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    Parámetros hematológicos y biomarcadores predictores de gravedad en Síndrome Inflamatorio Pediátrico Multisistémico asociado a SARS-CoV-2
    (2021)
    Patricia Verdugo
    ;
    Patricia Álvarez
    ;
    Patricia Aroca
    ;
    Vicente Enrique Montes-nogales
    ;
    <jats:p>El síndrome inflamatorio multisistémico pediátrico asociado a SARS-CoV-2 (MIS-C) se caracteriza por un estado hiperinflamatorio producto de una tormenta de citoquinas, evidenciado en alteraciones del laboratorio hematológico y proteínas de fase aguda.Objetivo: Describir las características clínicas y de laboratorio de pacientes hospitalizados por MIS-C e identificar marcadores predictores de gravedad.Pacientes y Método: Estudio retrospectivo de 32 pacientes. El grupo se dividió en crítico y no crítico según presentación clínica y tipo de terapia utilizada. En ellos se estudiaron aspectos clínicos y de laboratorio que incluyeron hemograma completo, pruebas de coagulación y biomarcadores. Resultados: 18/32 hombres, mediana de edad 6,8 años. Las manifestaciones más frecuentes fueron cardiovasculares (84,3%), digestivas (84%) y mucocutáneas (59%). El grupo de los críticos incluyó 15 pacientes, 12 hombres con mediana de edad de 8,9 años y los no críticos 17 pacientes; 6 hombres, con mediana de edad de 5,4 años. Los parámetros de laboratorio al ingreso en el grupo global mostraron aumento de la proteína C reactiva, dímero-D, leucocitos, neutrófilos, ferritina y fibrinógeno. La albúmina y la natremia en cambio se encontraban disminuidas. El grupo crítico se caracterizó por tener al ingreso: trombocitopenia, hipoalbuminemia, prolongación del tiempo de protrombina y elevación de la ferritina. Al deterioro hubo acentuación de la trombocitopenia, ascenso mayor de la proteína C reactiva junto a elevación de los neutrófilos.Conclusión: El hemograma, la proteína C reactiva y la albuminemia al ingreso resultaron ser de alto valor en la identificación de pacientes con riesgo de agravamiento clínico.</jats:p>
      20Scopus© Citations 10
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    Item type:Publication,
    Global research priorities for COVID-19 in maternal, reproductive and child health: Results of an international survey
    (2021)
    Melanie Etti
    ;
    Jackeline Alger
    ;
    Sofía P. Salas
    ;
    Robin Saggers
    ;
    Tanusha Ramdin
    <jats:sec id="sec001"> <jats:title>Background</jats:title> <jats:p>The World Health Organization’s “<jats:italic>Coordinated Global Research Roadmap</jats:italic>: <jats:italic>2019 Novel Coronavirus</jats:italic>” outlined the need for research that focuses on the impact of COVID-19 on pregnant women and children. More than one year after the first reported case significant knowledge gaps remain, highlighting the need for a coordinated approach. To address this need, the Maternal, Newborn and Child Health Working Group (MNCH WG) of the COVID-19 Clinical Research Coalition conducted an international survey to identify global research priorities for COVID-19 in maternal, reproductive and child health.</jats:p> </jats:sec> <jats:sec id="sec002"> <jats:title>Method</jats:title> <jats:p>This project was undertaken using a modified Delphi method. An electronic questionnaire was disseminated to clinicians and researchers in three different languages (English, French and Spanish) via MNCH WG affiliated networks. Respondents were asked to select the five most urgent research priorities among a list of 17 identified by the MNCH WG. Analysis of questionnaire data was undertaken to identify key similarities and differences among respondents according to questionnaire language, location and specialty. Following elimination of the seven lowest ranking priorities, the questionnaire was recirculated to the original pool of respondents. Thematic analysis of final questionnaire data was undertaken by the MNCH WG from which four priority research themes emerged.</jats:p> </jats:sec> <jats:sec id="sec003"> <jats:title>Results</jats:title> <jats:p>Questionnaire 1 was completed by 225 respondents from 29 countries. Questionnaire 2 was returned by 49 respondents. The four priority research themes which emerged from the analysis were 1) access to healthcare during the COVID-19 pandemic, 2) the direct and 3) indirect effects of COVID-19 on pregnant and breastfeeding women and children and 4) the transmission of COVID-19 and protection from infection.</jats:p> </jats:sec> <jats:sec id="sec004"> <jats:title>Conclusion</jats:title> <jats:p>The results of these questionnaires indicated a high level of concordance among continents and specialties regarding priority research themes. This prioritized list of research uncertainties, developed to specifically highlight the most urgent clinical needs as perceived by healthcare professionals and researchers, could help funding organizations and researchers to answer the most pressing questions for clinicians and public health professionals during the pandemic. It is hoped that these identified priority research themes can help focus the discussion regarding the allocation of limited resources to enhance COVID-19 research in MNCH globally.</jats:p> </jats:sec>
      3Scopus© Citations 8
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    Lifestyle Habits and Health Indicators in Migrants and Native Schoolchildren in Chile
    (2021)
    Mónica Suárez-Reyes
    ;
    Daiana Quintiliano-Scarpelli
    ;
    ;
    Cristian Cofré-Bolados
    ;
    Tito Pizarro
    <jats:p>In Chile, the migrant population has increased in the last years. Migrants adopt behaviors of this new culture, which can have an effect on their health. Contradictory results regarding differences between migrant and native children have been reported. The aim of this study was to explore the associations between nationality with health indicator and lifestyle habits among schoolchildren in Chile. A cross-sectional and observational study with a non-probabilistic sample was conducted in 1033 children (86.4% Chilean and 13.6% migrant) from second to fourth grade of seven public schools from low-income municipalities from the Metropolitan Region, Chile. Anthropometric measurements (weight, height, waist circumference, triceps and subscapular folds), handgrip strength, and standing long jump measurements, physical activity, self-esteem and food guidelines accomplishments were determined. Migrant children presented lower body mass index (BMI), Z-BMI, body fat% and waist circumference values; and higher handgrip strength, standing long jump, and more satisfactory compliance with food guidelines than natives (p &lt; 0.05). No significant difference for physical activity and self-esteem was observed. In the adjusted models, migrants presented lower odds for overweight/obesity, risk of abdominal obesity, low handgrip strength and unsatisfactory food guidelines accomplishment in all models (p &lt; 0.05). The nutritional and muscular fitness of migrant children was better than that of the Chilean ones.</jats:p>
      1Scopus© Citations 8  1
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    Infant Feeding and Information Sources in Chilean Families Who Reported Baby-Led Weaning as a Complementary Feeding Method
    (2021)
    Daiana Quintiliano-Scarpelli
    ;
    Nicole Lehmann
    ;
    Bárbara Castillo
    ;
    Estela Blanco
    <jats:p>Baby-Led Weaning (BLW) is a new and emerging method of introducing complementary feeding in solid consistency, without the use of a spoon and entirely guided by the baby. This study aims to analyze the implementation of the BLW approach in relation to compliance with basic components and sources of information in Chilean families. Using a cross-sectional design, we assessed early nutrition, including breastfeeding and foods offered, maternal/child characteristics and sources of information on BLW among a non-probabilistic sample of mothers of children &lt;24 months who reported practicing BLW (n = 261, median age = 28 years) in Chile. We found that 57.5% of mothers reported their child ate the same food as the family, 44.1% shared ≥3 meals with the family, 84.7% offered ≥3 foods at each meal and 75.6% reported only occasionally offering food with a spoon. The majority reported obtaining information on BLW from social media (82%). Moreover, 56% had offered cookies, 32% added salt and 9% sugar in the first 2 years. Exclusive breastfeeding for 6 months related to higher odds of consuming family foods (OR = 2.45, 95% CI 1.24–4.84), while having received information from professional sources and social media related to lower odds (OR = 0.45, 95% CI 0.22–0.88 and OR = 0.31, 95% CI 0.15–0.66, respectively). Those who had appropriate weight gain had lower odds of consuming ≥3 foods in meals (OR = 0.35, 95% CI 0.13–0.96). Among mothers who reported practicing BLW with their children, we observed a wide variety of feeding habits, sources of information and low compliance with the studied components. Eating the same food as the family was the most prevalent component and social media was the main source of information on BLW.</jats:p>
      6Scopus© Citations 13
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    Seroprevalence of Natural and Acquired Immunity against the SARS-CoV-2 Virus in a Population Cohort from Two Chilean Cities, 2020–2022
    (2023)
    Loreto Núñez-Franz
    ;
    Muriel Ramírez-Santana
    ;
    ;
    Macarena Said
    ;
    <jats:p>Background: Chile has achieved the highest coverage for vaccines against the SARS-CoV-2 virus worldwide. Objective: To assess the progression of immunity (natural and acquired by vaccine) in a cohort from two Chilean cities. Methods: Individuals (n = 386) who participated in three phases of population-based serial prevalence studies were included (2020–2021 and 2022). Presence of SARS-CoV-2 antibodies was measured in serum. Data including time of vaccination and type of vaccine received were analysed with descriptive statistics. Results: Seroprevalence was 3.6% in the first round and increased to 96.9% in the second and 98.7% in the third. In the third round, 75% of individuals who had received the basal full scheme were seropositive at 180 days or more since their last dose; 98% of individuals who received one booster dose were seropositive at 180 days or more, and 100% participants who received two boosters were seropositive, regardless of time since their last dose. Participants receiving mRNA vaccines had higher seroprevalence rates over time. Conclusions: The high vaccination coverage in Chile enabled the population to maintain high levels of antibodies. Vaccination boosters are essential to maintain immunity over time, which also depends on the type of vaccine administered.</jats:p>
      1Scopus© Citations 12
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    Los inicios de la enseñanza de pediatría en Chile y la fundación de hospitales de niños
    (2023)
    Luisa Schonhaut Berman
    ;
    Pablo Chavez Zuñiga
    ;
    Nelson Vargas Catalán
    <jats:p>El objetivo del presente manuscrito es revisar antecedentes históricos previos a la creación de la Sociedad Chilena de Pediatría (SOCHIPE) en el año 1922, con el propósito de reflexionar sobre su impacto en la profesionalización de la pediatría nacional, especialmente en la salud y sobrevida de los niños. Se revisaron documentos de la Junta de Beneficencia, libros y estudios especializados de la época. Hasta principios del siglo XX, el país ostentaba una de las tasas de mortalidad infantil más elevadas del mundo, y contaba con precarias instalaciones para enfrentarlas. En aquellos años, el único establecimiento cerrado para la atención de infantes era la Casa de Huérfanos, que estaba al cuidado de religiosas con apoyo de médicos; es ahí donde se desarrollaron los primeros cursos teórico-prácticos de la especialidad. Presionados por la alta mortalidad infantil y las mortíferas epidemias, la Junta de Beneficencia vio la urgencia de mejorar las condiciones higiénicas y crear instalaciones para el cuidado de los niños. El manuscrito aborda el surgimiento de espacios encargados del resguardo de la salud de los menores de cinco años, desde la creación de la cátedra de pediatría y del primer hospital de niños, el Hospital Roberto del Río, lo que marcó el inicio de las políticas de salud pública infantiles.</jats:p>
      4Scopus© Citations 3
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    Prácticas y preferencias alimentarias y de actividad física en niños y niñas: Una aproximación desde los Parlamentos Escolares en establecimientos educacionales
    (2023)
    Tito Pizarro
    ;
    Macarena Jara
    ;
    Daisy Margarit
    ;
    José Luis Palacios
    ;
    <jats:p>En Chile la malnutrición por exceso continúa en aumento, afectando especialmente a la población infantil. Solucionar esta problemática de salud pública requiere desarrollar estrategias de promoción y prevención que consideren las propuestas de las comunidades, especialmente la de los propios niños y niñas. Objetivo: Conocer las opiniones y sugerencias de niños y niñas de tercero y cuarto básico de escuelas de la zona sur de Santiago de Chile, respecto de sus prácticas alimentarias y de actividad física, en el marco del proyecto FONDEF IT 1810016. Sujetos y Método: Se desarrollaron siete parlamentos escolares en siete escuelas mediante una metodología cualitativa participativa, recogiendo las opiniones de 176 niños y niñas acerca de sus hábitos y preferencias tanto de alimentos como de actividad física. Resultados: Los alimentos más consumidos y preferidos son aquellos fáciles de preparar y de alta disponibilidad, como pan, tallarines y leche. Los alimentos que requieren preparación, como pescado, legumbres, frutas, verduras y preparaciones caseras, son menos consumidos y tienen menos preferencia. En las actividades físicas recreativas destacan los videojuegos y el fútbol. Los estudiantes proponen aumentar las horas de educación física, los recreos y mejorar la disponibilidad y acceso a alimentos saludables en los entornos escolares como estrategia de solución al problema de la malnutrición por exceso. Conclusiones: Los Parlamentos Escolares como estrategia participativa aportan en la generación conjunta de conocimiento. La necesidad de incluir a las comunidades como partes interesadas en las iniciativas de salud, reconoce a través de su participación, a los niños y las niñas como actores sujetos de derechos.</jats:p>
      2  1
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    Inborn errors of OAS–RNase L in SARS-CoV-2–related multisystem inflammatory syndrome in children
    (2023)
    Danyel Lee
    ;
    Jérémie Le Pen
    ;
    Ahmad Yatim
    ;
    Beihua Dong
    ;
    Yann Aquino
    <jats:p> Multisystem inflammatory syndrome in children (MIS-C) is a rare and severe condition that follows benign COVID-19. We report autosomal recessive deficiencies of <jats:italic>OAS1</jats:italic> , <jats:italic>OAS2</jats:italic> , or <jats:italic>RNASEL</jats:italic> in five unrelated children with MIS-C. The cytosolic double-stranded RNA (dsRNA)–sensing OAS1 and OAS2 generate 2′-5′-linked oligoadenylates (2-5A) that activate the single-stranded RNA–degrading ribonuclease L (RNase L). Monocytic cell lines and primary myeloid cells with OAS1, OAS2, or RNase L deficiencies produce excessive amounts of inflammatory cytokines upon dsRNA or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) stimulation. Exogenous 2-5A suppresses cytokine production in OAS1-deficient but not RNase L–deficient cells. Cytokine production in RNase L–deficient cells is impaired by MDA5 or RIG-I deficiency and abolished by mitochondrial antiviral-signaling protein (MAVS) deficiency. Recessive OAS–RNase L deficiencies in these patients unleash the production of SARS-CoV-2–triggered, MAVS-mediated inflammatory cytokines by mononuclear phagocytes, thereby underlying MIS-C. </jats:p>
      11Scopus© Citations 137
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    Breaking Down Barriers: Findings from a Literature Review on Housing for People with Disabilities in Latin America
    Accessibility to housing is crucial for people with disabilities as it provides them with equal opportunities and allows them to live independently. A systematic literature review has been conducted to understand the current research on accessibility in housing for people with disabilities in Latin America. The study analysed 56 papers and used co-word analysis to identify common themes and topics within the documents. The results of the analysis showed that Brazil (61%) is the country with the most research on the subject, physical disability, at 36%, is the impairment most analysed, and interventions or analysis for the older people (45%) in their homes is the most researched type of population. The co-word analysis revealed that topics such as policy, regulations, the use of technologies, ergonomics interventions, and architectural criteria or barriers to the daily life of disabled people were frequently discussed in the papers. Although this work shows a substantial and growing increase in research on housing for people with disabilities in Latin America, it also demonstrates the importance of increasing research on other types of impairment, such as visual and cognitive-intellectual disabilities, and including children, caregivers, or even young adults.
    Scopus© Citations 3  9