Carlos Manterola D

Cómo interpretar los “Niveles de Evidencia” en los diferentes escenarios clínicos

, pero su desarrollo, como seconoce en la actualidad, se origino con la creacionen 1976 de la Canadian Task Force on PreventiveHealth Care (CTFPHC), quienes fueron los prime-ros en generar y organizar los niveles de evidenciay los grados de recomendacion para pacientesasintomaticos, indicando cuales procedimientos eranlos mas adecuados y cuales debian ser evitados

Estudio de fibras colágenas y elásticas del tejido conjuntivo de pacientes con y sin hernia inguinal primaria

: Patients without hernia had compact collagen tractshomogenously distributed towards the deep dermis. In contrast, patients with hernia had zonesin the dermis with thinner and disaggregated collagen tracts. Connective tissue had a lax aspectin these patients. Collagen fiber density was 52% lower in patients with hernia, compared tosubjects without hernia. No differences in elastic fiber density or distribution was observed be-tween groups.

Productividad y calidad metodológica de artículos clínicos en cirugía oral y maxilofacial en Chile: Período 2001-2012

Productivity and methodological quality of clinical articles in oral and maxillofacial surgery in Chile. Period 2001-2012 Introduction: Until now, there are no reports of quantity and quality of publications in oral and maxillo- facial surgery (OMFS) conducted in Chile, which is why the aim of this study is to determine the productivity and methodological quality (MQ) of OMFS clinical articles in Chile in the period 2001-2012. Material and Methods: Bibliometric study. A systematic search in MEDLINE, Science Citation Index Expanded (Web of Science-ISI) and SciELO was conducted. Only clinical items related to OMFS made by Chilean authors were selected. Journal name, publication year, primary Chilean institution affiliated and specialty area were regis - tered. Those articles related to surgical therapy were evaluated according to Sacketts level of evidence and MINCIR-therapy scale for MQ. Results are presented using descriptive statistics. Results: 68 articles were selected. Growth was observed in the number of publications, from 3 (4.4%) in 2002 to 8 (11.7%) in 2012, showing a peak (13 articles) in 2009. The most productive institution was Universidad de Chile (n = 20). Ma- jority of items are cases of surgical pathology. 91.2% of the articles observed had a type 4 level of evidence. The MQ average of analyzed articles was 9.9 ± 4.0 points, verifying only 4 items of good MQ (18 or more points). Conclusion: OMFS scientific production in Chile has increased during the last decade. However, the amount of articles of good level of evidence is low and MQ is poor.

Cómo interpretar un artículo sobre pruebas diagnósticas

*Recibido el 21 de Enero de 2010 y aceptado para publicacion el 10 de Marzo de 2010.Este estudio ha sido fi nanciado parcialmente por el proyecto DI09-0060 de la Direccion de Investigacion de la Univer-sidad de La Frontera.Correspondencia: Dr. Carlos Manterola D. Casilla 54-D, Temuco, Chile. Fax: 56-45-325761 E-mail: cmantero@ufro.cl

Confiabilidad de la escala MINCIR para valorar calidad metodológica de estudios de terapia

Validation of a scale for assessing methodological quality of therapy studies. Pilot study Introduction: The methodological quality (MQ) is a complex multidimensional concept that assesses multiple items as design, methodology and analysis. There are few tools to assess MQ of studies in the field of therapy and these are also partially validated. The aim of this study is to determine the intra and inter observer reliability of the MINCIR scale for assess MQ of therapy articles. Methods: Study of validation scales. Was calculate sample size considering confidence level of 95%, accuracy of 2 points and standard deviation of 4.95, which gives 21 articles, select by simple random probabilistic sampling with Stata 10.0. Was determined intra and inter observer reliability of the scale and each one of its domains using intraclass correlation coeffi - cient (ICC). Results: The ICC for interobserver reliability was 0.9. The ICC observed for the domains one, two and three was 0.97, 0.88 and 0.64 respectively. The ICC observed for intraobserver reliability was 0.99. The ICC observed for the domains one, two and three were 1; 1 and 0.91 respectively. Conclusion: Interob- server and intraobserver reliability for the MINCIR scale to assess MQ of therapy articles were determined.

Publicaciones de autores chilenos en revistas quirúrgicas durante los últimos diez años

Resumen es: Introduccion: Caracterizar la produccion cienti fi ca personal, institucional o nacional es una necesidad para comprender y mejorar la generacion de cono...

Impacto y visibilidad de la Revista Chilena de Cirugía tras su indización en las bases de datos SciELO e ISI: Análisis bibliométrico

Objetivo: Caracterizar la visibilidad internacional e impacto de la Revista Chilena de Cirugia (RCC) tras su indizacion en las bases SciELO (2006) e ISI (2009). Metodo: Busqueda en la plataforma WOK de Thomson-Reuters de las citaciones ISI de articulos de la RCC en el periodo pre-indizacion (1992-2005), indizacion SciELO (2006-2008), e indizacion ISI (2009-2011). Las variables analizadas fueron: numero total y promedio anual de citas a la RCC, de articulos de la RCC citados y de articulos que citan a la RCC; autores, revistas e instituciones que citaron, asi como su caracter (nacional e internacional), y las citas trienales. Resultados: El promedio anual de citas ISI en el periodo pre-indizacion, SciELO e ISI fue de 16,9; 58,3 y 164,7, respectivamente; mientras que el grado de internacionalizacion de los articulos que originaron las citas a nivel de autores-instituciones/revistas para cada periodo fue de 8,6% / 32,4%; 8,5% / 38,3%; y 25,8% / 33,6%, respectivamente; las citas trienales de cada periodo fueron 3, 12 y 34. Las revistas con mas citas a RCC fueron Rev Med Chile, RCC, World J Surg y Cir Esp, mientras que a nivel de autores-instituciones vemos una concentracion en la Universidad de Chile, Pontificia Universidad Catolica y Universidad de La Frontera. Conclusion: La indizacion de RCC en las bases SciELO e ISI ha traido un incremento en su impacto (citas) y visibilidad internacional, aunque persiste una fuerte citacion endogamica que debe ser resuelta a fin de alcanzar un buen nivel internacional.

Diseño de una escala para evaluar calidad metodológica de estudios de pruebas diagnósticas. Estudio piloto

Construction of a scale to assess methodological quality of diagnostic tests articles Introduction: Despite the methodological quality (MQ) of scientifi c publications is a multidimensional concept diffi cult to understand, their evaluation is essential at the time of making decisions that support our clinical practice. However, in the fi eld of diagnostic tests (DT), which is in a steady and rapid development, there are no valid and reliable instruments to assess MQ. Aim: To report the results of the generation of items and domains of a scale to determine MQ in studies of DT and to determine interobserver reliability of this sca- le. Material and Methods: Construction of a scale to assess MQ of DT articles and pilot study to determine interobserver reliability. Designed scale was applied to 20 DT studies randomly selected. Interobserver relia- bility of the scale and each of the domains that compose it was determined by applying intraclass correlation coeffi cient. Results: The created scale has 9 items grouped into three domains. The ICC observed was 1.0 for the domain 1, 0.90 for the domain 2 and 0.86 for the domain 3. The overall ICC was 0.96. Conclusion: A scale to determine MQ in DT studies was created and it interobserver reliability was determined with a signifi cant level of agreement between observers.

Rol de las características clínicas e histológicas como factores pronósticos para la sobrevida en pacientes con carcinoma de células escamosas de la cavidad oral

Introduccion: El carcinoma de celulas escamosas de la cavidad oral (CCECO) es una patologia cuyo comportamiento es producto de interrelaciones con el huesped, esto es, por el patron de invasion (PI) histopatologica y la respuesta inflamatoria (RI). El objetivo de este estudio es analizar las caracteristicas clinicas e histopatologicas como factores pronostico, en terminos de supervivencia (SV) en pacientes con CCECO. Material y Metodo: Serie de casos. Se incluyeron pacientes diagnosticados en el Hospital Regional de Talca y Hospital Base de Curico entre los anos 1995 y 2006. Se revisaron las fichas clinicas y biopsias de 36 pacientes con CCECO. Se determino el Frente Invasivo Tumoral (FIT), evaluandose los parametros propuestos por el sistema de graduacion de Bryne (PI y RI) y factores de importancia clinica como localizacion topografica de la lesion, edad y genero, relacionandolos con SV mediante curvas de Kaplan-Meier y Log Rank test. Posteriormente, se aplico una regresion de Cox para obtener un analisis multivariado y calculo de RR. Del total de casos del estudio, 15 pacientes fallecieron por CCECO. Resultados: La mayor SV se asocio a un bajo escore de PI y una alta RI respectivamente (RR 1,5). La localizacion topografica de la lesion se relaciono significativamente con la SV, no asi el grupo de edad. Conclusiones: Nuestros resultados sugieren que la ubicacion de la lesion es un factor importante en el pronostico de la enfermedad y que una respuesta inmune/inflamatoria adecuada, expresada en un bajo escore de RI, mejora el pronostico de SV en pacientes con CCECO.

¿Es el absceso hepático de origen h¡datídico un factor de riesgo para el desarrollo de complicaciones postoperatorias en pacientes intervenidos por hidatidosis hepática?

Liver abscess of hydatid origin as a risk factor for postoperative complications in hydatidosis Background: Cyst infection and subsequent abscess formation is considered a complication of hepatic echinococcosis (HE). Aim: To determine whether liver abscess of hydatid origin (LAHO) is a risk factor for the development of postoperative complications (POC) in patients operated by HE. Material and Methods: Prospective cohort study. Patients consecutively operated by HE between 2000 and 2007 were studied. LAHO was considered as exposure and POC as outcome. Results: Fifty two patients with LAHO, aged 50 ± 21 years (52% females) and 126 without LAHO, aged 48 ± 20 years (56% females) were studied. Patients with LAHO had a higher frequency of coexistent cyst lesions and a lower frequency of biliary communications. The frequency of complications was 28.9 and 11.1% among patients with and without LAHO, respectively (p < 0.01, crude risk ratio of 2.6, 95% confidence intervals 1.4-5.0). Logistic regression showed a significant interaction of alkaline phosphatases with risk calculation. The risk ratio, adjusting by this variable, changed to 2.45 (95% confidence intervals 1.3-5.0). Conclusions: LAHO is a risk factor for the development of POC in patients operated by HE.