Browsing by Author "Oyarzún Andrade, María Angélica"
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- ItemBúsqueda de mutaciones en el gen UL 97 asociadas a resistencia a ganciclovir en citomegalovirus obtenidos desde muestras biológicas de pacientes chilenos(2010) Oyarzún Andrade, María Angélica; Bustos, Patricia; González Agüero, Marcela Margot; Domínguez Moreno, María Isabel; Aguayo González, Francisco Renan; Nervi Nattero, Bruno; Ferrés, MarcelaBackground: Long term use of ganciclovir (GCV) is associated with acquired resistance to it. Ninety percent of the responsible mutations occur in cytomegalovirus (CMV) UL97 gene. Aim: To search for these mutations, comparing nucleotide sequences of CMV-positive samples from post transplant and immunocompromised patients receiving GCV, with sequences of CMV isolates obtained from subjects not exposed to the drug. Patients and Methods: Codons 440 to 465 of gene UL97, including the most common mutations causing resistance to GCV, were amplified in 33 plasma samples from patients exposed to GCV and in 15 urine samples of newborns. Both populations and their nucleotide sequences were compared with the prototype strain CMV AD169. Results: Samples of exposed patients had multiple mutations but only one had a mutation associated with clinical resistance (M4601). Eight subjects had the D605E mutation, whose role in resistance is controversial. The remaining 150 mutations were silent mutations. Conclusions: A low frequency of mutations associated with CMV resistance to GCV was found in these exposed and unexposed samples. These mutations may reflect coexistence of multiple genetic variants of CMV. The absence of clinical expression of resistance, even with these mutations, can be explained by the use of GCV for a shorter lapse than that associated with the appearance of resistance. (Rev Med Chile 2010; 138: 421-427).
- ItemHospitalization due to influenza in children in Santiago, Chile, 2001-2005(SOC CHILENA INFECTOLOGIA, 2008) Vega Briceño, Luis Enrique; Platzer M., Lisbeth; Oyarzún Andrade, María Angélica; Escuela de medicina ; Abarca Villaseca, Katia ; 0000-0003-0404-3887 ; 70281; Pulgar B., Dahiana; Sánchez Díaz, Ignacio
- ItemManejo de la neumonía comunitaria del adulto mayor en el ámbito ambulatorio(2006) Moore Clive, Philippa Mary; Ortega, Juan Pablo; Saldías Peñafiel, Fernando; Oyarzún Andrade, María AngélicaCommunity Acquired Pneumonia (CAP) is the first cause of death by respiratory disease in Chile and the first specific cause of death in people over 80 years of age. The geriatric population has a greater risk of suffering pneumonia, its complications and consequently dying. This is not only related to chronological age but also to certain factors related to ageing such as the presence of comorbidity, malnutrition, and cognitive impairment. An atypical presentation that delays the diagnosis and treatment also increases the risk of complications. CAP in the elderly is caused by the same pathogens that cause it in younger patients. S pneumoniae is the main pathogen followed by viral infections particularly in winter. An important strategy to reduce CAP related health costs, is the identification of patients who are at low risk of complications and who therefore could be managed at home. Optimum management of CAP in the elderly includes early diagnosis and the definition of clinical severity, early antibiotic treatment at the tight dose and for an adequate length of time and a correct decision whether the patient should be managed in hospital or at home.
- ItemSíndrome de muerte súbita del lactante: prevalencia y cambios en los últimos años en Chile(2013) Brockmann Veloso, Pablo Edmundo; Oyarzún Andrade, María Angélica; Villarroel del Pino, Luis A.; Bertrand N., PabloBackground: The sudden infant's death syndrome (SD) is the leading cause of death in children under one year. Despite advances in its study, the pathogenesis has not been yet fully elucidated. Aim: To assess the prevalence of SD in Chilean infants and its changes in recent years. Material and Methods: Review of birth and death databases of the Ministry of Health from 1997 to 2009. All cases diagnosed as SD, according to the International Classification of Diseases, 10th edition, were selected. A demographic analysis was performed and mortality rates for each year were calculated. Results: We identified 1442 cases of SD (847 males, 517 deaths at home). The median age of death was 2 months (0 to 11.0 months). Ninety six percent of deaths occurred in children aged <6 months. Mortality rate for SD was 0.45/1000 live births. There was a 23% reduction between 1997 and 2009. When analyzing geographic distribution, more cases were found in the Southern latitudes of the country. Conclusions: The overall rate of SD in Chile is higher than in European countries and in North America. The observed decrease in cases over the years is still far from optimal.
- ItemSudden infant death syndrome(2020) Oyarzún Andrade, María Angélica; Brockmann Veloso, PabloSudden infant death syndrome is a challenging situation that involves ruling out all possible death causes through exhaustive examinations. It is the main cause of death in children under 1 year in developed countries, and has shown a general reduction, possibly related to education campaigns. Its etiology is still not clear but probably corresponds to a multifactorial polygenic condition whose main factors are genetic, environmental, and sociocultural. Its management relies on controlling existing risk factors through a consistent message from the child’s health team and public health educational campaigns.
- ItemTraqueostomía en niños: experiencia de 10 años en una Unidad de Cuidados Intensivos Pediátricos(Sociedad Chilena de Pediatria, 2021) Oyarzún Aguirre, Ignacio; Conejero Müller, María José; Adasme, Rodrigo; Pérez, Carolina; Segall, Dafne; Vulletin, Fernando; Oyarzún Andrade, María Angélica; Valle, PatricioLa indicación de traqueostomía en pediatría ha cambiado en los últimos 30 años, desde indicaciones agudas y transitorias por obstrucción de la vía aérea a indicaciones programadas y de uso crónico por necesidad de ventilación mecánica (VM) crónica. Objetivo: describir la indicación de traqueostomía y morbilidad asociada al procedimiento, en una cohorte de una década. Pacientes y Método: Estudio descriptivo. Revisión de fichas de egresos hospitalarios (2005-2015) en menores de 15 años traqueostomizados durante su estadía, en una unidad de cuidados intensivos de un hospital universitario. Se evaluaron variables demográficas y clínicas pre y post traqueostomía, estadía en unidad de intensivo, edad al momento de traqueostomía, indicación de ésta, complicaciones precoces (< 7 días), complicaciones tardías (> 7 días), y mortalidad. Resultados: Se consignaron 59 pacientes traqueostomizados, 36 (59%) de ellos menores de 6 meses y 60% en varones. El 39% tuvo una genopatía confirmada o en estudio y el 42% una cardiopatía congénita. Las principales indicaciones fueron compromiso de vía aérea (58%) y VM crónica (42%). En el subgrupo de vía aérea, las principales causas fueron estenosis subglótica, parálisis cordal y traqueobroncomalacia, mientras que en el subgrupo de VM crónica las principales indicaciones fueron displasia broncopulmonar y daño pulmonar crónico. No encontramos mortalidad asociada a traqueostomía. El 89% fue egresado con traqueostomía y el 59% con VM crónica. Los pacientes de menor edad presentaron mayor probabilidad de alta con traqueostomía y aquellos con mayor número de fallas de extubación previo a traqueostomía, presentaron mayor tasa de egreso con VM. Conclusiones: La traqueostomía es un procedimiento seguro en niños, siendo las causas preponderantes la patología de vía aérea y necesidad de VM crónica. La mayoría de los niños traqueostomizados egresó con traqueostomía y VM crónica. Los niños de menor edad, weaning difícil, genopatía confirmada o sospecha, o con necesidad especiales en salud tienen mayor riesgo de necesitar traqueostomía y VM crónica.