Browsing by Author "Pérez C., Carlos"
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- ItemDiagnóstico de la infección por Treponema pallidum en pacientes con sífilis temprana y neurosífilis mediante reacción de la polimerasa en cadena(2011) García Cañete, Patricia; Grassi Corrales, Bruno; Fich, Félix; Salvo Lizama, Aurelio Fernando; Araya, Luis; Abarzúa C., Fernando; Soto, Julia; Poggi, Helena; Lagos L., Marcela; Vásquez T., Patricia; Leon C., Eugenia; Pérez C., Carlos; Wozniak Banchero, AnielaLa sífilis es una enfermedad de transmisión sexual producida por Treponema pallidum, cuyo diagnóstico se realiza presuntivamente basándose en aspectos clínicos y análisis de especificidad limitada. La reacción de la polimerasa en cadena (RPC) ha sido planteada como una alternativa diagnóstica de mayor sensibilidad y especificidad. El objetivo de este trabajo fue validar una RPC para el diagnóstico de sífilis temprana (ST) y neurosífilis (NS). Se utilizaron muestras de lesiones muco-cutáneas y de LCR de pacientes con sospecha de cursar ST y NS respectivamente, previamente diagnosticados, utilizando un estándar de oro ampliado. La RPC fue realizada con partidores dirigidos al gen tpN47. De las 21 muestras de pacientes con ST, la RPC resultó positiva en 20, lo que resulta en una sensibilidad clínica de 95%. De las 8 muestras de pacientes con NS, la RPC resultó positiva en 4, obteniéndose una sensibilidad clínica de 50%. La especificidad clínica para ST y NS fue de 100%. La excelente sensibilidad y especificidad de la RPC para muestras muco-cutáneas permitió la exitosa implementación de este análisis en nuestro laboratorio para el diagnóstico de rutina. Si bien la sensibilidad de la RPC en LCR es baja, es muy útil para apoyar el diagnóstico clínico
- ItemEvaluación de un test comercial de avidez de IgG: Aporte al diagnóstico de primoinfección por Toxoplasma gondii(2010) Canales Romero, Marilena; Navia González, Felipe; Torres Hidalgo, Marisa; Concha Corvalán, Mónica Isabel; Guzman Durán, Ana Maria; Pérez C., Carlos; Garcia Cañete, PatriciaIntroduction: Toxoplasmosis (T) is a major chronic parasitic infection in immunocompromised patients and pregnant women. It is important to discriminate between acute phase (AT) and chronic phase (CT). Diagnosis is serological in immunocompetent patients (concentration of IgG and IgM). Objective: To evaluate the utility of an IgG avidity test (A-IgG) to identify the acute and chronic stage. Avidity is the strength of affinity between a specific immunoglobulin and the protein antigenic epitope of the infecting agent, an affinity that increases over time. Patients and Methods: We used a qualitative kit that measures the avidity of IgG, discriminating the two phases. In 35 patients with clinical diagnosis of AT and/or CT, IgG, IgM and IgG A (VIDAS®) were performed. Results: Patients with AT were positive for IgM and IgG, but presented weak avidity. In the 21 cases with CT, 52% (n: 11) were IgM positive and 100% (n: 21) had positive IgG with strong avidity. Discussion: The results confirm that the test of A-IgG may be useful in the diagnosis of AT, and has 100% concordance with reference test (qualitative IgM + quantitative IgG). The result is available within 24 hrs, and may be useful in diagnosis of AT in pregnant women.
- ItemMalaria: revisión retrospectiva de 12 casos no autóctonos en Chile(2006) Pérez C., Carlos; Baudrand Biggs, René; Labarca L., Jaime; Perret Pérez, Cecilia; Andresen Hernández, Max; Guzmán Durán, Ana MaríaMalaria is a protozoan infection caused by four Plasmodia species transmitted by female Anopheles mosquito. Nearly 40% of the world population is at risk of acquiring the disease because of increasing resistance to treatment, climate changes and travels to endemic zones. We report twelve patients with diagnosis of malaria, supported by the identification of parasites on blood smear. All cases had traveled to endemic zones (Peru, Ecuador, Central America, Africa), but only three used chemoprophylaxis. Seven cases were infected with Plasmodium vivax and five cases with P. falciparum. Three of latter required intensive care. All patients were treated with standard drugs according to the severity and Plasmodium specie, with excellent results and no mortality.
- ItemSíndrome cardiopulmonar por Hantavirus: Utilidad de la monitorización con el sistema PiCCO(2003) Romero Patino; Carlos Miguel; Andresen Hernández, Max Alfonso; Díaz Patiño, Orlando; Tomicic, Vinko; Baraona Reyes, Fernando Exequiel; Mercado Flores, Marcelo Esteban; Pérez C., Carlos; Downey, Patricio; Dougnac Labatut, AlbertoWe report a 68 years old man, farmer from the metropolitan region, admitted with a Hantavirus Cardiopulmonary Syndrome. The diagnosis was made using serologic test and was later confirmed by the Public Health Institute. He evolved to an early multiple organ failure, requiring high concentrations of oxygen and invasive ventilatory assistance, vasopressor drugs and renal replacement therapy. Swan Ganz and PiCCO were used simultaneously for hemodynamic monitoring. Treatment consisted in global support therapy, antimicrobial therapy and systemic corticosteroids. Intrathoracic blood volume was a more reliable parameter than pulmonary capillary wedge pressure for the assessment of preload. As expected in situations of increased vascular permeability, there was an increase in extravascular lung water. There was a good correlation between extravascular lung water and oxygenation parameters (PaO2/FiO2 and oxygenation index). PiCCO system may become a helpful tool in the management of patients with Hantavirus Cardiopulmonary Syndrome