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    Ecocardiografía Funcional y sus aplicaciones clínicas en Neonatología
    (2021)
    Irene Montoya Claramunt
    ;
    Claudia Sánchez Ramírez
    ;
    Raul Nachar Hidalgo
    ;
    Jorge Torres Torretti
    <jats:p>La Ecocardiografía funcional surge como una herramienta clínica para la valoración del estado hemodinámico del paciente, luego de demostrarse que los métodos clínicos usados tradicionalmente en la unidad de cuidados intensivos neonatales son limitados y muchas veces tardíos. Esto nos permite establecer un diagnóstico hemodinámico más certero y así mejorar la morbimortalidad neonatal ya que permite formular una recomendación basada en la fisiología, que resulta en un plan de tratamiento racional e individualizado. Los escenarios en los cuales se ha visto su utilidad son: transición inadecuada del recién nacido prematuro de muy bajo peso de nacimiento, inestabilidad hemodinámica, valoración del ductus arterioso persitente y su repercusión hemodinámica e hipertensión pulmonar. La presente revisión actualiza la información sobre la utilidad de la ecocardiografía funcional en la unidad de cuidados intensivos neonatales y los escenarios clínicos en donde se recomienda su uso.</jats:p>
      1Scopus© Citations 4
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    Breaking the breach in Latin America: A pilot study of mechanical thrombectomy in the public healthcare system in Chile
    (2020)
    Rodrigo Rivera
    ;
    Cristian Amudio
    ;
    Enzo Brunetti
    ;
    Pascual Catalan
    ;
    Juan Gabriel Sordo
    <jats:sec><jats:title>Background</jats:title><jats:p> Mechanical Thrombectomy (MT) is the standard of care for treatment of large vessel occlusion stroke. Until the beginning of 2020 MT was not funded nor widely implemented at the public healthcare level in Chile. </jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p> To describe the results of a pilot program created to provide access to public MT in Santiago - Chile. </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> Analysis from a prospectively collected database of MT cases performed between September 2017 and September 2019 in one center. A stroke network was developed with a single MT capable stroke center and five primary stroke centers. The primary efficacy endpoint was the rate of functional independence (mRS 0-2) at 90 days. Successful reperfusion was defined as 2 b-3 according to the thrombolysis in cerebral infarction scale. Safety outcomes include the rates of symptomatic intracranial hemorrhage and 90-day mortality. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> A total of 100 patients were treated over the study period. Their mean age was 62.8 ± 11.8 years and median baseline National Institute of Health Stroke Scale (NIHSS) measurement was 17. Seventy-seven percent of the patients received intra venous thrombolysis. Successful reperfusion was achieved in 95% of the cases. NIHSS at 24 hours showed a median drop of 7 points from baseline (p &lt; 0.00001) and 50% of the follow-up patients were functionally independent at 90 days. Symptomatic Intracerebral hemorrhage occurred in 5% of the patients and 90-day all case mortality was 11%. </jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p> We demonstrated the feasibility of a publicly funded MT program in Chile, with similar results as other international randomized control trials. </jats:p></jats:sec>
    Scopus© Citations 10  4
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    Epidemiology of Parkinson’s Disease in Chile
    (2021)
    VIAL UNDURRAGA, FELIPE AGUSTIN  
    ;
    DELGADO BECERRA, OROZIMBA IRIS  
    ;
    Francisca Canal
    ;
    IDIAQUEZ RIOS, JUAN FRANCISCO  
    ;
    Pedro Chana-Cuevas
    <jats:p>&lt;b&gt;&lt;i&gt;Introduction:&lt;/i&gt;&lt;/b&gt; Parkinson’s disease (PD) is one of the most common neurodegenerative disorders. There is no epidemiological description of PD in Chile and not many descriptions in Latin America. This study aims to describe the incidence and prevalence of PD in Chile. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; The study group was the population on the public health system in Chile between 2010 and 2018 that were registered in the GES system as having PD. Crude and standardized prevalence and incidence were calculated with a 95% confidence interval. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; 33,345 patients were found in the register as confirmed cases with PD. The crude incidence in 2018 was 23.7/100,000; the crude prevalence in 2018 was 160.7/100,000. The male-to-female ratio was 1.03. &lt;b&gt;&lt;i&gt;Conclusion:&lt;/i&gt;&lt;/b&gt; The prevalence and incidence observed in the Chilean population are consistent with studies from other countries. </jats:p>
    Scopus© Citations 8  114
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    Clinical characteristics, microbiology and outcomes of a cohort of patients treated with ceftolozane/tazobactam in acute care inpatient facilities, Houston, Texas, USA
    (2022)
    Truc T Tran
    ;
    Nicolo L Cabrera
    ;
    Anne J Gonzales-Luna
    ;
    Travis J Carlson
    ;
    Faris Alnezary
    <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>Ceftolozane/tazobactam is a β-lactam/β-lactamase inhibitor combination with activity against a variety of Gram-negative bacteria, including MDR Pseudomonas aeruginosa. This agent is approved for hospital-acquired and ventilator-associated bacterial pneumonia. However, most real-world outcome data come from small observational cohorts. Thus, we sought to evaluate the utilization of ceftolozane/tazobactam at multiple tertiary hospitals in Houston, TX, USA.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>We conducted a multicentre retrospective study of patients receiving at least 48 h of ceftolozane/tazobactam therapy from January 2016 through to September 2019 at two hospital systems in Houston. Demographic, clinical and microbiological data were collected, including the infecting bacterial isolate, when available. The primary outcome was composite clinical success at hospital discharge. Secondary outcomes included in-hospital mortality and clinical disposition at 14 and 30 days post ceftolozane/tazobactam initiation. Multivariable logistic regression analysis was used to identify predictors of the primary outcome and mortality. Recovered isolates were tested for susceptibility to ceftolozane/tazobactam and underwent WGS.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>A total of 263 patients were enrolled, and composite clinical success was achieved in 185 patients (70.3%). Severity of illness was the most consistent predictor of clinical success. Combination therapy with ceftolozane/tazobactam and another Gram-negative-active agent was associated with reduced odds of clinical success (OR 0.32, 95% CI 0.16–0.63). Resistance to ceftolozane/tazobactam was noted in 15.4% of isolates available for WGS; mutations in ampC and ftsI were common but did not cluster with a particular ST.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Clinical success rate among this patient cohort treated with ceftolozane/tazobactam was similar compared with previous experiences. Ceftolozane/tazobactam remains an alternative agent for treatment of susceptible isolates of P. aeruginosa.</jats:p> </jats:sec>
    Scopus© Citations 3  2