Universidad del Desarrollo

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Association of Ventilatory Ratio with Acute Cor Pulmonale and Mortality in COVID-19 ARDS: A Cohort Study
(SAGE Publications, 2025-09-08)
Martín H. Benites
;
Romina Battiato
;
Pablo Mercado
;
Ronald Pairumani
;
Juan Nicolás Medel
Purpose : An elevated ventilatory ratio (VR) and acute cor pulmonale (ACP) are associated with mortality in ARDS patients. The primary aim of this study was to assess the association between VR and ACP in patients with COVID-19-related ARDS (C-ARDS). The secondary objectives were to analyze the association between VR and ICU mortality, describe VR temporal behavior in survivors and non-survivors, and evaluate the association between VR and pulmonary embolism. Materials and Methods : We studied a cohort of patients with C-ARDS. The VR was calculated using a validated formula. Echocardiography was used to diagnose ACP, and CT pulmonary angiography was performed to identify PE. To evaluate the associations between VR and ACP, mortality, and PE, a generalized logistic regression model was used. Results : Of the 140 subjects, 60 (43%) had a VR < 2, while 80 (57%) had a VR >= 2. Patients with a VR >= 2 had a higher risk of developing ACP than those with a VR <2 (Odds Ratio (OR), 3.77; 95% CI: 1.30 - 8.72). The ICU mortality rate was 29%. Of the 40 patients who died, 30 (75%) had a VR >= 2. Mortality was significantly associated with VR >= 2 and driving pressure >= 15 cm H2O. In non-survivor patients with a VR < 2 at ICU admission, a significant increase in VR was observed over the 7-day observation period. No significant association was observed between PE and VR (p = .118). Conclusion : Elevated VR was associated with ACP in patients with C-ARDS. VR >= 2 combined with driving pressure >= 15 cm H2O significantly improved the ability to identify patients at risk for ACP. Additionally, at ICU admission, elevated VR values and initially low values that increased over the first week were associated with higher ICU mortality.
Scopus© Citations 1 1
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Molecular Analysis of PIK3CA in Metastatic Hormone Receptor-Positive Breast Cancer in Chile: Clinical and Pathological Insights
(2024)
Carla Araya
;
Bárbara Mino
;
Patricio Le Cerf
;
Fancy Gaete
;
ARMISEN YAÑEZ, RICARDO AMADO
<jats:p>Breast cancer is the most common cancer among women and a leading cause of cancer-related deaths. PIK3CA gene mutations, which are often present in advanced HR+ breast cancer, can be targeted by alpelisib. However, data on PIK3CA mutations in Chile are limited. Here, we aim to assess the mutational status of PIK3CA in metastatic breast cancer tissues from Chilean patients and describe their clinicopathological characteristics and survival outcomes. We analyzed 102 formalin-fixed, paraffin-embedded metastatic breast cancer samples from 96 patients diagnosed at three Chilean hospitals between 2007 and 2023. PIK3CA mutations were identified using targeted sequencing, and clinicopathological data were collected. We evaluated associations between mutational status, clinicopathological features, and survival. The median age at diagnosis was 56 years. The most common metastatic sites were liver (29.4%), bone (17.6%), and lung/pleura (16.7%). Most patients were HR+ HER2− (83.3%), with 57.3% showing HER2-low status. PIK3CA mutations were present in 40.6% of patients, mainly in exons 7, 9, and 20. No significant associations were found between PIK3CA mutations and clinicopathological characteristics or survival. Our study reveals a high frequency of PIK3CA mutations in HR+ metastatic breast cancer, consistent with global data. The majority of mutations are targetable with alpelisib. The proportion of HER2-low status patients suggests potential benefits from novel HER2-targeted therapies. These findings highlight the need for routine molecular diagnostics in Chile to improve personalized treatment and address economic and access challenges.</jats:p>
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Cardiac function in critically ill patients with severe COVID: A prospective cross-sectional study in mechanically ventilated patients
(2022)
Emilio Daniel Valenzuela
;
Pablo Mercado
;
Ronald Pairumani
;
Juan Nicolás Medel
;
Edward Petruska
Scopus© Citations 6 64
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Critical care echocardiography in prone position patients during COVID-19 pandemic: a feasibility study
(2022)
Diego Ugalde
;
Juan Nicolas Medel
;
Pablo Mercado
;
Ronald Pairumani
;
Daniela Eisen
Scopus© Citations 5 1

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