X2) and Fisher's exact test methods, the former to analyze the relationship between ascites and adherence and the latter for the relationship between hepatic encephalopathy and adherence. Finally, in order to identify factors associated with both clinical complications, a logistic regression analysis was performed. The results showed that 76.9% (80) of the participants were nonadherent, that is, on the MMAS-8 scale they had at least 1 question where their response was classified as nonadherent (<8 points). Regarding clinical complications, 31.7% (33) had ascites, 12.5% (13) had hepatic encephalopathy, 29.8% (31) had a history of esophageal variceal bleeding, and 51.9% (54) had previous cirrhosis-related hospitalizations. Regarding hypothesis testing, both the relationship between ascites and adherence and that between hepatic encephalopathy and adherence were not significant. Logistic regression showed that high adherence is a protective factor for both ascites (OR: 0.44 95% CI: [0.11;1.74]) and hepatic encephalopathy (OR: 0.55 95% CI: [0.11;2.75]), without being statistically significant. Furthermore, in the multivariate model for ascites, some associations were found to be statistically significant such as history of hospitalizations (OR: 3.33 95% CI: [1.03;11.07]) and male sex (OR: 4.00 95% CI: [1.24;12.91]) as risk factors. In conclusion, therapeutic adherence measured with the MMAS-8 scale was not associated with ascites and hepatic encephalopathy in this sample, so new studies with other research designs and multicenter studies including a larger number of patients are needed...
Cirrhosis is the final stage of chronic liver damage, which is associated with high morbidity and mortality. The clinical expression of cirrhosis encompasses the appearance of several complications and its treatment includes numerous drugs, which hinders patients' therapeutic adherence, worsening their prognosis and quality of life. The available evidence is insufficient to study the adherence of cirrhotic patients in Chile and its relationship with the complications of the pathology. The aim of this report was to study the association of coexistence between therapeutic adherence, measured with the eight-item Morisky Medication Adherence Scale (MMAS-8) and clinical complications in cirrhotic patients who are treated on an outpatient basis in a high complexity center. The type of study carried out was an analytical cross-sectional study that included a population of 104 cirrhotic patients treated on an outpatient basis at the Hospital Clínico de la Universidad de Chile José Joaquín Aguirre, recruited during the period July - November 2021, to whom a sociodemographic and clinical survey was applied with the aim of characterizing the population. The MMAS-8 scale was used to evaluate adherence and the information collected was complemented with data from the clinical records. Subsequently, statistical analysis was performed using the chi-square (X2) and Fisher's exact test methods, the former to analyze the relationship between ascites and adherence and the latter for the relationship between hepatic encephalopathy and adherence. Finally, in order to identify factors associated with both clinical complications, a logistic regression analysis was performed. The results showed that 76.9% (80) of the participants were nonadherent, that is, on the MMAS-8 scale they had at least 1 question where their response was classified as nonadherent (<8 points). Regarding clinical complications, 31.7% (33) had ascites, 12.5% (13) had hepatic encephalopathy, 29.8% (31) had a history of esophageal variceal bleeding, and 51.9% (54) had previous cirrhosis-related hospitalizations. Regarding hypothesis testing, both the relationship between ascites and adherence and that between hepatic encephalopathy and adherence were not significant. Logistic regression showed that high adherence is a protective factor for both ascites (OR: 0.44 95% CI: [0.11;1.74]) and hepatic encephalopathy (OR: 0.55 95% CI: [0.11;2.75]), without being statistically significant. Furthermore, in the multivariate model for ascites, some associations were found to be statistically significant such as history of hospitalizations (OR: 3.33 95% CI: [1.03;11.07]) and male sex (OR: 4.00 95% CI: [1.24;12.91]) as risk factors. In conclusion, therapeutic adherence measured with the MMAS-8 scale was not associated with ascites and hepatic encephalopathy in this sample, so new studies with other research designs and multicenter studies including a larger number of patients are needed...
Celulitis bacteriemia por pasteurella multocida en una paciente con cirrosis hepática
(Hospital Clínico Universidad de Chile, 2010)
agresividad con que puede desarrollarse el cuadro
clínico.
caso clÍnico
Paciente de sexo femenino de 86 años de edad con
antecedentes de hipotiroidismo en tratamiento y
cirrosis hepática Child-Pugh A de causa no pre-
cisada, en tratamiento con furosemida...
exámenes de ingreso in- dicaron anemia (hematocrito 27%, hemoglobina Celulitis y bacteriemia por Pasteurella multocida en una paciente con cirrosis hepática Alberto Fica C.(1), Thomas Weitzel(1), Wilson Wigant C.(2), Lorena Porte T.(2), Stephanie Braun J...
exámenes de ingreso in- dicaron anemia (hematocrito 27%, hemoglobina Celulitis y bacteriemia por Pasteurella multocida en una paciente con cirrosis hepática Alberto Fica C.(1), Thomas Weitzel(1), Wilson Wigant C.(2), Lorena Porte T.(2), Stephanie Braun J...
Bacteriemia primaria por Listeria monocytogenes en paciente con cirrosis hepática. Caso clínico
(SOC MEDICA SANTIAGO, 2008-02)
paciente con
cirrosis hepática. Caso clínico
Leonardo Chanqueo C1,3, Catalina Gutiérrez Ra,
Rodolfo Armas M2, Gabriela Urriola J3b,
Marisol Bustos M1, Cecilia Tapia P3, Patricia Vásquez T1.
Primary Listeria monocytogenes
infection in a cirrhotic woman...
últimos años existen numerosos reportes de otras manifestaciones sisté- micas de infección por L. monocytogenes especial- mente en pacientes inmunodeprimidos7,8. Comunicamos el caso de una paciente porta- dora de cirrosis hepática y de diabetes mellitus C...
últimos años existen numerosos reportes de otras manifestaciones sisté- micas de infección por L. monocytogenes especial- mente en pacientes inmunodeprimidos7,8. Comunicamos el caso de una paciente porta- dora de cirrosis hepática y de diabetes mellitus C...