Examinando por Autor "Becerra Farfán, Álvaro"

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  • Miniatura
    Ítem
    Anatomy of vertebral artery hypoplasia and its relationship with clinical implications: a systematic review and meta-analysis of prevalence
    (Springer, 2024-05-19) Valenzuela Fuenzalida, Juan José; Rojas Navia, Constanza; Quirós Clavero, Amanda; Sanchis Gimeno, Juan; Rodriguez Luengo, Macarena; Nova Baeza, Pablo; Orellana-Donoso, Mathias; Becerra Farfán, Álvaro; Bruna Mejias, Alejandro; Sepúlveda Loyola, Walter; Iwanaga, Joe
    Purpose: The vertebral artery (VA) is a vital branch of the subclavian artery, coursing through the transverse foramina of the cervical vertebrae, and playing a crucial role in irrigating the posterior region of the arterial cerebral circle, also known as the Polygon of Willis. Among the various possible alterations that can affect the VA, vertebral artery hypoplasia (HAV) emerges as a significant variant. This study aims to discern the anatomical features of HAV and its correlation with the clinical conditions of the posterior cerebral circulation. Methods: The databases Medline, Scopus, Web of Science, Google Scholar, CINAHL, and LILACS were searched until January 2024. Two authors independently performed the search, study selection, and data extraction. Methodological quality was evaluated with an assurance tool for anatomical studies (AQUA). Pooled prevalence was estimated using a random effects model. Results: A total of 24 studies met the established selection criteria, with a total of 8847 subjects. In this study, 6 articles were included for the meta-analysis with a total of subjects. The average prevalence of VAH reported in each study was 11% (95% CI 10-12%); the studies had a heterogeneity of 41% based on the funnel plot and a low risk of bias. Conclusion: The prevalence of VAH is low, but in the presence of this condition, the changes are mainly in diameter rather than morphological. If it is present, some clinical safeguards must be taken to avoid complications such as stroke.
  • Miniatura
    Ítem
    Use of ketamine in patients with multifactorial neuropathic pain: a systematic review and meta-analysis
    (MDPI, 2024-09-03) Bruna Mejias, Alejandro; Baeza, Vicente; Gamboa, Javiera; Baez Flores, Belén; San Martin, Jessica; Astorga, Constanza; Leyton, Javiera; Nova Baeza, Pablo; Orellana-Donoso, Mathias; Suazo Santibañez, Alejandra; Becerra Farfán, Álvaro; Oyanedel Amaro, Gustavo; Valenzuela Fuenzalida, Juan José
    Neuropathic pain (NP) is a heterogeneous group of conditions characterized by the experience of a number of sensory disturbances including pain, burning sensations, paroxysms of stabbing pain, dysesthesias, allodynia, and hyperalgesia. The above-mentioned sensations may occur in a specific dermatome area or other delimited region of the body. The objective of this review was to analyze the evidence for ketamine in multifactorial neuropathic pain. The research group systematically searched the databases MEDLINE (via PubMed), EMBASE, SCOPUS, the Cochrane Central Register of Controlled Trials, the Cumulative Index to Nursing and Allied Health Literature (Cinahl), and the Web of Science. The findings of this review show that different forms of low doses of ketamine (LDK) do not present statistically significant changes for any of the scales included. In this study, the total symptom score [standardized mean difference (SMD) = -3.59, confidence interval (CI) = -4.16 to -3.02, and p < 0.00001], neuropathy impairment score (SMD = -1.42, CI = -3.68 to 0.84, and p = 0.22), and neuropathy symptom checklist (SMD = -0.09, CI = -0.15 to -0.02, and p = 0.01) were taken into account. For finality compared to the use of a placebo, the findings suggest that LDK does not exhibit significant differences in terms of pain reduction and functionality. Moreover, no specific dosages are identified to support the use of LDK in the reduction in NP.