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Author: search.filters.author.Pablo GonzálezHas files: No

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    Intravenous Thrombolysis in Patients 90 Years or Older with Moderate to Severe Acute Ischemic Stroke Increases Ambulation at Discharge and Is Safe: A Prospective Cohort Study from a Single Center in Santiago, Chile
    (2024)
    Pablo González
    ;
    LAVADOS GERMAIN, PABLO MANUEL  
    ;
    André I. Aguirre
    ;
    BRUNSER RABOVICH, ALEJANDRO MICHEL  
    ;
    OLAVARRIA IANISZEWSKY, VERONICA VIVIANA  
    <jats:p>&lt;b&gt;&lt;i&gt;Introduction:&lt;/i&gt;&lt;/b&gt; The World Health Organization predicts that the global population aged 60 years and older will double by 2050, leading to a significant rise in the public health impact of acute ischemic stroke (AIS). Existing stroke guidelines do not specify an upper age limit for the administration of intravenous thrombolysis (IVT), although some suggest a relative exclusion criterion in patients aged ≥80 in the 3–4.5-h window. Many physicians avoid treating these patients with IVT, argumenting high risk and little benefit. Our aim was to investigate the efficacy and safety of IVT treatment in patients with non-minor AIS aged ≥90, admitted to our institution. The primary efficacy endpoint was the ability to walk at discharge (mRS 0–3), and the primary safety endpoints were death and symptomatic intracranial hemorrhagic transformation (sIHT) at discharge. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; Patients with AIS aged ≥90 admitted to our center from January 2003 to December 2022 were included. They were selected if had an NIHSS ≥5, were previously ambulatory (prestroke mRS score 3 or less), and arrived within 6 h from symptom onset. Those treated or not with IVT were compared with univariate analysis. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; The mean age was 93.2 (2.4) years, and 51 (73.9%) were female. The admission mRS and NIHSS were 1 (IQR 0–2) and 14 (IQR 7–22), respectively. Thrombolyzed patients had a shorter time from symptom onset to door and lower glycemia on admission. IVT was associated with a higher proportion of patients achieving mRS 0–3 at discharge (&lt;i&gt;p&lt;/i&gt; = 0.03) and at 90 days (&lt;i&gt;p&lt;/i&gt; = 0.04). There were no differences between groups in the risk of death (&lt;i&gt;p&lt;/i&gt; = 0.55) or sIHT (&lt;i&gt;p&lt;/i&gt; = 0.38). &lt;b&gt;&lt;i&gt;Conclusion:&lt;/i&gt;&lt;/b&gt; In this small sample, ambulatory patients aged ≥90 with moderate or severe AIS treated with IVT had increased odds of being able to walk independently at discharge than those not treated, without safety concerns. </jats:p>
      4Scopus© Citations 1
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    Asymptomatic herpes simplex virus brain infection elicits cellular senescence phenotypes in the central nervous system of mice suffering multiple sclerosis-like disease
    (2024)
    DUARTE PEÑALOZA, LUISA FERNANDA  
    ;
    Verónica Villalobos
    ;
    Mónica A. Farías
    ;
    Ma. Andreina Rangel-Ramírez
    ;
    Enrique González-Madrid
    Experimental autoimmune encephalomyelitis (EAE) is a demyelinating disease affecting the central nervous system (CNS) in animals that parallels several clinical and molecular traits of multiple sclerosis in humans. Herpes simplex virus type 1 (HSV-1) infection mainly causes cold sores and eye diseases, yet eventually, it can also reach the CNS, leading to acute encephalitis. Notably, a significant proportion of healthy individuals are likely to have asymptomatic HSV-1 brain infection with chronic brain inflammation due to persistent latent infection in neurons. Because cellular senescence is suggested as a potential factor contributing to the development of various neurodegenerative disorders, including multiple sclerosis, and viral infections may induce a premature senescence state in the CNS, potentially increasing susceptibility to such disorders, here we examine the presence of senescence-related markers in the brains and spinal cords of mice with asymptomatic HSV-1 brain infection, EAE, and both conditions. Across all scenarios, we find a significant increases of senescence biomarkers in the CNS with some differences depending on the analyzed group. Notably, some senescence biomarkers are exclusively observed in mice with the combined conditions. These results indicate that asymptomatic HSV-1 brain infection and EAE associate with a significant expression of senescence biomarkers in the CNS.
    Scopus© Citations 2  5
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    A Multidimensional Approach to Measuring Quality of Employment (QoE) Deprivation in Six Central American Countries
    (2021)
    Pablo González
    ;
    Kirsten Sehnbruch
    ;
    APABLAZA SALINAS, MAURICIO IVÁN  
    ;
    Rocío Méndez Pineda
    ;
    Veronica Arriagada
    <jats:title>Abstract</jats:title><jats:p>This paper proposes a methodology for measuring Quality of Employment (QoE) deprivation from a multidimensional perspective in six Central American countries (Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, and Panama) using a dataset specifically designed to measure employment conditions. Building on previous work on multidimensional poverty and employment indicators, the paper uses the Alkire/Foster (AF) method to construct a synthetic indicator of the QoE <jats:italic>at an individual level.</jats:italic> It selects four dimensions that must be considered as essential to QoE deprivation: income, job stability, job security and employment conditions. These dimensions then subdivide into several indicators, a threshold for each indicator and dimension is established before defining an overall cut-off line that allows for the calculation of composite levels of deprivation. The results generated by this indicator show that Central American countries can be divided into three distinct and robust performance groups in terms of their QoE deprivation. Overall, approximately 60% of the deprivation levels are attributable to non-income variables, such as occupational status and job tenure. The methodology used can allow policymakers to identify and focus on the most vulnerable workers in a labour market and highlights the fact that having a formal written contract is no guarantee of good job quality, particularly in the case of women.</jats:p>
    Scopus© Citations 27  4
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    Síndrome de Mounier-Kuhn: reporte de caso y revisión de la literatura
    (2022)
    Israel Díaz
    ;
    Andrés Vicentela
    ;
    Bastián Lara
    ;
    Pablo González
    ;
    Fabián Villacrés
      25
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    Safety and Non-Inferiority Evaluation of Two Immunization Schedules with an Inactivated SARS-CoV-2 Vaccine in Adults: A Randomized Clinical Trial
    (2022)
    Katia Abarca
    ;
    Carolina Iturriaga
    ;
    Marcela Urzúa
    ;
    Nicole Le Corre
    ;
    Augusto Pineda
    <jats:p>Several vaccines have been developed to control the COVID-19 pandemic. CoronaVac®, an inactivated SARS-CoV-2 vaccine, has demonstrated safety and immunogenicity, preventing severe COVID-19 cases. We investigate the safety and non-inferiority of two immunization schedules of CoronaVac® in a non-inferiority trial in healthy adults. A total of 2302 healthy adults were enrolled at 8 centers in Chile and randomly assigned to two vaccination schedules, receiving two doses with either 14 or 28 days between each. The primary safety and efficacy endpoints were solicited adverse events (AEs) within 7 days of each dose, and comparing the number of cases of SARS-CoV-2 infection 14 days after the second dose between the schedules, respectively. The most frequent local AE was pain at the injection site, which was less frequent in participants aged ≥60 years. Other local AEs were reported in less than 5% of participants. The most frequent systemic AEs were headache, fatigue, and myalgia. Most AEs were mild and transient. There were no significant differences for local and systemic AEs between schedules. A total of 58 COVID-19 cases were confirmed, and all but 2 of them were mild. No differences were observed in the proportion of COVID-19 cases between schedules. CoronaVac® is safe, especially in ≥60-year-old participants. Both schedules protected against COVID-19 hospitalization.</jats:p>
      1  2Scopus© Citations 9
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    Inactivated Vaccine-Induced SARS-CoV-2 Variant-Specific Immunity in Children
    (2022)
    Jorge A. Soto
    ;
    Felipe Melo-González
    ;
    Cristián Gutierrez-Vera
    ;
    Bárbara M. Schultz
    ;
    Roslye V. Berríos-Rojas
    <jats:p>This work evaluated the immune response induced by two doses of CoronaVac separated by 4 weeks in healthy children and adolescents in Chile. To date, few studies have described the effects of CoronaVac in the pediatric population.</jats:p>
      1Scopus© Citations 20  16