Browsing by Author "Ortiz Koh, Catalina Alejandra"

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    A new approach for the acquisition of trauma surgical skills: an OSCE type of simulation training program
    (2022) Ortiz Koh, Catalina Alejandra; Contreras Bertolo, Caterina; Vela Ulloa, Javier Ignacio; Belmar, Francisca; Paul, Ivan; Achurra Tirado, Pablo; Varas Cohen, Julián
    Background Worldwide, trauma-related deaths are one of the main causes of mortality. Appropriate surgical treatment is crucial to prevent mortality, however, in the past decade, general surgery residents’ exposure to trauma cases has decreased, particularly since the COVID-19 pandemic. In this context, accessible simulation-based training scenarios are essential. Methods A low-cost, previously tested OSCE scenario for the evaluation of surgical skills in trauma was implemented as part of a short training boot camp for residents and recently graduated surgeons. The following stations were included bowel anastomosis, vascular anastomosis, penetrating lung injury, penetrating cardiac injury, and gastric perforation (laparoscopic suturing). A total of 75 participants from 15 diferent programs were recruited. Each station was videotaped in high defni tion and assessed in a remote and asynchronous manner. The level of competency was assessed through global and specifc rating scales alongside procedural times. Self-confdence to perform the procedure as the leading surgeon was evaluated before and after training. Results Statistically signifcant diferences were found in pre-training scores between groups for all stations. The lowest scores were obtained in the cardiac and lung injury stations. After training, participants signifcantly increased their level of competence in both grading systems. Procedural times for the pulmonary tractotomy, bowel anastomosis, and vascular anastomosis stations increased after training. A signifcant improvement in self-confdence was shown in all stations. Conclusion An OSCE scenario for training surgical skills in trauma was efective in improving profciency level and self confdence. Low pre-training scores and level of confdence in the cardiac and lung injury stations represent a defcit in resi dency programs that should be addressed. The incorporation of simulation-based teaching tools at early stages in residency would be benefcial when future surgeons face extremely severe trauma scenarios. Keywords Trauma surgery · Simulation training · Surgical training · Surgical education tec
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    Reduced Immune Response to Inactivated Severe Acute Respiratory Syndrome Coronavirus 2 Vaccine in a Cohort of Immunocompromised Patients in Chile
    (Oxford University Press for the Infectious Diseases Society of America, 2022) Balcells Marty, María Elvira; Le Corre Pérez, Monique Nicole; Durán Santa Cruz, Josefina Gracia; Ceballos Valdivielso, María Elena Andrea; Vizcaya Altamirano, María Cecilia; Mondaca Contreras, Sebastián Patricio; Dib Marambio, Martin Javier; Rabagliati Borie, Ricardo Miguel; Sarmiento Maldonado, Mauricio; Burgos Cañete, Paula Isabel; Espinoza Sepúlveda, Manuel Antonio; Ferres Garrido, Marcela Viviana; Martínez Valdebenito, Constanza Pamela; Ruiz-Tagle Seguel, Cinthya Grace; Ortiz Koh, Catalina Alejandra; Ross Pérez, Patricio Daniel; Budnik Bitran, Sigall; Solari Gajardo, Sandra; Vizcaya Vergara, María De Los Ángeles; Lembach, Hanns; Berríos Rojas, Roslye; Melo González, Felipe; Rios Raggio, Mariana; Kalergis Parra, Alexis Mikes; Bueno Ramírez, Susan Marcela; Nervi Nattero, Bruno
    Background Inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines have been widely implemented in low- and middle-income countries. However, immunogenicity in immunocompromised patients has not been established. Herein, we aimed to evaluate immune response to CoronaVac vaccine in these patients. Methods This prospective cohort study included 193 participants with 5 different immunocompromising conditions and 67 controls, receiving 2 doses of CoronaVac 8-12 weeks before enrollment. The study was conducted between May and August 2021, at Red de Salud UC-CHRISTUS, Santiago, Chile. Neutralizing antibody (NAb) positivity, total anti-SARS-CoV-2 immunoglobulin G antibody (TAb) concentrations, and T-cell responses were determined. Results NAb positivity and median neutralizing activity were 83.1% and 51.2% for the control group versus 20.6% and 5.7% (both P < .001) in the solid organ transplant group, 41.5% and 19.2% (both P < .0001) in the autoimmune rheumatic diseases group, 43.3% (P < .001) and 21.4% (PP = .001) in the cancer with solid tumors group, 45.5% and 28.7% (both P < .001) in the human immunodeficiency virus (HIV) infection group, 64.3% and 56.6% (both differences not significant) in the hematopoietic stem cell transplant group, respectively. TAb seropositivity was also lower for the solid organ transplant (20.6%; P < .0001), rheumatic diseases (61%; P < .001), and HIV groups (70.9%; P = .003), compared with the control group (92.3%). On the other hand, the number of interferon gamma spot-forming T cells specific for SARS-CoV-2 tended to be lower in all immunocompromising conditions but did not differ significantly between groups. Conclusions Diverse immunocompromising conditions markedly reduce the humoral response to CoronaVac vaccine. These findings suggest that a boosting vaccination strategy should be considered in these vulnerable patients.
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    SARS-CoV-2 vaccine booster in solid organ transplant recipients previously immunised with inactivated versus mRNA vaccines: A prospective cohort study
    (2022) Dib Marambio, Martín Javier; Le Corre Pérez, Monique Nicole; Ortiz Koh, Catalina Alejandra; García, Daniel; Ferrés, Marcela; Martínez Valdebenito, Constanza; Ruiz-Tagle, Cinthya; Ojeda Valenzuela, María José; Espinoza Sepúlveda, Manuel Antonio; Jara Contreras, Aquiles; Arab Verdugo, Juan Pablo; Rabagliati B., Ricardo; Vizcaya Altamirano, Cecilia; Ceballos, María Elena; Sarmiento Maldonado, Mauricio; Mondaca Contreras, Sebastián Patricio; Viñuela Morales, Macarena Rocío; Pastore Thomson, Antonia; Szwarcfiter Neiman, Vania; Galdames Lavín, Elizabeth Alejandra; Barrera Vásquez, Aldo Vincent; Castro Gálvez, Pablo Federico; Gálvez Arriagada, Nicolás Marcelo Salvador; Soto Ramírez, Jorge Andrés; Bueno Ramírez, Susan; Kalergis Parra, Alexis Mikes; Nervi Nattero, Bruno; Balcells Marty, María Elvira
    Solid-organ transplant (SOT) recipients have worse COVID-19 outcomes than general population and effective immunisation in these patients is essential but more difficult to reach. We aimed to determine the immunogenicity of an mRNA SARS-CoV-2 vaccine booster in SOT recipients previously immunised with either inactivated or homologous SARS-CoV-2 mRNA vaccine. Methods: Prospective cohort study of SOT recipients under medical care at Red de Salud UC-CHRISTUS, Chile, previously vaccinated with either CoronaVac or BNT162b2. All participants received a BNT162b2 vaccine booster. The primary study end point was anti-SARS-CoV-2 total IgG antibodies (TAb) seropositivity at 8-12 weeks (56-84 days) post booster. Secondary end points included neutralising antibodies (NAb) and specific T-cell responses. Findings: A total of 140 (50% kidney, 38% liver, 6% heart) SOT recipients (mean age 54 [13.6] years; 64 [46%] women) were included. Of them, 62 had homologous (three doses of BNT162b2) and 78 heterologous vaccine schedules (two doses of CoronaVac followed by BNT162b2 booster). Boosters were received at a median of 21.3 weeks after primary vaccination. The proportion achieving TAb seropositivity (82.3% vs 65.4%, P = 0.035) and NAb positivity (77.4% vs 55.1%, P = 0.007) were higher for the homologous versus the heterologous group. On the other hand, the number of IFN-γ and IL-2 secreting SARS-CoV-2-specific T-cells did not differ significantly between groups. Interpretation: This cohort study shows that homologous mRNA vaccine priming plus boosting in SOT recipients, reaches a significantly higher humoral immune response than inactivated SARS-CoV-2 vaccine priming followed by heterologous mRNA booster.