Browsing by Author "Gajardo, Jorge"

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    Clinical and pulmonary function analysis in long-COVID revealed that long-term pulmonary dysfunction is associated with vascular inflammation pathways and metabolic syndrome
    (FRONTIERS MEDIA SA, 2023) Sanhueza, Sergio; Vidal, Mabel A.; Hernandez, Mauricio A.; Henriquez-Beltran, Mario E.; Cabrera, Camilo; Quiroga, Romina; Antilef, Barbara E.; Aguilar, Kevin P.; Castillo, Daniela A.; Llerena, Faryd J.; Figueroa, Marco Fraga; Nazal, Mauricio; Castro, Eritson; Lagos, Paola; Moreno, Alexa; Lastra, Jaime J.; Gajardo, Jorge; Garces, Pamela; Riffo, Benilde; Buchert, Jorge; Sanhueza, Rocio; Ormazaba, Valeska; Saldivia, Pablo; Vargas, Cristian; Nourdin, Guillermo; Koch, Elard; Zuniga, Felipe A.; Lamperti, Liliana; Bustos, Paula; Guzman-Gutierrez, Enrique; Tapia, Claudio A.; Ferrada, Luciano; Cerda, Gustavo; Woehlbier, Ute; Riquelme, Marcelo; Yuseff, Maria Isabel; Ramirez, Braulio A. Munoz; Lombardi, Giovanna; De Gonzalo-Calvo, David; Salomon, Carlos; Verdugo, Ricardo A.; Quinones, Luis A.; Colombo, Alicia; Barria, Maria I.; Labarca, Gonzalo; Nova-Lamperti, Estefania
    Introduction: Long-term pulmonary dysfunction (L-TPD) is one of the most critical manifestations of long-COVID. This lung affection has been associated with disease severity during the acute phase and the presence of previous comorbidities, however, the clinical manifestations, the concomitant consequences and the molecular pathways supporting this clinical condition remain unknown. The aim of this study was to identify and characterize L-TPD in patients with long-COVID and elucidate the main pathways and long-term consequences attributed to this condition by analyzing clinical parameters and functional tests supported by machine learning and serum proteome profiling. Methods: Patients with L-TPD were classified according to the results of their computer-tomography (CT) scan and diffusing capacity of the lungs for carbon monoxide adjusted for hemoglobin (DLCOc) tests at 4 and 12-months post-infection. Results: Regarding the acute phase, our data showed that L-TPD was favored in elderly patients with hypertension or insulin resistance, supported by pathways associated with vascular inflammation and chemotaxis of phagocytes, according to computer proteomics. Then, at 4-months post-infection, clinical and functional tests revealed that L-TPD patients exhibited a restrictive lung condition, impaired aerobic capacity and reduced muscular strength. At this time point, high circulating levels of platelets and CXCL9, and an inhibited FCgamma-receptor-mediated-phagocytosis due to reduced Fc gamma RIII (CD16) expression in CD14+ monocytes was observed in patients with L-TPD. Finally, 1-year post infection, patients with L-TPD worsened metabolic syndrome and augmented body mass index in comparison with other patient groups. Discussion: Overall, our data demonstrated that CT scan and DLCOc identified patients with L-TPD after COVID-19. This condition was associated with vascular inflammation and impair phagocytosis of virus-antibody immune complexes by reduced Fc gamma RIII expression. In addition, we conclude that COVID-19 survivors required a personalized follow-up and adequate intervention to reduce long-term sequelae and the appearance of further metabolic diseases.
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    Resultados Chilenos del registro internacional de factores de riesgo y tratamiento de angina inestable e infarto al miocardio sin supradesnivel del segmento ST: ACCORD (ACute CORonary syndrome Descriptive study)
    (SOC MEDICA SANTIAGO, 2011) Stockins, Benjamin; Albornoz, Francisco; Martinez, Dario; Campos, Pabla; Gajardo, Jorge; Lamich, Ruben; Manriquez, Leopoldo; Perez, Victor; Rojo, Pamela; Sepulveda, Pablo; Gabriela Pumarino, M.; Corbalan, Ramon
    Background: Guidelines for the management of unstable angina (UA) and non ST elevation myocardial infarction (NSTEMI) have been issued, however current practices are unknown in Chile. Aim: To evaluate in a prospective cohort of NSTEMI patients the current practices, treatments and risk factors. Material and Methods: One year prospective International non interventional registry, conducted in Chile between January 2005 and November 2006. Results: Two hundred thirty three Chilean NSTEMI patients were enrolled. Mortality was 5.5% at the end of the follow-up. Mean age was 61.6 years, and 30.6% were female. Most of the patients had at least one risk factor (98%): hypertension (84%), previous myocardial infarction (33%), dyslipidemia (54%), diabetes (33%), current smoking (30%). Main procedures during the hospitalization were coronary angiogram (67%), angioplasty (33%; 88% with stent) and coronary bypass surgery (7%). During procedures, 31% of patients received clopidogrel, and 4.2% glycoprotein IIb/IIIa antagonists. Medical management was selected for 60% of patients. In comparison to men, women received less interventional procedures despite having more risk factors. Treatments prescribed at discharge were aspirin (97%), clopidogrel (49%), beta blockers (78%), diuretics (21%), lipid lowering agents (78%), oral hypoglycemic agents (13%) and insulin (9%). At the end of the 1-year follow-up, treatments were aspirin (84%), beta blockers (72%), diuretics (19%), and dual antiplatelet therapy with clopidogrel (16%). Conclusions: A high prevalence of multiple risk factors for cardiovascular disease in Chilean patients with NSTEMI was observed. More aggressive primary and secondary preventive measures are urgently needed. Use of therapies proposed in the guidelines is high, but dual antiplatelet therapy is less than 50% at discharge and decreases during the one year-follow-up. (Rev Med Chile 2011; 139: 19-26).