Manuel Quiroz Flores

All Publications

• Harnessing the Power of ChatGPT in Cardiovascular Medicine: Innovations, Challenges, and Future Directions. Journal of clinical medicine Leon, M., Ruaengsri, C., Pelletier, G., Bethencourt, D., Shibata, M., Flores, M. Q., Shudo, Y. 2024; 13 (21)

  Abstract

  Cardiovascular diseases remain the leading cause of morbidity and mortality globally, posing significant challenges to public health. The rapid evolution of artificial intelligence (AI), particularly with large language models such as ChatGPT, has introduced transformative possibilities in cardiovascular medicine. This review examines ChatGPT's broad applications in enhancing clinical decision-making-covering symptom analysis, risk assessment, and differential diagnosis; advancing medical education for both healthcare professionals and patients; and supporting research and academic communication. Key challenges associated with ChatGPT, including potential inaccuracies, ethical considerations, data privacy concerns, and inherent biases, are discussed. Future directions emphasize improving training data quality, developing specialized models, refining AI technology, and establishing regulatory frameworks to enhance ChatGPT's clinical utility and mitigate associated risks. As cardiovascular medicine embraces AI, ChatGPT stands out as a powerful tool with substantial potential to improve therapeutic outcomes, elevate care quality, and advance research innovation. Fully understanding and harnessing this potential is essential for the future of cardiovascular health.

  View details for DOI 10.3390/jcm13216543

  View details for PubMedID 39518681

• [Social Security Profile of Cardiovascular Surgical Treated Patients of a Public Hospital in the Macro-Northern Zone, Analysis of a Decade]. Revista medica de Chile Peña J, R., Rivano G, P., Quiroz F, O., Quiroz F, S., Gómez R, A., Martín C, A. S., Cofré U, D., Quiroz F, M., Flores R, V. 2024; 152 (4): 444-453

  Abstract

  Cardiovascular pathology is the leading cause of death in Chile, with an inverse relationship between socioeconomic status and morbidity/ mortality. Currently, there is a lack of information regarding the Macro North Zone of Chile. Our aim is to describe the profile of patients undergoing interventions in a public hospital over a decade.An observational ecological study was conducted on patients who underwent interventions from 2012 to 2022. Data were obtained through standardized searches using FONASA codes, including "major" cardiovascular interventions. "Minor" interventions and patients operated on in other centers were excluded. Data collection took place between 2021 and 2023. A database was created and analyzed using descriptive statistics, considering variables such as age range, health insurance, and the number of patients treated per year.A total of N= 9.075 records were obtained, with 8.908 corresponding to FONASA. The age ranges with the highest number of interventions were 18-60 years (49,8%) and over 60 years (49,6%). Since 2017, more than 50% of interventions have been in individuals over 60 years old. Annual interventions presented an increase in the percentage variation by 117%. Regarding interventions based on health insurance, tier B accounted for 46,7% (4.335) and tier A for 24,2% (2.194). We observed an increase in tier A by 24%.We found that patients are older and belong to lower-income tiers. Additionally, there is a migration towards tier A in recent years and an increase in interventions.

  View details for DOI 10.4067/s0034-98872024000400444

  View details for PubMedID 39450812

• Comparative Outcomes of Minimally Invasive Versus Open Pancreatoduodenectomy in Distal Cholangiocarcinoma: A Systematic Review and Meta-Analysis. Cureus Domene, S., Quiroz Flores, M., Fulginiti, D., Thomas Garcia, K. D., Abera Woldehana, N., Nunez Jimenez, K. M., Lagos Herrarte, V. M., Guevara Benavides, J. A., Alegría Perdomo, C. R., Estrella-Gaibor, C., Arruarana, V. S., Martinez Ramirez, M. 2024; 16 (4): e59404

  Abstract

  Pancreatoduodenectomy, the primary surgical strategy for managing cholangiocarcinoma, is executed via two distinct methodologies, namely minimally invasive pancreatoduodenectomy (MIPD) and open pancreatoduodenectomy (OPD). The selection between these surgical options is critical, as it directly influences patient outcomes, encompassing both short-term recovery metrics and long-term survival rates. Despite the clinical significance of these procedures, there exists a notable void in the literature regarding a comprehensive comparison of MIPD and OPD, particularly in assessing their respective efficacies and complications. This lack of detailed comparative analysis has left a gap in evidence-based guidance for clinicians faced with the decision of choosing the most appropriate surgical approach for their patients. The absence of robust data comparing the two techniques underscores the necessity for a meta-analysis that rigorously examines and contrasts the outcomes associated with MIPD and OPD. By drawing upon a wide array of international studies, this research aims to shed light on the advantages and potential drawbacks of each method, thereby providing a more informed basis for surgical decision-making in the treatment of cholangiocarcinoma.

  View details for DOI 10.7759/cureus.59404

  View details for PubMedID 38817514

  View details for PubMedCentralID PMC11139538

• [Cardiac myxomas. Analysis of 78 cases]. Revista medica de Chile Merello, L., Elton, V., González, D., Elgueta, F., Salazar, R., Quiroz, M., Pedemonte, O., Aranguiz, E. 2020; 148 (1): 78-82

  Abstract

  The incidence rates of cardiac tumors are low.To report the clinical presentation of cardiac myxomas and long-term evolution after resection.Review of a database of surgical patients undergoing surgical resection of a cardiac myxoma in a public hospital between 1990 and 2018.Seventy-eight patients aged 53 ± 15 years (65% females) were included. The most frequent comorbidities were arterial hypertension (40.5%), hypothyroidism (15%) and diabetes mellitus (12%). The main presenting symptoms were dyspnea (33%), neurological deficit secondary to embolism (30%) and acute pulmonary edema (5%). The most common location was the left atrium, in 87%. During surgery, cardiopulmonary bypass and aortic cross-clamp times were 50.2 ± 19.6 and 33.4 ± 15.2 min, respectively. One patient died due to severe neurological involvement. Follow-up was completed in seventy-seven patients, with a mean echocardiographic follow-up time of 10.4 ± 7.7 years. Thirty-four patients were followed for more than 10 years. Six patients (7.7%) died during the follow-up and in six patients (7%) a recurrence was identified.Cardiac myxoma usually has nonspecific symptoms. Surgical excision offers excellent short and long-term results. Complications and recurrence rates are low in non-hereditary myxomas but obligates to perform echocardiographic follow-up for early diagnosis of recurrence.

  View details for DOI 10.4067/S0034-98872020000100078

  View details for PubMedID 32730439

• [Hospital mortality and long-term survival of 103 patients with infective endocarditis requiring surgery]. Revista medica de Chile Merello, L., Salazar M, R., Elgueta G, F., González, D., Elton, V., Quiroz, M., Pedemonte, O., Aránguiz-Santander, E. 2019; 147 (12): 1535-1542

  Abstract

  Background Infective endocarditis (IE) is a serious disease with high mortality, especially among the most severe cases undergoing surgery. Aim To analyze the clinical features, perioperative mortality and long-term survival of patients with infective endocarditis requiring surgery. Material and Methods Review of medical records of patients who underwent heart valve surgery for active infective endocarditis in a public hospital between 1995 and 2008. Demographic characteristics and comorbidities were described. Perioperative and 10 year survival were analyzed retrieving death certificates from the Chilean Identification Service. Results Data from 103 patients aged 46 ± 14 years (74% males) was analyzed. Thirty five percent of patients had an underlying predisposing heart condition such as congenital heart disease in 18.5% and prosthetic valves in 10%. The most common location was the aortic valve and the most common surgical procedure was heart valve replacement with a mechanical prosthetic valve in 87% of the cases. Pathogen identification in blood cultures was achieved in 48% of the cases. The most common causative microorganisms were S. aureus in 12%, coagulase-negative Staphylococcus in 11%, S. viridans in 10% and Enterococcus in 7%. Hospital mortality was 20.4% and ten-year survival was 65%. Conclusions Patients with severe IE requiring surgical treatment still have high perioperative and late mortality.

  View details for DOI 10.4067/S0034-98872019001201535

  View details for PubMedID 32186617

• [Arteria coronaria única y cardiopatía coronaria: origen anómalo de la arteria coronaria derecha desde la descendente anterior. Casos clínicosAnomalous origin of the right coronary artery in the middle third of the anterior descending artery. Report of two cases]. Revista medica de Chile Quiroz, M., Aninat, M. 2019; 147 (12): 1626-1629

  Abstract

  The anomalous origin of the coronary arteries is uncommon and the origin of the right coronary artery from the middle third of the anterior descending artery is a finding of extreme rarity. We report two patients with coronary atherosclerotic disease and with an acute coronary syndrome, in whom a single left coronary artery was found. The clinical and angiographic characteristics and the treatment of these patients are described.

  View details for DOI 10.4067/S0034-98872019001201626

  View details for PubMedID 32186627

• [Lung epithelioid hemangioendothelioma: Report of one case]. Revista medica de Chile Quiroz, M., Undurraga, Á., Moya, R., Fernández, C., Bezares, K., Linacre, V. 2017; 145 (5): 662-666

  Abstract

  Epithelioid hemangioendothelioma is a multifocal tumor that rarely metastasizes. It is difficult to diagnose, most often it is an incidental finding in young asymptomatic women. The radiologic pattern is heterogeneous. Histologic confirmation of Weibel-Palade bodies or immunohistochemistry based on specific tumor markers such as factor VIII and CD34 are the most important finding to confirm the diagnosis. We report a 21 years old woman Presenting with cough and dyspnea. A chest X ray was suggestive of tuberculosis. Sputum smears were negative for acid fat bacilli and the tuberculin test was negative. A chest CAT scan showed multiple nodular lesions. A surgical biopsy of the lesions confirmed the presence of a hemangioendothelioma. The patient was initially treated with prednisone and azathioprine without response. Thereafter, the patient is without treatment and without evidence of disease progression.

  View details for DOI 10.4067/S0034-98872017000500015

  View details for PubMedID 28898344