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Prevalencia de patología oftalmológica en prematuros menores de un año de edad

2012 , Juan Pablo López G , Diego Osandón V , Oliver Denk V , Ricardo Stevenon A , Ricardo Agurto R , Andrés Uauy N , Ricardo Salinas G , Marcela Pérez R , Horacio Cox M , MATURANA PEREA, ANDRES , Soledad Elías A

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Medicina Basada en Evidencia: ¿podemos confiar en los resultados de los estudios clínicos aleatorizados bien diseñados?

2014 , MATURANA PEREA, ANDRES , Carla Benagli

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Interactive Guidance Intervention to Address Sustained Social Withdrawal in Preterm Infants in Chile: Protocol for a Randomized Controlled Trial

2020 , Jorge Bustamante Loyola , Marcela Perez Retamal , Monica Isabel Morgues Nudman , MATURANA PEREA, ANDRES , Ricardo Salinas Gonzalez , Horacio Cox , José Miguel González Mas , Lucia Muñoz , Lilian Lopez , Andrés Mendiburo-Seguel , Sandra Simó , Pascual Palau Subiela , Antoine Guedeney

Background Preterm newborns can be exposed early to significant perinatal stress, and this stress can increase the risk of altered socioemotional development. Sustained social withdrawal in infants is an early indicator of emotional distress which is expressed by low reactivity to the environment, and if persistent, is frequently associated with altered psychological development. Infants born prematurely have a higher probability of developing sustained social withdrawal (adjusted odds ratio 1.84, 95% CI 1.04-3.26) than infants born full term, and there is a correlation between weight at birth and sustained social withdrawal at 12 months of age. Objective The aims of this study are to compare the effect of the interactive guidance intervention to that of routine pediatric care on sustained social withdrawal in infants born moderately or late preterm and to explore the relationship between sustained social withdrawal in these infants and factors such as neonatal intensive care unit hospitalization variables, parental depression, and posttraumatic stress symptoms. Methods This study is designed as a multicenter randomized controlled trial. Moderate and late preterm newborns and their parents were recruited and randomized (1:1 allocation ratio) to control and experimental groups. During neonatal intensive care unit hospitalization, daily duration of skin-to-skin contact, breastfeeding, and parental visits were recorded. Also, a daily score for neonatal pain and painful invasive procedures were recorded. After discharge from neonatal intensive care, for the duration of the study, both groups will attend follow-up consultations with neonatologists at 2, 6, and 12 months of age (corrected for gestational age) and will receive routine pediatric care. Every consultation will be recorded and assessed with the Alarm Distress Baby Scale to detect sustained social withdrawal (indicated by a score of 5 or higher). The neonatologists will perform an interactive guidance intervention if an infant in the intervention group exhibits sustained social withdrawal. In each follow-up consultation, parents will fill out the Edinburgh Postnatal Depression Scale, the modified Perinatal Posttraumatic Stress Disorder Questionnaire, and the Impact of Event Scale–revised. Results Recruitment for this trial started in September 2017. As of May 2020, we have completed enrollment (N=110 infants born moderately or late preterm). We aim to publish the results by mid-2021. Conclusions This is the first randomized controlled trial with a sample of infants born moderately or late preterm infants who will attend pediatric follow-up consultations during their first year (corrected for gestational age at birth) with neonatologists trained in the Alarm Distress Baby Scale and who will receive this interactive guidance intervention. If successful, this early intervention will show significant potential to be implemented in both public and private health care, given its low cost of training staff and that the intervention takes place during routine pediatric follow-up. Trial Registration ClinicalTrials.gov NCT03212547; https://clinicaltrials.gov/ct2/show/NCT03212547. International Registered Report Identifier (IRRID) DERR1-10.2196/17943

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Systematic Reviews in Neonatal Respiratory Care: Are Some Conclusions Misleading?

2020 , Andres Maturana , Fernando Moya , Steven M. Donn

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Bombas de infusión continua de jeringa en unidades neonatales

2011 , NADIA SCHMIDT S , CLAUDIA SÁEZ H , MATURANA PEREA, ANDRES

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Profesionalismo y auto cuidado de los residentes, ¿cómo debemos enfocar su formación?

2021 , Carla Benaglio , MATURANA PEREA, ANDRES , Luigina Mortari , Arnoldo Riquelme

El profesionalismo es una competencia bien definida en la educación de los residentes, sin embargo, es un constructo complejo, sensible a variables sociales y culturales. Puede definirse como el nivel de destreza, buen juicio y comportamiento adecuado esperable de personas entrenadas para realizar bien su trabajo. Es una competencia que no se mantiene estable en el tiempo y decae cuando el profesional está sometido a altos niveles de estrés y se asocia a calidad de cuidado, educación, ética, moral, filosofía y humanismo. Es una competencia esencial en el profesional por lo cual debemos replantear los currículos para incluir formas de enseñar y evaluar el profesionalismo. Es fundamental pensar en programas que logren equilibrar la carga de trabajo con el bienestar de los futuros profesionales. Debemos generar un clima adecuado de aprendizaje donde el profesional en entrenamiento sea un protagonista activo, y el auto cuidado sea visibilizado como una competencia esencial para mantener el equilibrio entre la vida personal y profesional. Este articulo plantea una revisión y reflexión de este tema que cobra cada vez mas importancia en la formación de postgrado de futuros especialistas.

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Animal-Derived Surfactants Versus Past and Current Synthetic Surfactants: Current Status

2007-03-01 , Moya, Fernando , MATURANA PEREA, ANDRES

In this review, the authors assess major outcomes resulting from head-to-head comparison trials of animal-derived surfactants with previous and newer synthetic surfactants and among them. They also pay special attention to issues of study design and quality of the trials reviewed. Animal-derived surfactants that contain surfactant proteins (Survanta, Infasurf, and Curosurf) perform clinically better than Exosurf, a synthetic surfactant containing only phospholipids, primarily in outcomes related to acute management of respiratory distress syndrome (RDS; faster weaning and pneumothorax) but not in overall mortality or incidence of bronchopulmonary dysplasia (BPD). Trials comparing various animal-derived surfactants that provide different amounts of surface protein B (SP-B) or phospholipids have shown minor differences in outcomes related to the management of RDS or none at all. The exception is the suggestion of better survival using a high initial dose of Curosurf when compared with Survanta. This observation is based on analysis of trials of relatively lesser quality that have included a smaller number of infants than other surfactant comparisons, however. Data from recent trials comparing a new-generation synthetic surfactant that contains a peptide mimicking the action of SP-B, Surfaxin, have shown that it performs better than Exosurf (faster weaning and less BPD) and at least as well as the animal-derived surfactants Survanta and Curosurf. The ideal surfactant comparison trial to demonstrate which surfactant is better has yet to be conducted. Future surfactant comparison trials should pay particular attention to study design, be appropriately sized, and include long-term follow-up. © 2007 Elsevier Inc. All rights reserved.

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Investigación Clínica en tiempos de COVID-19

2020 , María Alicia Mordojovich , Gabriel Cavada , Andrés Maturana , LAVADOS GERMAIN, PABLO MANUEL

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Investigación traslacional en salud: un camino para la investigación pragmática e interdisciplinaria

2015 , Margarita Bernales , CABIESES VALDES, BALTICA BEATRIZ , MATURANA PEREA, ANDRES , OBACH KING, ALEXANDRA ALICE

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Association of Cow's Milk Protein Allergy Prevalence With Socioeconomic Status in a Cohort of Chilean Infants

2020 , María E. Arancibia , LUCERO, YALDA , Isabel Miquel , Pamela Marchant , Lorena Rodriguez , Francisco Alliende , Gloria Ríos , MATURANA PEREA, ANDRES