Examinando por Autor "Oyanedel-Amaro, Gustavo"

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    Anatomical variants in pancreatic irrigation and their clinical considerations for the pancreatic approach and surrounding structures: a systematic review with meta-analysis
    (MDPI, 2025-02-19) Valenzuela Fuenzalida, Juan José; Núñez-Castro, Camila Ignacia; Morán-Durán, Valeria Belén; Nova-Baeza, Pablo; Orellana-Donoso, Mathias; Suazo Santibañez, Alejandra; Becerra-Farfan, Alvaro; Oyanedel-Amaro, Gustavo; Bruna-Mejías, Alejandro; Granite, Guinevere; Casanova-Martinez, Daniel; Sanchis-Gimeno, Juan
    Background and Objectives: The pancreas receives blood through a complex network of multiple branches, primarily originating from the celiac trunk (CeT) and the superior mesenteric artery (SMA). This blood supply is structured into three main arterial groups, each serving different regions of the pancreas to effectively support its endocrine and exocrine functions. Materials and Methods: The databases Medline, Scopus, Web of Science, Google Scholar, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Latin American and the Caribbean Literature in Health Sciences (LILACS) were searched until January 2025. Methodological quality was evaluated using an assurance tool for anatomical studies (AQUA). Pooled prevalence was estimated using a random effects model. Results: A total of sixteen studies met the established selection criteria in this study for meta-analysis. Pancreatic irrigation variants presented a prevalence of 11.2% (CI: 7–14%) and a heterogeneity of 88.2%. The other studies were analyzed by subgroups, showing statistically significant differences in the following subgroups: (1) sample type—a larger sample of images analyzed in the included studies (p = 0.312), which did not show statistically significant differences; (2) geographical region (p = 0.041), which showed a greater presence in the Asian population studied, and this was statistically significant; and (3) sex (male or female) (p = 0.12), where there were no statistically significant differences. Conclusions: The discovery of variations in pancreatic irrigation is common due to the numerous blood vessels involved in supplying this vital organ. Understanding different vascular patterns (such as those from the splenic and mesenteric arteries) is crucial for surgical interventions on the pancreas. For transplant patients, a thorough vascular analysis of both the donor and recipient is essential. Variations can impact blood flow and compatibility, potentially leading to transplant rejection if not addressed. To enhance outcomes, it is recommended to develop more accurate imaging tools for pre-surgical analysis, necessitating ongoing research in this area.
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    Clinical Characteristics of Neuropathic Pain and Its Relationship with Cancer in Different Corporal Areas—A Systematic Review
    (MDPI, 2025-01-06) Danés-López, Fernanda; Diaz-Palominos, Cristóbal; Ortiz Domínguez, Anggie; Silva Rodriguez, Alanna; Astorga, Constanza; Martínez-Hernández, Daniela; Valenzuela Fuenzalida, Juan José; Sanchis-Gimeno, Juan; Nova-Baeza, Pablo; Suazo Santibañez, Alejandra; Oyanedel-Amaro, Gustavo; Orellana-Donoso, Mathias; Gutiérrez Espinoza, Héctor
    Neuropathic pain (NP) and cancer are caused by nerve damage due to cancer or treatments such as chemotherapy, radiotherapy, and surgery, with a prevalence that can reach up to 40%. Causes of neuropathic cancer pain (NCP) include direct nerve invasion or compression by the tumor, as well as neural toxicity associated with treatments. This type of pain is classified into several categories, such as plexopathy, radiculopathy, and peripheral neuropathies. Methods: Medline, Web of Science, Google Scholar, CINAHL, and LILACS databases were searched until October 2024. Two authors independently performed the search, study selection, and data extraction. Methodological quality was analyzed using the Robins-I tool. Results: The main findings of this review indicate that, depending on the cancer type, neuropathic pain will exhibit different characteristics, as well as identifying which types of cancer have a higher probability of presenting neuropathic pain. Additionally, there is a direct relationship whereby the more advanced the cancer, the greater the likelihood of experiencing neuropathic pain. Finally, although chemotherapy is employed as a cancer treatment, this therapy is quite invasive, and one of its adverse effects is that treated patients have a higher probability of developing neuropathic pain. Conclusions: Neuropathic pain is a condition that adversely affects patients with cancer. A detailed understanding of the relationships and triggers that produce this condition is present in only a small percentage of patients with cancer and is necessary to provide better treatment and gain a more comprehensive understanding of the characteristics of neuropathic pain. The objective of this study is to describe the relationship between different types of cancer or various treatments and the presence of NP.
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    Comparison of the Mediterranean Diet and Other Therapeutic Strategies in Metabolic Syndrome: A Systematic Review and Meta-Analysis
    (MDPI, 2025-06-19) Bruna-Mejías, Alejandro; San Martin, Jessica; Arciniegas-Diaz, Danna; Meneses-Caroca, Trinidad; Salamanca-Cerda, Amelia; Beas-Gambi, Antonia; Loaiza-Giraldo, Jessica Paola; Ortiz-Ahumada, Cynthia; Nova-Baeza, Pablo; Oyanedel-Amaro, Gustavo; Orellana-Donoso, Mathias; Suazo Santibañez, Alejandra; Sanchis-Gimeno, Juan; Valenzuela Fuenzalida, Juan José
    The Mediterranean diet (MD) is one of the healthiest diets, high in fiber, antioxidants, and unsaturated fats. MD improves lipid profiles, reduces inflammation, controls blood pressure, decreases insulin resistance, and enhances the sensitivity to this hormone, lowering the risks of Metabolic syndrome (MS). MS is characterized by central obesity, hypertension, insulin resistance, and dyslipidemia, increasing the risk of cardiovascular disease and type II diabetes. The objective of this study was to know the effectiveness of the MD versus other treatments in patients with MS. A systematic search across multiple databases, Medline, Embase, Web of Science, Scopus, Google Scholar, and Cinahl, was conducted using keywords such as “Mediterranean diet”, “Mediterranean food”, “eat mediterranean”, “Metabolic syndrome”, and “x syndrome”. A total of 12 studies met the inclusion criteria. Mediterranean diet at different doses versus other diets or other treatments showed significant improvements in clinical parameters, including BMI (mean difference of −0.83 95% CI: −0.93 to −0.74; p < 0.00001),waist circumference (mean difference = −1.81, CI = −2.63 to −0.99, p < 0.00001) triglycerides (mean difference = −22.38, CI = −32.86 to −11.90, p < 0.00001), Glucose (mean difference = −4.28, CI = −7.64 to −0.93, p = 0.005) and, HOMA IR (mean difference = −0.72, CI = −0.78 to −0.65, p < 0.00001), and Insulin resistance (mean difference = −2.98, CI = −3.27 to −2.69, p < 0.00001), all of which improved, Although there were more outcomes, these are the most important changes for patients with metabolic syndrome. MD improves metabolic and cardiovascular health, but study heterogeneity limits the results’ generalizability. Because of that, further research is needed to standardize approaches and explore their mechanisms. MD should be part of an optimized strategy that includes education and physical activity. The strength of the evidence was very low according to the GRADE approach. Further research is needed to support the efficacy of the Mediterranean diet in patients with MS.
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    Effectiveness of Vitamin D Supplementation on Biochemical, Clinical, and Inflammatory Parameters in Patients with Different Types of Diabetes: A Systematic Review and Meta-Analysis
    (MDPI, 2025-09-18) Bruna-Mejías, Alejandro; Valdivia-Arroyo, Rocío; Becerra-Rodríguez, Emelyn Sofía; Clasing-Cárdenas, Ignacio; Castaño-Gallego, Yesica Tatiana; Granite, Guinevere; Orellana-Donoso, Mathias; Oyanedel-Amaro, Gustavo; Nova-Baeza, Pablo; Cifuentes-Suazo, Gloria; Suazo Santibañez, Alejandra; Sanchis-Gimeno, Juan; Gutiérrez Espinoza, Héctor; Valenzuela Fuenzalida, Juan José
    Background and Aims: Numerous clinical and observational studies have examined the role of vitamin D in glycemic control and metabolic regulation among diabetic patients, but findings remain inconsistent. This meta-analysis aimed to assess the effects of vitamin D supplementation on glycosylated hemoglobin (HbA1c%), HOMA-IR, HOMA-β, LDL cholesterol, total cholesterol, triglycerides, fasting insulin, fasting plasma glucose, C-reactive protein, and the likelihood of reversion to normoglycemia in prediabetic individuals. Methods: A comprehensive search of multiple databases was performed using keywords including “diabetes mellitus,” “type 2 diabetes,” “vitamin D supplementation,” and “VD supplementation.” Twenty studies met the inclusion criteria. Results: Vitamin D supplementation was associated with significant improvements across several parameters, including HOMA-β (SMD = 0.71; 95% CI: 0.63–0.80; p < 0.00001), HDL cholesterol (SMD = 0.07; 95% CI: 0.05–0.09; p < 0.00001), and others (SMD = −0.40; 95% CI: −0.45 to −0.34; p < 0.00001). Conclusions: Vitamin D supplementation appears to provide beneficial effects on glycemic, lipid, and inflammatory markers in patients with diabetes and prediabetes. Specifically, supplementation significantly reduced HbA1c%, HOMA-IR, LDL cholesterol, total cholesterol, triglycerides, fasting insulin, fasting glucose, and C-reactive protein while increasing the rate of normoglycemia among prediabetic individuals. Further research is needed to strengthen the evidence base regarding vitamin D’s role in diabetes management.
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    The Effect of Diabetes Mellitus on Central Corneal Thickness Values: A Systematic Review and Meta-Analysis
    (MDPI, 2025-09-06) Uzunoglu, Arda; Valenzuela Fuenzalida, Juan José; Morales-Calderón, Karin; Aguilar-Aguirre, Isidora; Bruna-Mejías, Alejandro; Nova-Baeza, Pablo; Orellana-Donoso, Mathias; Oyanedel-Amaro, Gustavo; Suazo Santibañez, Alejandra; Sanchis-Gimeno, Juan A.; León Rojas, Jose E.; Granite, Guinevere
    Diabetes mellitus (DM) is a chronic metabolic disorder that can induce systemic and ocular complications. Among the latter, an increase in central corneal thickness (CCT) has been reported, potentially affecting endothelial function and increasing the risk of ocular disease. This study aimed to determine the impact of DM on CCT and to assess its correlation with diabetes duration and glycosylated hemoglobin (HbA1c) levels. A systematic literature search was conducted in Web of Science (1980–2025) following a PICO-based strategy. Observational studies evaluating CCT in diabetic patients were included. Data were analyzed using a random-effects model. Statistical heterogeneity was assessed with χ2 test, p values, and I2 index. Publication bias was evaluated using Begg’s funnel plot and Egger’s regression test. Twenty-nine studies were included in the meta-analysis. Diabetic patients showed significantly higher CCT values compared to controls, particularly in those with long-standing DM (p < 0.001) and poor glycemic control (HbA1c, p < 0.001). Egger’s regression suggested an association between increasing CCT, disease duration, and HbA1c levels, while funnel plot asymmetry indicated potential publication bias. CCT appears to increase in patients with long-term DM and inadequate glycemic control. These findings highlight the relevance of CCT assessment as a potential indicator of corneal changes in diabetic patients.
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    The Gastric Vein Variants: An Evidence-Based Systematic Review of Prevalence and Clinical Considerations
    (MDPI, 2025-05-22) Bruna-Mejías, Alejandro; Salgado-Torres, Cristian; Cáceres-Gálvez, Constanza; Rodriguez-Osorio, Benjamin; Orellana-Donoso, Mathias; Nova-Baeza, Pablo; Suazo Santibañez, Alejandra; Oyanedel-Amaro, Gustavo; Sanchis-Gimeno, Juan; Piagkou, Maria; Triantafyllou, George; Konschake, Marko; Valenzuela Fuenzalida, Juan José
    The objective of the present systematic study was to analyze and characterize the gastric vein (GV) variations to understand their significance within clinical contexts, particularly in gastric and liver surgeries and managing conditions associated with the portal vein system. Methods: We conducted a systematic review, examining various databases, including Medline, Scopus, Web of Science, Google Scholar, CINAHL, and EMBASE, up to April 2025. Two independent authors conducted the literature search, selected pertinent studies, and extracted relevant data. The methodological quality of the studies was evaluated utilizing the Assessment Tool for Anatomical Studies (AQUA). The pooled prevalence was estimated through the application of a random effects model. Results: Among the 279 articles reviewed, 11 studies were ultimately incorporated into the systematic analysis, encompassing 47,993 subjects. The pooled prevalence of GV variants was determined to be 8.32%, revealing considerable heterogeneity (I2 = 98.92%). A subgroup analysis showed a greater prevalence of GV variants in diagnostic imaging studies than in cadaveric studies, with a higher frequency observed in males than in females. Conclusions: The morphological variability of the GVs holds clinical significance, as it may significantly impact the management of abdominal disorders, particularly during surgical and endovascular interventions. This study emphasizes the necessity of thorough preoperative evaluations to identify these variations, thereby minimizing surgical complications and enhancing therapeutic outcomes for patients suffering from gastric and portal vein system disorders. Integrating advanced imaging techniques into clinical practice may facilitate improved surgical and therapeutic planning.