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F Cumsille

Publications and source records attributed to F Cumsille.

At least 37 records · Page 2Linked to original sources
PubMed1996

[Dichotomization of continuous variables in logistic regression models].

It is highly to observe in the biomedical literature, that the continuous variables such as systolic blood pressure and cholesterol, are dichotomized and used in such manner in a given statistical analysis. The consequences of such transformation can be very varied. In this article, how the dichotomization of a continuous exposure variable affects the quality of the prediction of a response using the logistic regression is examined. One can conclude that, in almost all the studied stimulation, the percentages of misclassification can increase drastically, reaching over there times the probability of misclassification of the ones using the original variable. Therefore, we recommend to avoid dichotomization.

Logistic Models↗
PubMed1996

[Assessment of the use of statistical methods in health research].

BACKGROUND: Computer use has lead to a great development of statistical methods. AIM: To assess the use of statistical methods in Chilean medical literature. METHODS: Two hundred sixty four papers appeared in Revista Médica de Chile and Revista Chilena de Pediatría between 1983 and 1993 were reviewed. RESULTS: Student's "t", Fisher's, and chi 2 test are the most frequently used statistical methods in 67% of papers. Correlation coefficients are used in 10% of papers. Multivariate methods are seldom used. CONCLUSIONS: Statistical analysis of papers published in Chilean medical journals is restricted to very few methods.

Chile↗
PubMed1996

[Prognostic value of noninvasive makers of coronary reperfusion in patients with acute myocardial infarction treated with thrombolysis].

BACKGROUND: The immediate prognosis of patients with acute myocardial infarction treated with thrombolysis primarily depends on obtaining a satisfactory coronary reperfusion. AIM: To assess the prognostic power of four markers of coronary artery patency in patients with acute myocardial infarction treated with Streptokinase 1.5 million U within the first six hours of symptoms. PATIENTS AND METHODS: In 807 consecutive patients from the Chilean National Registry of Acute Myocardial Infarction we analyzed the resolution of chest pain and ST segment elevation over 50% within the first 90 min, abrupt CK rise within 8 h and T wave inversion in infarct related EKG leads within the first 24 h after thrombolysis. RESULTS: Global in-hospital mortality was 12.1%. Mortality of patients with the presence of 3 or 4 markers of coronary artery patency was 5.1%, in those with resolution of ST elevation and abrupt CK rise was 6.25% and in those with T wave inversion it was 3.9% (p < 0.001). Multivariate analysis, adjusted by age, gender, risk factors, Killip class and infarct location showed that early T wave inversion was the better predictor of a low in-hospital mortality and that its combination with other markers of coronary artery patency did not increase its prognostic power. Early CK rise and the presence of 3 out of 4 reperfusion criteria were also independent predictors of a low mortality. CONCLUSIONS: Non invasive markers of coronary artery patency are associated with a lower in-hospital mortality and may serve as surrogate end points in clinical trials.

Female↗
PubMed1993

[Changes in ethical attitudes during medical studies].

The aim of this work was to explore the attitude changes towards ethico-medical issues in medical students as they went through medical school. A personal standardized questionnaire containing 14 closed and direct questions was applied to 27 freshmen, 38 interns and 14 post graduates. The most outstanding differences in ethical attitudes occurred between first year students and the older groups. The younger students adhered to ethical principles, valued justice towards patients and moral integrity in physicians. The older students and post graduates emphasized the professional role of physicians and preferred institutional ethical regulations over public control. They also considered more valuable therapeutic efficiency and paternal attitudes towards patients as well as social prestige and economical rewards. We conclude that there is a progressive erosion of humanistic principles along the medical studies, that are substituted by a model of professional competence, social recognition and internal ethical control.

Attitude of Health Personnel↗
PubMed1991

[Morbidity and mortality of essential arterial hypertension treated in Chile: a 15 years' follow-up study].

In order to establish morbidity and mortality in treated patients with essential hypertension, a prospective study was started in 1974. 714 patients were followed for 15 years. Admission criteria included diastolic blood pressure over 95 mmHg during one month on placebo, absence of malignant or accelerated hypertension and no recent (6 month) cardiovascular complication. According to target organ damage, 51% of patients were in WHO stage I, 35% in stage II and 14% in stage III. There were 342 males and 372 females, with mean age 58.7 +/- 9.8 years. Mean initial blood pressure was 181/110 +/- 12/8.9 mmHg. Treatment schedules included diuretics alone (23%), beta blockers alone (32%), diuretic and betablocker (38%), combined therapy with vasodilators (9%) and other forms of therapy (5%). 75 subjects failed to comply with therapy but were maintained in the analysis (intention to treat). A significant reduction in blood pressure was observed in the group as a whole (154/93 +/- 7/9 mmHg). Sustained normalization of BP (< 90 mmHg) was obtained in 40.2% of patients, reductions to between 91 and 100 mmHg in 37.2% and reductions to over 101 mmHg in 22.5% 47 patients died from cerebro vascular complications (15-year cumulative death rate of 12.3%). Total morbidity rate was 40.1% (232 events) with 61 coronary events (13.3%), 43 cerebrovascular events (8.7%), 30 cases of heart failure (12.9%) and 21 cases of renal failure (4.3%). These figures are in agreement with internationally reported ones with the exception of coronary morbidity which appears lower in this study.

Adult↗
PubMed1990

Relationship between small intestinal fasting motility and vomiting in dogs.

Preceding vomiting, several changes in small intestinal motility have been described. They consist mainly of high-amplitude retrograde contractions and inhibition of motility before and after these contractions. The recordings of 94 episodes of emesis occurring spontaneously, during manometric studies of intestinal motility by means of infused catheters in dogs with gastric and duodenal cannulae, showed that 95.7% of all episodes developed during phase II of the migratory motor complex. In order to establish whether different phases of the fasting cyclic activity are associated with a different sensitivity to emetic stimulus, two agents, apomorphine, a centrally acting drug and copper sulfate, a peripherally acting agent, were administered at the beginning of phases I and II of the migratory motor complex. Coincident with spontaneously occurring vomiting, a statistically significative greater number of responses to both emetic agents was observed during phase II as compared to phase I. This finding suggests that cyclic changes of the small bowel motility are related to changes in the threshold of the vomiting center.

Animals↗
PubMed1990

[Paratyphoid B fever in 2 areas of Santiago. An analysis of the epidemiological significance].

Salmonella isolates from 3920 patients with typhoid fever from 2 areas in Santiago were analyzed to determine the frequency of association with S paratyphi B infection. This was demonstrated in 18.8% of subjects in both areas, a figure significantly higher than the 8-10% previously reported. The association with S paratyphi B was higher for females, especially for the younger age group. These findings suggest an infectious agent-gender-age interaction which may explain the discrepancy with previously reported rates of infection. Their possible relation to the chronic salmonella carrier state and association with biliary tract lithiasis and cancer is discussed.

Adolescent↗
PubMed1990

[Nontraumatic deaths associated with a natural catastrophe. The experience of the earthquake in Chile 1985].

We analyzed causes of death before and after the March 1985 earthquake in Valparaíso, Chile. Causes of death were obtained from death certificates. Apart from death directly due to trauma during the earthquake, a significant increase was observed in deaths due to accidents (+51), cardiovascular disease (+38), malnutrition (+13) and psychiatric disorders (+13). Retired males over age 65 were most affected.

Adolescent↗
PubMed1989

[Prostitutes of the east sector of Santiago: characteristics and pathology of sexual transmission].

We studied the frequency of venereal disease in 329 prostitutes working at massage parlours in Santiago. The mean age was 24 years and half of them had high school or university studies. In spite of frequent sexual contacts averaging 2.8 per day, the prevalence of significant venereal disease was not high in this group. Notably, AIDS infection was not detected. Vaginitis due to Trichomonas or Candida infection was the commonest problem and this was half as frequent among gum preservative users. Marital condition, age, obstetrical history and other variables were not related to genital infection.

Adult↗
PubMed1989

[Medical care in 12 Chilean cities].

Frequency of diseases and accidents and the main aspects of medical care were studied in 12 larger Chilean cities, excluding the metropolitan area of Santiago. A survey of 4,737 individuals was performed in a random sample of homes and medical problems observed during a 2 week period were analyzed. A mean of 4.17 disease episodes per person-year was registered, 47% of them receiving medical care. This rate was higher for acute conditions (69%) than for chronic diseases (32%). The sum of consults for disease and health controls gave a total assistance of 3.42 per person-year. 70% of visits took place in outpatient hospital clinics and 30% in private practice facilities. Two thirds of the visits were done in National Health Service's outpatient clinics. The quality of medical care was rated by patients as good or very good in 81% of cases, fair in 13% and deficient in 6%. Main reasons given by patients for not seeking medical care (31% in acute episodes and 68% in chronic patients) were the short course of disease in acute conditions or a feeling that control was not needed in chronic diseases. Problems linked to the medical care system, including financial reasons, explained lack of care in 28% of cases. The medical care situation in these 12 larger cities is similar to that observed in Santiago, using the same type of survey.

Accidents↗
PubMed1985

Influence of vertical dimension on masseter muscle electromyographic activity in patients with mandibular dysfunction.

Occlusal splints were adjusted to different vertical heights and used to single out the influence of vertical dimension of occlusion in increments on BT-EMG activity of the masseter muscle in patients with mandibular dysfunction. The vertical dimension of least EMG activity was determined for each of 60 patients, who were randomly divided into three groups according to the vertical dimension at which the occlusal splint was adjusted: group No. 1, 1 mm from occlusal vertical dimension; group No. 2, mean vertical dimension, 4.25 mm; group No. 3, mean vertical dimension, 8.25 mm. Results showed a significant reduction of masseter BT-EMG activity (series A and B) at the end of the 3-week treatment period for patients in group Nos. 2 and 3 in comparison with group No. 1. Furthermore, the short-term use of occlusal splints with a vertical height that exceeded the so-called physiologic interocclusal distance did not result in an increase in masseter BT-EMG activity. This study suggests that an increase of vertical dimension of occlusion to or near the vertical dimension of least EMG activity by means of occlusal splints can be an effective way to obtain a reduction in masseteric muscle activity.

Adolescent↗