Cristian Papuzinski

Universidad de Valparaíso (Chile) | CINV · Interdisciplinary Centre for Health Studies (CIESAL)

Background. Evidence-based information on genetic sensorineural hearing loss in Latin America is limited, hindering the advancement of related clinical practice and the development of relevant healthcare policies in the field. This study describes sociodemographic and clinical characteristics of a group of Chilean participants with congenital, chil...

The pathophysiology of non-pulsatile chronic tinnitus is unclear, but it is recognized a relevant psychological component. In this sense, different psychotherapeutic approaches have been studied. Cognitive behavioral therapy is the psychotherapy with the most evidence. It considers the restructuring of dysfunctional cognitions that favor the presen...

The word placebo has been used interchangeably to refer to a substance or procedure that is “inert” (“placebo”) and the effect that occurs as a consequence of its administration (“placebo effect”). The placebo effect corresponds to a psychobiological phenomenon that has been explained from behaviorism (classical conditioning), from preconscious phe...

Extramedullary plasmacytoma is a rare plasma cell neoplasm, affecting 80% to 90% of the head or neck. This neoplasm represents less than 1% of all malignant head and neck pathology. Given the infrequency of the pathology and the scarcity of published cases, this entity presents great clinical and therapeutic difficulty. Diagnosis is based on histol...

Introducción: El trasplante renal corresponde al tratamiento de elección para la enfermedad renal crónica. No existe un protocolo universalmente aceptado para la evaluación otorrinolaringológica del receptor del riñón a implantar, existiendo una gran heterogeneidad en su práctica. La tomografía computada de cavidades paranasales es uno de los estud...

Epistaxis is one of the most frequent otorhinolaryngological emergencies, and it is estimated that 6% require some type of intervention. Depending on the location of the bleeding site, it may be classified as anterior, posterior or superior. Throughout history, its treatment has remained the same, including nasal compression, head positioning, nasa...

Resumen El envejecimiento del sistema inmune o «inmunosenescencia» afecta a la respuesta inmune viral en el adulto mayor, sobre todo si existe fragilidad. Algunos hallazgos destacan un desbalance en los mecanismos pro- y antiinflamatorios, una menor producción y diversificación de linfocitos T, alteración de la inmunovigilancia y en la síntesis de...

Resumen Introducción La salud basada en evidencia (SBE) integra el uso de la mejor evidencia, la experiencia clínica y los valores y preferencias del paciente para la toma de decisiones. Su incorporación en las carreras sanitarias de Chile es desconocida. Métodos Se realizó un estudio de corte transversal para evaluar la incorporación de SBE en l...

Background Postoperative pain management contributes to reducing postoperative morbidity and unscheduled readmission. Compared to other opioids that manage postopera- tive pain like morphine, few randomized trials have tested the efficacy of intraoper- atively administered methadone to provide evidence for its regular use or be in- cluded in clinic...

Somatoform disorders (SD) make up a group of entities with polymorphic expression, characterized by the relevance of somatic symptoms associated to a significant psychological stress whether or not noticeable, but without a defined structural basis. When the symptomatology is related to the nervous system, they are known as conversion disorders (CD...

The pandemic caused by the novel coronavirus designed SARS-CoV-2 has rapidly spread across the world, challenging all medical teams. Otolaryngologists are at particular risk because of interventions and care of aerodigestive secretions. At this level, tracheostomy it seen as a highly risk procedure involved in COVID-19 infected or suspected patient...

Introduction: Chile has an incipient policy regarding humanized birth practices. Obstetric violence is becoming an issue in the public discussion, as brought up by women. Despite this advancement, no initiatives were observed to overcome the conflict. Questions arise from the different points of view of the main stakeholders involved. These questi...

Appendix 1: Summary of documents included.

Appendix 2: Other actors' expressions.

Introducción. Chile tiene una política incipiente en relación con prácticas de parto humanizado y la violencia obstétrica es una materia de creciente discusión pública levantada por las mujeres. A pesar de este avance, no se han observado iniciativas para superar el conflicto. Surge la pregunta acerca de los diferentes puntos de vista de los princi...

Anexo 1: Síntesis de documentos incluidos.

Anexo 2: Expresión de otros actores.

Anexo 2: Expresión de otros actores.

Resumen Introducción: El cáncer laríngeo es una de las neoplasias de cabeza y cuello más fre-cuentes, asociado al envejecimiento y a los hábitos de vida. Los análisis de supervivencia de cáncer laríngeo en Chile son escasos. Objetivo: Calcular y analizar la supervivencia y las características clínicas del cáncer laríngeo en pacientes del Servicio d...

Introducción: El cáncer laríngeo es una de las neoplasias de cabeza y cuello más frecuentes, asociado al envejecimiento y a los hábitos de vida. Los análisis de supervivencia de cáncer laríngeo en Chile son escasos. Objetivo: Calcular y analizar la supervivencia y las características clínicas del cáncer laríngeo en pacientes del Servicio de Otorri...

Objective The Chilean health system mandates providers to ensure assistance under a guaranteed system, the Explicit Guarantees in Healthcare Program (EGH). The Health Ministry has developed clinical practice guidelines (CPG), but independent assessment of their quality is lacking. Therefore, we assessed all CPG of the EGH. Study Design and Setting...

Gender is a psychosocial construct referring to the socially built roles, behaviors, expressions and identities of girls, women, boys, men and people with gender diversity, while sex is related to the biological attributes of a woman or a man. Even though the terms "sex" and "gender" are often used in a binary way, there is considerable diversity i...

En los estudios experimentales, el investigador aplica una intervención sobre los participantes, por lo que su eje temporal es prospectivo. Estas características permiten probar relaciones causales, pero implican una rigurosa evaluación bioética y una inscripción previa del protocolo de estudio. Entre las investigaciones experimentales se encuentra...

Resumen El género es una construcción psicosocial referida a los roles, comportamientos, ex-presiones e identidades socialmente construidos de niñas, mujeres, niños, hombres y personas con diversidad de género, mientras que el sexo se relaciona con los atributos biológicos de una mujer o un hombre. Aun cuando los términos "sexo" y "género" suelen u...

In experimental studies, researchers apply an intervention to a group of study participants and analyze the effects over a future or "prospective" timeline. The prospective nature of these types of studies allows for the determination of causal relationships , but the interventions they are based on require rigorous bioethical evaluation, approval...

El género es una construcción psicosocial referida a los roles, comportamientos, expresiones e identidades socialmente construidos de niñas, mujeres, niños, hombres y personas con diversidad de género, mientras que el sexo se relaciona con los atributos biológicos de una mujer o un hombre. Aun cuando los términos "sexo" y "género" suelen utilizarse...

Introducción: La laringe de cerdo doméstico tiene similitudes con la laringe humana. La capacidad elástica de las cuerdas vocales del cerdo demuestran tener la mayor similitud con la humana comparado con otros animales por lo que se ha propuesto usar las laringes de cerdo como modelo de entrenamiento quirúrgico. Objetivo: Determinar las diferencia...

Introducción: El uso de condones masculinos permite la prevención de infecciones de transmisión sexual y de embarazo, pero su uso en estudiantes de carreras sanitarias ha sido poco estudiado en Chile. El objetivo del presente estudio es evaluar el uso de condón y caracterizar la actividad sexual y el antecedente de infección de transmisión sexual e...

Cohort studies evaluate the relationship between exposure to a specific event or phenomenon and the occurrence of an associated out-come of interest (or lack thereof). This methodological design has been widely used in certain areas of medicine, such as the study of cardiovascular risk factors and the effects of ionizing radiation in humans. It is...

Los estudios con diseño de cohorte evalúan la relación entre una exposición y la ocurrencia o no de un evento de interés, comenzando el análisis desde la exposición. Habiendo sido diseños muy utilizados en algunas áreas de la medicina, como la descripción de factores de riesgo cardiovascular o los efectos de la radiación ionizante en humanos, repre...

Case-control studies have been essential to the field of epidemiology and in public health research. In this design, data analysis is carried out from the outcome to the exposure, that is, retrospectively, as the association between exposure and outcome is studied between people who present a condition (cases) and those who do not (controls). They...

Los estudios de casos y controles han sido esenciales en el desarrollo de la epidemiología y de la salud pública. En este diseño, el análisis de los datos se realiza desde el desenlace hacia la exposición, es decir, retrospectivamente, ya que se estudia la asociación entre factores de exposición y un desenlace conocido entre personas que ya present...

Resumen Los estudios observacionales analizan las variables de interés en la muestra o en la población, sin intervenir en ellas. Pueden ser meramente descriptivos si se focalizan en la descripción de las variables, o analíticos, en el caso de presentar grupos de comparación para establecer asociaciones mediante la inferencia estadística. Los estudi...

Observational studies evaluate variables of interest in a sample or a population , without intervening in them. They can be descriptive if they focus on the description of variables, or analytical when comparison between groups is made to establish associations through statistical inference. Cross-sectional studies and ecological-also called correl...

Abstract Observational studies evaluate variables of interest in a sample or a population, without intervening in them. They can be descriptive if they focus on the description of variables, or analytical when comparison between groups is made to establish associations through statistical inference. Cross-sectional studies and ecological—also calle...

La investigación biomédica, particularmente la que involucra a seres humanos, está siempre sometida a fuentes de error que deben ser reconocidas. El error sistemático o sesgo, se asocia con debilidades en el diseño metodológico o de la fase de ejecución del estudio. Éste afecta su validez y se valora cualitativamente. Por su parte, el error aleator...

Sebaceous carcinoma is a rare anexal neoplasm that can develop on any part of the body containing sebaceous glands, but nearly the 70% of sebaceous carcinoma occur on the head and neck, being two ways of presentation, ocular and extraocular. It represents 0.2–4.6 % of all malignant neoplastic cutaneous lesions, whit a peak incidence in the eighth d...

Systematic reviews help healthcare professionals, consumers and other stakeholders when making decisions about health issues. Some systematic reviews, however, may not be reliable due to the presence of bias, and ROBIS is a tool designed to identify them. In this research we translated and validated the Spanish version of the instrument, to encoura...

Background : Evidence-based health care (EBH) is the conscientious, explicit, judicious and reasonable use of the best available evidence to make decisions about the care of individual patients, integrating clinical experience, patients' values, and the best available information. Achieving significant learning and skills in EBH practice is a desir...

Background: Critical thinking and research are considered priority domains for medical education and their introduction into the medical curriculum significantly improves learning. The School of Medicine at the University of Valparaíso has offered a competency-based curriculum since 2005, which includes two courses of progressive formation: 'Resear...

Introduction: The decannulation process consist in the evaluation of the upper airways competences which carry the definite extraction of the traqueostomy cannula. The prediction of its success is difficult due to the high number of variables that affect it. In order to reach this goal, is fundamental to count with an adequate protocol of the healt...

Background: Cochrane recommends a specific tool for assessing risk of bias, where the domain called 'other bias' (OB) refers to any potential systematic error not included within the classical bias which may lead to deviations from the truth. Nevertheless, the interpretation of other bias is often vague, no guidelines have been provided. Moreover,...

Laryngeal cancer accounts for 25% of head and neck cancers. For T1 laryngeal carcinomas treated with radiotherapy or laser surgery, there is no significant difference in terms of quality of voice perceived by the patient between both therapeutic forms. The total laryngectomy is still used as the therapeutic alternative in advanced carcinomas. The l...

Purpose Biliary atresia precedes liver cirrhosis and liver transplantation. Amniotic membrane (AM) promotes tissue regeneration, inhibits fibrosis, and reduces inflammation. Here, we test amniotic membrane potential as a therapeutic tool against cholestatic liver fibrosis. Methods Three groups of rats were used: sham surgery (SS), bile duct ligatu...

Critical appraisal of the 86 clinical practice guidelines of the ”explicit guarantees in healthcare” program in Chile, using AGREE-II tool

The non-familial medullary thyroid carcinoma (FNMTC) represents approximately between 3.2 and 9.6% of all thyroid cancers, and is defined by the presence of differentiated thyroid cancer in 2 or more families in the absence of other known familial syndromes or radiation exposure. Although the pathophysiology is still uncertain, some investigators p...

Persistent tracheostoma is the most common late complication associated with the use of tracheostomy. We report three cases in which patients underwent a successful closure of persistent tracheostoma using primary closure in layers with inverted flap technique. The advantages of this method are that it represents a simple alternative and is able to...

Münchausen's syndrome by proxy is a form of child abuse with severe consequences for the affected child. The diagnosis of this condition is a challenge for physicians due to the heterogeneity of the presentation symptoms. A lot of otorhinolaryngological manifestations have been described in this syndrome. We present a case of a 2 year old patient w...

Heterotopic salivary gland tissue is the presence of salivary tissue outside of the salivary glands. It is an uncommon condition but it can be the source of the full spectrum of salivary gland diseases. We present a rare case of pleomorphic adenoma developing from heterotopic salivary gland tissue in an upper neck lymph node not related to the majo...

Sudden deafness is usually a condition of acute unilateral sensorineural hearing loss, installation less than or equal to 72 hours period, which in most cases are idiopathic; however, infectious, autoimmune and vascular causes, have been proposed as key mechanisms involved. Sudden deafness is considered an ENT urgency, however this treatment remain...

Myoepithelial carcinoma is a rare neoplasm, representing about 1% of malignant tumours from salivary glands. Diagnosis is based on morphological and inmunohistochemical features. Vimentin, S-100 protein and calponin are the most frecuent immunohistochemical findings. Treatment is based on surgical removal with free margins, and sometimes, neck diss...

Background: Tracheostomy is the most common surgical procedure in critically ill patients. Within the main indications for tracheostomy highlights prolonged intubation in patients requiring mechanical ventilation. Aim: To determine the complications of patients hospitalized in the Intensive Care Unit (ICU) of the Hospital Carlos Van Buren (HCVB) of...

Introduction: Oral anticoagulant therapy is an essential tool for prevention of thromboembolic events. The drugs most commonly used for this purpose are the vitamin K antagonists, which are monitored through the International Normalized Ratio (INR). Several factors affect the level of anticoagulation. Aim: To identify factors associated with an INR...

Lateral sinus thrombosis (LST) is a potentially life threatening complication of acute otitis media. However, report rates have been decreasing since the spreaded use of antibiotic prescription. Patient developing LST usually complain about fever, headache and ear pain. Consequently, they may develop vomiting, papilledema and unhealthy-ness. Magnet...

Introduction. Obstructive sleep apnea hypopnea syndrome (OSAHS) in children is associated with numerous adverse cognitive and behavioral consequences. The most common risk factor identified for OSAHS is tonsillar enlargement, and primary treatment is adenotonsillectomy. Aim. To compare the efficacy of early adenotonsillectomy versus watchful waitin...

Introduction. Delirium is a common neuropsychiatric syndrome arising among elderly inpatients. It has been associated with increased mortality, cognitive decline and increased healthcare costs. Multicomponent interventions might be useful in preventing incident delirium. Objectives. To assess the available evidence regarding multicomponent interven...

We review the main topics related to loxocelism, both in its cutaneous (CL) and cutaneous-visceral (CVL) presentation. We include entomological data and pathophysiology of the Loxoceles venom; and the treatment nowadays, discussing relevance of antivenom serum and other measures. We present a brief review of local statistical data and a case of CVL...

INTRODUCTION: Constipation is a multifactorial disease and its differential diagnosis covers many pathologies. North American studies show a prevalence of chronic constipation in adults of 15%, but in Chile there isn’t any research about it. OBJETIVES: To determine the prevalence of constipation, its association with chronic disease, the difference...