Browsing by Author "Rojas Orellana, Luis"
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- ItemAnti-Xa Activity After Enoxaparin Prophylaxis In Hospitalized Patients Weighing Less Than Fifty-Five Kilograms(2013) Rojas Orellana, Luis; Aizman, Andrés; Ernst Diaz, Daniel Matias; Acuña, M. Paz; Moya, Pablo; Mellado Suazo, Rosemarie; Paul Delfau, María de los Ángeles; Cerda, Jaime
- ItemAssociation of SNPs with the efficacy and safety of immunosuppressant therapy after heart transplantation(2015) Sánchez Lazaro, Ignacio; Herrero, Maria Jose; Jordan-De Luna, Consuelo; Boso, Virginia; Almenar, Luis; Rojas Orellana, Luis; Martínez Dolz, Luis; Megías Vericat, Juan E.; Sendra, Luis; Miguel, Antonio; Poveda, José L.; Aliño, Salvador F.
- ItemCost-minimization analysis of subcutaneous versus intravenous trastuzumab administration in Chilean patients with HER2-positive early breast cancer(2020) Rojas Orellana, Luis; Muniz, S.; Medina Araya, Lidia; Peña Durán, José Esteban; Acevedo Claros, Francisco Nicolás; Pinto Paganini, Mauricio Arturo; Sánchez Rojel, César Giovanni
- ItemEffect of CYP3A5∗3 on kidney transplant recipients treated with tacrolimus : a systematic review and meta-analysis of observational studies(2015) Rojas Orellana, Luis; Neumann Burotto, Gonzalo Ignacio; Herrero, M. José; Bosó, V.; Reig, J.; Poveda, J. Luis; Megías, J.; Bea, S.; Aliño, S. F.
- ItemHipoglicemia recurrente como causa reversible de síndrome demencial en adultos mayores diabéticos, a propósito de un caso(2010) Aizman, Andrés; Luis Manuel Sanhueza, A.; Iruretagoyena B., Mirentxu; Abbott Cáceres, Eduardo Francisco; Rodríguez, J.C.; Rojas Orellana, LuisWe report a 78 year-old diabetic woman, treated with gliburide and metformin, consulting in the emergency room for a non fuctuating impairment in consciousness. She had a history of similar episodes in the last two months. A brain CAT scan showed an old putamen lacunar infarction. Noteworthy was the presence of a low glycosilated hemoglobin level of 5.2%. Hypoglycemic medications were discontinued and the patient was discharged in good conditions. After six months of follow up, the patient did not have further episodes of impairment of consciousness.
- ItemImpact of ABC single nucleotide polymorphisms upon the efficacy and toxicity of induction chemotherapy in acute myeloid leukemia(2017) Megías Vericat, Juan Eduardo; Montesinos, Pau; Herrero, María José; Moscardó, Federico; Bosó, Virginia; Rojas Orellana, Luis; Martínez Cuadrón, David; Hervás, David; Boluda, Blanca; García Robles, Ana
- ItemImpact of NADPH oxidase functional polymorphisms in acute myeloid leukemia induction chemotherapy(2018) Megías-Vericat, J.E.; Montesinos, P.; Herrero, M.J.; Moscardó, F.; Bosó, V.; Rojas Orellana, Luis; Martínez-Cuadrón, D.; Rodríguez-Veiga, R.; Sendra, L.; Cervera, J.; Poveda, J.L.; Sanz, M.Á.; Aliño, S.F.
- ItemInfluence of ABCB1 polymorphisms upon the effectiveness of standard treatment for acute myeloid leukemia : A systematic review and meta-analysis of observational studies(2015) Megias, J.; Rojas Orellana, Luis; Herrero, M.; Boso, V.; Montesinos, P.; Moscardo, F.; Poveda, J.; Sanz, M.; Alino, S.
- ItemInfluence of cytarabine metabolic pathway polymorphisms in acute myeloid leukemia induction treatment(2017) Megías Vericat, J.; Montesinos, P.; Herrero, M.; Moscardó, F.; Bosó, V.; Martínez Cuadrón, D.; Rojas Orellana, Luis; Rodríguez Veiga, R.; Boluda, B.; Sendra, L.; Cervera, J.; Poveda, J.; Sanz, M.; Aliño, S.
- ItemIntubation timing as determinant of outcome in patients with acute respiratory distress syndrome by SARS-CoV-2 infection(2021) Vera Alarcón, María Magdalena; Kattan Tala, Eduardo José; Born, Pablo; Rivas, E.; Amthauer, M.; Nesvadba, A.; Lara, Bárbara; Rao, I.; Espíndola, Eduardo; Rojas Orellana, Luis; Hernández Poblete, Glenn; Bugedo Tarraza, Guillermo; Castro López, RicardoBackground: SARS-CoV-2 infection presents in many cases with pneumonia and respiratory failure. It is not clear whether the time of intubation and connection to mechanical ventilation (MV) in this condition is associated with an increase in mortality or represents the natural course of the disease. We conducted an observational, prospective, single-center study to describe the characteristics and outcomes of acute respiratory distress syndrome (ARDS) patients with confirmed COVID-19 and treated with invasive MV to determine whether the time-to-intubation following hospital admission is associated with worse outcomes. Methods: We prospectively included consecutive patients with SARS-CoV-2 infection and moderate to severe ARDS, admitted to an intensive care unit (ICU) and connected to MV between March 17 and July 31, 2020. We examined their general characteristics, ventilatory management, and clinical outcomes. Time of intubation was defined as the time from hospital admission to endotracheal intubation and was categorized as early (<72 hours) or late (≥72 hours). Mann-Whitney U, Kruskal Wallis, chi-square, and Fisher’s exact, were used when appropriate. Uni and multivariate analyses between main outcome and explanatory variables were performed. Results: A total of 183 consecutive patients were included, 28% (51/183) were female, and their median age was 62 years [54-70]. One hundred (55%) patients were subjected to early and 83 (45%) to late intubation. Patients intubated after 72 hours were older and presented more comorbidities. Mortality was higher in the group of patients with late intubation (41% versus 21%; p= 0.002), a PaO2/FiO2 ratio <100 mmHg at admission (p= 0.029), and that were older than 60 years (p= 0.008). Conclusions: In acute COVID-19 patients with moderate to severe ARDS, intubation after 72 hours following hospital admission, age >60 years-old and a PaO2/FiO2 ratio <100 at admission may appear to be associated with increased ICU mortality. Further studies are required to confirm our findings and establish the best timing for intubation in COVID-19 patients admitted to the ICU with respiratory failure.
- ItemIs acetaminophen beneficial in patients with cancer pain who are on strong opioids? A randomized controlled trial(2023) Leiva, Ofelia; Letelier Saavedra, Luz María; Rojas Orellana, Luis; Viviani García, Paola; Castellano, Joel; González Candia, Antonio Felipe; Pérez Cruz, PedroContextPain is common among cancer patients. The evidence recommends using strong opioids in moderate to severe cancer pain. No conclusive evidence supports the effectiveness of adding acetaminophen to patients with cancer pain who are already using this regime.ObjectiveTo assess the analgesic efficacy of acetaminophen in hospitalized cancer patients with moderate to severe pain receiving strong opioids.MethodsIn this randomized blinded clinical trial, hospitalized cancer patients with moderate or severe acute pain managed with strong opioids were randomized to acetaminophen or placebo. The primary outcome was pain intensity difference between baseline and 48 hours using the Visual Numeric Rating Scales (VNRS). Secondary outcomes included change in morphine equivalent daily dose (MEDD), and patients’ perception of improved pain control.ResultsAmong 112 randomized patients, 56 patients received placebo, 56 acetaminophen. Mean (standard deviation (SD)) decrease in pain intensity (VNRS) at 48 hours were 2.7 (2.5) and 2.3 (2.3), respectively (95% Confidence Interval(CI) [-0.49;1.32];p=0.37). Mean (SD) change in MEDD was 13.9 (33.0) mg/day and 22.4 (57.7), respectively (95% CI [-9.24;26.1];p=0.35). The proportion of patients perceiving pain control improvement after 48 hours was 82% in the placebo and 80% in the acetaminophen arms (p=0.81).ConclusionAmong patients with cancer pain on strong opioid regime, acetaminophen may not improve pain control, or decrease total opioid use. These results add to the current evidence available suggesting not to use acetaminophen as an adjuvant for advanced cancer patients with moderate to severe cancer pain who are on strong opioids.
- ItemMeta-analysis and systematic review of the effect of the donor and recipient CYP3A5 6986A>G genotype on tacrolimus dose requirements in liver transplantation(2013) Rojas Orellana, Luis; Herrero, M.; Boso, V.; García Eliz, M.; Poveda, J.; Librero, J.; Alino, S.
- ItemMetodología de adaptación de una guía clínica para el manejo de pacientes adultos con neumonía adquirida en la comunidad en una red de salud privada(2011) Pantoja Calderón, Tomás; Ferdinand Olivares, Constanza; Saldías Peñafiel, Fernando; Rojas Orellana, Luis; Balcells Marty, María Elvira; Castro López, Ricardo; Poblete Umanzor, Rodrigo EduardoBackground: Clinical practice guidelines (CPG) are widely used as tools for improving quality of health care. Guidelines developed elsewhere, can be adapted using a valid and systematic process. Aim: To describe the methodology used in the process of adaptation of a guideline for the management of adults with community-acquired pneumonia (CAP) in a private health care organization. Material and Methods: We used the ADAPTE framework involving three main phases. At the set-up phase a guideline adaptation group integrated by medical specialists from different disciplines, a methodologist and a nurse coordinator was formed. At the adaptation phase, the specific clinical questions to be addressed by the guidelines were identified. Results: Twenty five guidelines were initially retrieved. After their assessment, the number was reduced to only three. Recommendations from these guidelines were 'mapped' and focused searches were carried out where 'evidence gaps' were identified. An initial draft was written and revised by the adaptation group. At the finalization phase, the external review of the guideline was carried out and a process for the regular review and update of the adapted guideline was defined. Conclusions: We developed a guideline for the management of adults with CAP, adapted to the local context of our health care system, using guidelines developed elsewhere. This guideline creation method can be an efficient means of saving professional resources.
- ItemRandomized double-blind controlled trial to assess the efcacy of intravenous acetaminophen associated with strong opioids in the treatment of acute pain in adult cancer patients: study protocol(2022) Leiva, Ofelia; Castellano, Joel; Letelier Saavedra, Luz María; Rojas Orellana, Luis; Viviani García, Paola; González Candia, Antonio Felipe; Pérez Cruz, PedroBackground: Cancer pain is one of the most frequent and relevant symptoms in cancer patients and impacts on patient’s quality of life. International and local standards recommend as an initial strategy the use of an analgesic scheme composed of strong opioids associated with adjuvants such as acetaminophen, based upon the assumption that combining drugs could have a better analgesic effect, could allow lowering opioid dosing, and could prevent the occurrence of adverse effects of opioids. However, there is uncertainty about the impact of acetaminophen as an adjuvant in patients who use strong opioids for moderate to severe pain management in cancer patients. The aim of this study is to assess the efficacy and safety of intravenous acetaminophen associated with strong opioids in hospitalized adult cancer patients who have moderate to severe cancer-related pain. Methods: We will perform a randomized double-blinded controlled study comparing intravenous acetaminophen 1 g 4 times a day versus placebo for 48 h as an adjuvant to strong opioids. We will assess pain intensity as a primary outcome, using the verbal numerical rating scale (VNRS, I0 to 10 scale with higher scores meaning higher pain intensity), and we will compare the mean difference in pain intensity between baseline and 48 h among the placebo and intervention groups. We estimate that a decrease of 1 point in the VNRS would be clinically significant. Assuming a standard deviation in pain intensity of 1.7 points, an alpha of 0.025, and a power of 0.8, we estimate a sample size of 112 patients, with 56 patients in each arm. Secondary outcomes include the difference in total opioid use between baseline and at 48 h among the groups, and adverse effects such as drowsiness, constipation, nausea, and vomiting would be evaluated. Discussion: The randomized, double-blind, placebo-controlled design is the best strategy to assess the efficacy of acetaminophen as an adjuvant in adult cancer patients with moderate to severe pain who are receiving strong opioids. We expect to contribute to national and international guidelines with these results.