Browsing by Author "Altermatt, Fernando"

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    Acquiring skills in malignant hyperthermia crisis management: comparison of high-fidelity simulation versus computer-based case study
    (2018) Mejia, Vilma; Gonzalez, Carlos; Delfino, Alejandro; Altermatt, Fernando; Corvetto Aqueveque, Marcia Antonia; Mejia, Vilma; Gonzalez, Carlos; Delfino, Alejandro; Altermatt, Fernando; Corvetto Aqueveque, Marcia Antonia
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    Anestesia espinal parte V. Efectos fisiológicos
    (2021) Lacassie Quiroga, Héctor; Cuadra F., Juan Carlos de la; Kychenthal Loyola, Catalina Sofía; Irarrázaval Mainguyague, María Jesús; Altermatt, Fernando
    La anestesia espinal es una técnica ampliamente utilizada hoy en día en contextos intraoperatorios. Esta posee efectos fisiológicos característicos en los diferentes sistemas corporales, los cuales son esenciales de conocer a la hora de utilizar este método anestésico. Dichos efectos pueden cobrar principal relevancia en ciertos pacientes según sus requerimientos, comorbilidades o el procedimiento al cual serán sometidos. En esta revisión se destacan los efectos que la anestesia espinal produce en los principales sistemas del organismo. En el sistema nervioso autonómico, los efectos dependerán de la regulación de los sistemas simpático y parasimpático secundaria al nivel de bloqueo, el cual puede ser estimado mediante el nivel de discriminación térmica. El bloqueo simpático producido se traduce en vasodilatación arterial y venosa sistémica, lo que a su vez causa una disminución de la resistencia vascular periférica, retorno venoso, frecuencia cardiaca y contractilidad miocárdica. En cuanto al sistema nervioso central, la anestesia espinal causaría un efecto sedante mediante distintas teorías. En condiciones normales, la función ventilatoria no resulta significativamente afectada, pero podría volverse insuficiente en ciertos pacientes o verse afectada en cuanto a la regulación de la broncodilatación. Debido a la redistribución de flujo, se ve afectada la termorregulación, presentando disminuciones en la temperatura corporal. Otros sistemas que pueden verse afectados por la regulación del sistema nervioso autonómico son el gastrointestinal y el excretor urinario, además de producirse un eventual bloqueo adrenal que llevaría a una menor respuesta metabólica de estrés.
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    Biomechanical analysis of expert anesthesiologists and novice residents performing a simulated central venous access procedure
    (2021) Villagrán Gutiérrez, Ignacio Andrés; Moenne Vargas, Cristóbal Matías; Aguilera Siviragol, Victoria Ignacia; Garcia, Vicente; Reyes, Jose Tomas; Rodriguez, Sebastian; Miranda Mendoza, Constanza; Altermatt, Fernando; Fuentes López, Eduardo; Delgado Bravo, Mauricio Antonio; Neyem, Andrés
    Background Central venous access (CVA) is a frequent procedure taught in medical residencies. However, since CVA is a high-risk procedure requiring a detailed teaching and learning process to ensure trainee proficiency, it is necessary to determine objective differences between the expert’s and the novice’s performance to guide novice practitioners during their training process. This study compares experts’ and novices’ biomechanical variables during a simulated CVA performance. Methods Seven experts and seven novices were part of this study. The participants’ motion data during a CVA simulation procedure was collected using the Vicon Motion System. The procedure was divided into four stages for analysis, and each hand’s speed, acceleration, and jerk were obtained. Also, the procedural time was analyzed. Descriptive analysis and multilevel linear models with random intercept and interaction were used to analyze group, hand, and stage differences. Results There were statistically significant differences between experts and novices regarding time, speed, acceleration, and jerk during a simulated CVA performance. These differences vary significantly by the procedure stage for right-hand acceleration and left-hand jerk. Conclusions Experts take less time to perform the CVA procedure, which is reflected in higher speed, acceleration, and jerk values. This difference varies according to the procedure’s stage, depending on the hand and variable studied, demonstrating that these variables could play an essential role in differentiating between experts and novices, and could be used when designing training strategies.
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    Bloqueio perioperatório do plexo lombar e isquemia cardíaca em pacientes com fratura de quadril: ensaio clínico randomizado
    (2018) Altermatt, Fernando; Echevarría, Ghislaine C.; Cuadra F., Juan Carlos de la; Baeza Vergara, Ricardo Gabriel; Ferrada, Marcela; De La Cuadra Fontaine, Juan Carlos; Corvetto Aqueveque, Marcia Antonia
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    Boundary integral formulation and semi-implicit scheme coupling for modeling cells under electrical stimulation
    (2017) Henríquez F.; Jerez Hanckes, Carlos F.; Altermatt, Fernando
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    Bringing clinical simulation into an Anesthesia residency training program in a university hospital. Participants' acceptability assessment
    (2013) Corvetto Aqueveque, Marcia Antonia; Bravo, M. P.; Montana, R. A.; Altermatt, Fernando; Delfino, Alejandro; Corvetto Aqueveque, Marcia Antonia; Bravo, M. P.; Montana, R. A.; Altermatt, Fernando; Delfino, Alejandro
    Introduction Clinical simulation is currently an integral part of the curriculum of the Anesthesiology residency programs in other countries. We aimed to describe and evaluate the insertion of simulation in an anesthesia residency training program. Methods Activities feasible to be used for training in a simulated environment were classified into 2 modules: workshops for technical skills conducted with first year residents, and high fidelity simulation scenarios performed with second and third year residents. After each activity, and using an anonymous questionnaire, residents assessed their satisfaction and objectives accomplished. Results A total of 18 activities: 6 skills workshops and 12 high fidelity scenarios were assessed. A total of 206 questionnaires were analyzed, corresponding to 41 residents. Almost all (96%) of respondents agreed or strongly agreed that workshops met the objectives and should be mandatory in the anesthesia curriculum; however, 11% agreed that the activity caused anxiety and/or nervousness. The high fidelity scenarios were considered realistic and consistent with the objectives by 97% of residents, and 42% felt that workshops caused anxiety and/or nervousness. Conclusions The inclusion of simulation has been well accepted by the residents. The activities have been described as realistic, and limited to the objectives, essential points in adult education, as according to Kolb's learning model this is associated with profound, useful and long lasting knowledge.Introduction Clinical simulation is currently an integral part of the curriculum of the Anesthesiology residency programs in other countries. We aimed to describe and evaluate the insertion of simulation in an anesthesia residency training program. Methods Activities feasible to be used for training in a simulated environment were classified into 2 modules: workshops for technical skills conducted with first year residents, and high fidelity simulation scenarios performed with second and third year residents. After each activity, and using an anonymous questionnaire, residents assessed their satisfaction and objectives accomplished. Results A total of 18 activities: 6 skills workshops and 12 high fidelity scenarios were assessed. A total of 206 questionnaires were analyzed, corresponding to 41 residents. Almost all (96%) of respondents agreed or strongly agreed that workshops met the objectives and should be mandatory in the anesthesia curriculum; however, 11% agreed that the activity caused anxiety and/or nervousness. The high fidelity scenarios were considered realistic and consistent with the objectives by 97% of residents, and 42% felt that workshops caused anxiety and/or nervousness. Conclusions The inclusion of simulation has been well accepted by the residents. The activities have been described as realistic, and limited to the objectives, essential points in adult education, as according to Kolb's learning model this is associated with profound, useful and long lasting knowledge.
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    Clinical Research Ethics: Critical and Qualitative Analysis of Facilitators and Barriers
    (2020) Valera, Luca; González, Karla; Ramos, Paulina; Altermatt, Fernando
    To analyze the ethical challenges dealing with clinical research, we carried out a systematic review of the literature and qualitative research, determining facilitators, barriers, and ethical paradigms perceived by Chilean clinical researchers. Through the analysis of the literature, we identified the main ethical challenges involved “in” clinical research (hic et nunc) and those that arise “from” clinical research itself (ex post). Semi-structured interviews showed four critical knots associated with clinical research (founding, legislation, multi-center research, and the relationship with regulatory entities), together with facilitating aspects and barriers when implementing researches.
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    Complicaciones cardiopulmonares asociadas a Propofol versus sedación tradicional para procedimientos endoscópicos digestivos en adultos : revisión sistemática y metaanálisis de estudios clínicos randomizados (ECR)
    (2016) Carmona B., Javiera; Auad A., Hernán; Altermatt, Fernando; Dagnino Sepúlveda, Jorge; Carmona B., Javiera; Auad A., Hernán; Altermatt, Fernando; Dagnino Sepúlveda, Jorge
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    Congreso LASRA 2023, Lima, Perú. Delegación Chilena
    (2023) Aliste, Julián; Altermatt, Fernando; Atton, Rousmery; Carrasco, Cristóbal; Cuadra F., Juan Carlos de la; Pesce, Ítalo
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    Control-flow analysis of procedural skills competencies in medical training through process mining
    (2020) Fuente Sanhueza, René Francisco de la; Fuentes Henríquez, Ricardo Sergio; Muñoz Gama, Jorge; Riquelme Pérez, Arnoldo; Altermatt, Fernando; Pedemonte Trewhela, Juan Cristóbal; Corvetto Aqueveque, Marcia Antonia; Sepúlveda Fernández, Marcos Ernesto
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    Diseño curricular en Anestesiología utilizando la simulación como herramienta docente (réplica)
    (2014) Corvetto Aqueveque, Marcia Antonia; Altermatt, Fernando; Delfino, Alejandro
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    Effect of acute arterial hypertension on morphine requirements and postsurgical pain
    (2015) Delfino, Alejandro; De La Fuente, Natalia; Altermatt, Fernando; Cortínez Fernández, Luis Ignacio; Echevarría, Ghislaine C.; Delfino, Alejandro; De La Fuente, Natalia; Altermatt, Fernando; Cortínez Fernández, Luis Ignacio; Echevarria, Ghislaine C.
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    Effects of Long-Term Nitric Oxide Synthesis Inhibition on Plasma Volume Expansion and Fetal Growth in the Pregnant Rat
    (1995) Salas, Sofía P.; Altermatt, Fernando; Campos, Mauricio; Giacaman, Andrea; Rosso R., Pedro Pablo
    We conducted the present study to investigate whether the vasodilator nitric oxide plays a role in plasma volume homeostasis during pregnancy. Pregnant Sprague-Dawley rats were randomly assigned to a control group (n = 18) or to groups receiving 0.69 mmol/L (n = 11) or 1.7 mmol/L (n = 14) N-omega-nitro-L-arginine, a competitive inhibitor of nitric oxide synthetase, from gestational days 7 through 21. On day 20 systolic pressure was measured. On day 21 blood samples were taken for plasma volume, hematocrit, and hormonal measurements. Fetal and placental weights also were determined. Systolic pressure was significantly higher in experimental rats (101+/-6 and 115+/-6 mm Hg in the 0.69 and 1.7 mmol/L groups, respectively) than in controls (79.7+/-7.5 mm Hg), and plasma volume was lower (18.4+/-1.1 and 17.1+/-0.5 mL) than in controls (21.5+/-0.8 mL). Both experimental groups had increased hematocrit levels. Plasma renin activity was significantly lower in the experimental groups (11.5+/-3 and 7.2+/-1.5 ng angiotensin I/mL per hour) than in controls (21.9+/-2.7 ng angiotensin I/mL per hour); however, no changes were observed in aldosterone levels. Experimental groups had lower fetal weight (4.6+/-0.1 and 5.1+/-0.1 g) than controls (5.5+/-0.1 g). In addition, fetal hindlimb hypoplasia was observed in the experimental groups. In conclusion, the present data indicate that long-term N-omega-nitro-L-arginine administration to pregnant rats leads to increased blood pressure, reduced plasma volume expansion, lower plasma renin activity, and fetal growth retardation. These results suggest that nitric oxide may play an important role in maternal systemic vasodilatation and indirectly in plasma volume homeostasis and fetal growth.
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    ¿Es efectiva la ketamina endovenosa para el manejo del dolor postoperatorio en adultos?
    (2017) Stuardo,Camila; Lobos Urbina, Diego; Altermatt, Fernando
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    ¿Es efectiva la pregabalina perioperatoria para reducir el dolor postoperatorio en cirugías mayores?
    (2017) Canihuante, José; Molina, Ian; Altermatt, Fernando
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    ¿Es efectivo y seguro el betabloqueo perioperatorio en pacientes sometidos a cirugía no cardíaca?
    (2016) Armstrong, Andrés; Rada G., Gabriel; Altermatt, Fernando
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    Inclination towards research and the pursuit of a research career among medical students: an international cohort study
    (2018) Ha, Tam C.; Altermatt, Fernando; Ng, Sheryl.; Chen, Cynthia.; Yong, Sook K.; Koh, Gerald C H.; Tan, Say B.; Malhotra, Rahul.; Seim, Arnfinn.; Biderman, Aya.
    Abstract Background Involvement of clinicians in biomedical research is imperative for the future of healthcare. Several factors influence clinicians’ inclination towards research: the medical school experience, exposure to research article reading and writing, and knowledge of research. This cohort study follows up medical students at time of graduation to explore changes in their inclination towards research and pursuing a research career compared to their inclination at time of entry into medical school. Methods Students from medical schools in six different countries were enrolled in their first year of school and followed-up upon graduation in their final year. Students answered the same self-administered questionnaire at both time points. Changes in inclination towards research and pursuing a research career were assessed. Factors correlated with these changes were analysed. Results Of the 777 medical students who responded to the study questionnaire at entry into medical school, 332 (42.7%) completed the follow-up survey. Among these 332 students, there was no significant increase in inclination towards research or pursuing a research career over the course of their medical schooling. Students from a United States based school, in contrast to those from schools other countries, were more likely to report having research role models to guide them (51.5% vs. 0%–26.4%) and to have published in a peer-reviewed journal (75.7% vs. 8.9%–45%). Absence of a role model was significantly associated with a decrease in inclination towards research, while an increased desire to learn more about statistics was significantly associated with an increase in inclination towards pursuing a research career. Conclusion Most medical students did not experience changes in their inclination towards research or pursuing a research career over the course of their medical schooling. Factors that increased their inclination to undertaking research or pursuing a research career were availability of a good role model, and a good knowledge of both the research process and the analytical tools required.Abstract Background Involvement of clinicians in biomedical research is imperative for the future of healthcare. Several factors influence clinicians’ inclination towards research: the medical school experience, exposure to research article reading and writing, and knowledge of research. This cohort study follows up medical students at time of graduation to explore changes in their inclination towards research and pursuing a research career compared to their inclination at time of entry into medical school. Methods Students from medical schools in six different countries were enrolled in their first year of school and followed-up upon graduation in their final year. Students answered the same self-administered questionnaire at both time points. Changes in inclination towards research and pursuing a research career were assessed. Factors correlated with these changes were analysed. Results Of the 777 medical students who responded to the study questionnaire at entry into medical school, 332 (42.7%) completed the follow-up survey. Among these 332 students, there was no significant increase in inclination towards research or pursuing a research career over the course of their medical schooling. Students from a United States based school, in contrast to those from schools other countries, were more likely to report having research role models to guide them (51.5% vs. 0%–26.4%) and to have published in a peer-reviewed journal (75.7% vs. 8.9%–45%). Absence of a role model was significantly associated with a decrease in inclination towards research, while an increased desire to learn more about statistics was significantly associated with an increase in inclination towards pursuing a research career. Conclusion Most medical students did not experience changes in their inclination towards research or pursuing a research career over the course of their medical schooling. Factors that increased their inclination to undertaking research or pursuing a research career were availability of a good role model, and a good knowledge of both the research process and the analytical tools required.Abstract Background Involvement of clinicians in biomedical research is imperative for the future of healthcare. Several factors influence clinicians’ inclination towards research: the medical school experience, exposure to research article reading and writing, and knowledge of research. This cohort study follows up medical students at time of graduation to explore changes in their inclination towards research and pursuing a research career compared to their inclination at time of entry into medical school. Methods Students from medical schools in six different countries were enrolled in their first year of school and followed-up upon graduation in their final year. Students answered the same self-administered questionnaire at both time points. Changes in inclination towards research and pursuing a research career were assessed. Factors correlated with these changes were analysed. Results Of the 777 medical students who responded to the study questionnaire at entry into medical school, 332 (42.7%) completed the follow-up survey. Among these 332 students, there was no significant increase in inclination towards research or pursuing a research career over the course of their medical schooling. Students from a United States based school, in contrast to those from schools other countries, were more likely to report having research role models to guide them (51.5% vs. 0%–26.4%) and to have published in a peer-reviewed journal (75.7% vs. 8.9%–45%). Absence of a role model was significantly associated with a decrease in inclination towards research, while an increased desire to learn more about statistics was significantly associated with an increase in inclination towards pursuing a research career. Conclusion Most medical students did not experience changes in their inclination towards research or pursuing a research career over the course of their medical schooling. Factors that increased their inclination to undertaking research or pursuing a research career were availability of a good role model, and a good knowledge of both the research process and the analytical tools required.Abstract Background Involvement of clinicians in biomedical research is imperative for the future of healthcare. Several factors influence clinicians’ inclination towards research: the medical school experience, exposure to research article reading and writing, and knowledge of research. This cohort study follows up medical students at time of graduation to explore changes in their inclination towards research and pursuing a research career compared to their inclination at time of entry into medical school. Methods Students from medical schools in six different countries were enrolled in their first year of school and followed-up upon graduation in their final year. Students answered the same self-administered questionnaire at both time points. Changes in inclination towards research and pursuing a research career were assessed. Factors correlated with these changes were analysed. Results Of the 777 medical students who responded to the study questionnaire at entry into medical school, 332 (42.7%) completed the follow-up survey. Among these 332 students, there was no significant increase in inclination towards research or pursuing a research career over the course of their medical schooling. Students from a United States based school, in contrast to those from schools other countries, were more likely to report having research role models to guide them (51.5% vs. 0%–26.4%) and to have published in a peer-reviewed journal (75.7% vs. 8.9%–45%). Absence of a role model was significantly associated with a decrease in inclination towards research, while an increased desire to learn more about statistics was significantly associated with an increase in inclination towards pursuing a research career. Conclusion Most medical students did not experience changes in their inclination towards research or pursuing a research career over the course of their medical schooling. Factors that increased their inclination to undertaking research or pursuing a research career were availability of a good role model, and a good knowledge of both the research process and the analytical tools required.
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    International fragility fracture network delphi consensus statement on the principles of anaesthesia for patients with hip fracture
    (2018) White, S.M.; Altermatt, Fernando; Barry, J.; Ben‐David, B.; Coburn, M.; Coluzzi, F.; Degoli, M.; Dillane, D.; Foss, N.B.; Gelmanas, A.
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    Intra-operative lidocaine in the prevention of vomiting after elective tonsillectomy in children
    (2018) Echevarría, Ghislaine C.; Altermatt, Fernando; Paredes, S.; Puga, V.; Auad, H.; Veloso, A.; Elgueta Le-Beuffe, María Francisca