Browsing by Author "Vizcaya Altamirano, María Cecilia"
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- ItemBreath sound analysis and wheezing in cystic fibrosis(SOCIEDAD CHILENA DE PEDIATRIA, 2003) Sánchez Díaz, Ignacio; Vizcaya Altamirano, María Cecilia; García Palomer, María Daniela
- ItemChikungunya, enfermedad emergente en América Latina. Descripción de los primeros casos en Chile(2018) Perret Pérez, Cecilia; Vizcaya Altamirano, María Cecilia; Weitzel, Thomas; Rosas, Reinaldo; Dabanch, Jeannette; Martínez, Constanza
- ItemConsenso sobre riesgo de complicaciones infecciosas en pacientes usuarios de medicamentos biológicos seleccionados. Parte II: Guía clínica chilena de Prevención de Infecciones Asociadas al Uso de Terapias Biológicas (PREVITEB)(2019) Cerón Araya, Inés María; Vizcaya Altamirano, María Cecilia; Gambra, Pilar; Ferres Garrido, Marcela Viviana; Bidart, Teresa; Lépez Quizhpi,Tania Lorena; Acuña, María Paz; Álvarez, Ana María; Zubieta, Marcela; Durán, Luisa; Rabagliati Borie, Ricardo MiguelThe use of biological therapies has meant a great improvement in the management of several conditions like autoimmune, neoplastic or others diseases. Although its use has implied significant improvements in the prognosis of these diseases, it is not exempt from complications: infectious diseases as one of them. The objective of this consensus was to evaluate, from an infectious viewpoint, the safeness of the most frequently used biological therapies and give recommendations for the prevention of infections in patients treated with these drugs. These recommendations were based on the highest quality evidence available for the selected biologics. The consensus counts of 2 manuscripts. This second part is a guideline that details these recommendations through screening strategies, prophylactic therapies and vaccines indications for bacterial, mycobacterial, viral, fungal and parasitic infections, both for adults and children.
- ItemDetección precoz de infección por citomegalovirus en pacientes sometidos a trasplante alogéneico de precursores hematopoyéticos por reacción de polimerasa en cadena cuantitativa en tiempo real(2014) Ceballos, María Elena; Vizcaya Altamirano, María Cecilia; Pavez, D.; Cerda, Jaime; Martínez Valdebenito, C.; Montecinos, L.; Ferrés Garrido, Marcela Viviana
- ItemEarly versus deferred anti-SARS-CoV-2 convalescent plasma in patients admitted for COVID-19: A randomized phase II clinical trial(2021) Balcells Marty, Maria Elvira; Rojas Orellana, Luis Esteban; Martínez Valdebenito, Constanza Pamela; Ceballos Valdivielso, María Elena Andrea; Ferrés Garrido, Marcela Viviana; Chang Rathkamp, Mayling Raquel; Vizcaya Altamirano, María Cecilia; Mondaca Contreras, Sebastián Patricio; Huete Garín, Isidro Álvaro; Castro López, Ricardo Adolfo; Sarmiento Maldonado, Mauricio; Villarroel Del Pino, Luis Antonio; Pizarro Ibáñez, Alejandra Valentina; Ross Pérez, Patricio Daniel; Santander Toro, Jaime Andrés; Lara Hernández, Bárbara Alejandra; Ferrada Koch, Marcela Patricia; Vargas Salas, Sergio Sebastián; Beltrán Pávez, Carolina; Soto Rifo, Ricardo; Valiente Echeverria, Fernando Andrés; Caglevic, Christian; Mahave, Mauricio; Selman Bravo, Carolina Antoniett; Gazitúa, Raimundo; Briones, José Luis; Villarroel Espíndola, Franz; Balmaceda Araque, Carlos Felipe; Espinoza Sepúlveda, Manuel Antonio; Pereira Garces, Jaime; Nervi Nattero, Bruno; Le Corre Perez, Monique NicoleBackground: Convalescent plasma (CP), despite limited evidence on its efficacy, is being widely used as a compassionate therapy for hospitalized patients with COVID-19. We aimed to evaluate the efficacy and safety of early CP therapy in COVID-19 progression.", "Methods and findings", "The study was an open-label, single-center randomized clinical trial performed in an academic medical center in Santiago, Chile, from May 10, 2020, to July 18, 2020, with final follow-up until August 17, 2020. The trial included patients hospitalized within the first 7 days of COVID-19 symptom onset, presenting risk factors for illness progression and not on mechanical ventilation. The intervention consisted of immediate CP (early plasma group) versus no CP unless developing prespecified criteria of deterioration (deferred plasma group). Additional standard treatment was allowed in both arms. The primary outcome was a composite of mechanical ventilation, hospitalization for >14 days, or death. The key secondary outcomes included time to respiratory failure, days of mechanical ventilation, hospital length of stay, mortality at 30 days, and SARS-CoV-2 real-time PCR clearance rate. Of 58 randomized patients (mean age, 65.8 years; 50% male), 57 (98.3%) completed the trial. A total of 13 (43.3%) participants from the deferred group received plasma based on clinical aggravation. We failed to find benefit in the primary outcome (32.1% versus 33.3%, odds ratio [OR] 0.95, 95% CI 0.32-2.84, p > 0.999) in the early versus deferred CP group. The in-hospital mortality rate was 17.9% versus 6.7% (OR 3.04, 95% CI 0.54-17.17 p = 0.246), mechanical ventilation 17.9% versus 6.7% (OR 3.04, 95% CI 0.54-17.17, p = 0.246), and prolonged hospitalization 21.4% versus 30.0% (OR 0.64, 95% CI, 0.19-2.10, p = 0.554) in the early versus deferred CP group, respectively. The viral clearance rate on day 3 (26% versus 8%, p = 0.204) and day 7 (38% versus 19%, p = 0.374) did not differ between groups. Two patients experienced serious adverse events within 6 hours after plasma transfusion. The main limitation of this study is the lack of statistical power to detect a smaller but clinically relevant therapeutic effect of CP, as well as not having confirmed neutralizing antibodies in donor before plasma infusion.", "Conclusions", "In the present study, we failed to find evidence of benefit in mortality, length of hospitalization, or mechanical ventilation requirement by immediate addition of CP therapy in the early stages of COVID-19 compared to its use only in case of patient deterioration.
- ItemFeohifomicosis nasal por Curvularia spicifera en un paciente pediátrico con neutropenia y leucemia mieloide aguda. Nasal phaeohyphomycosis by Curvularia spicifera in pediatric patient with neutropenia and acute myeloid leukemia(2017) Bay, C.; González, T.; Muñoz, G.; Legarraga Raddatz, Paulette; Vizcaya Altamirano, María Cecilia; Abarca Villaseca, Katia
- ItemInfección atípica y neurorretinitis por Bartonella henselae en una unidad de hospitalización pediátrica: comunicación de tres casos(2020) Pérez Pérez, Regina Elizabeth; Fischman, Alexandra; Poblete, María José; Vizcaya Altamirano, María Cecilia; Perret Pérez, Cecilia; García, Cristián; Muñoz, Aldo; Le Corre Pérez, Monique NicolBartonella henselae es el agente etiológico de la enfermedad por arañazo de gato (EAG), infección endémica en Chile. Típicamente se presenta como una linfadenopatía regional autolimitada y menos frecuentemente con compromiso sistémico y manifestaciones extraganglionares: en hígado, bazo, hueso, ojo, entre otros. Se presentan tres casos de infección atípica por Bartonella henselae en las que se evidenció compromiso ocular, manifestado como una neurorretinitis. Esta revisión destaca la importancia de la búsqueda activa de complicaciones oculares en pacientes con compromiso sistémico por Bartonella henselae, implicando un cambio en el tratamiento y pronóstico de la enfermedad.
- ItemInfecciones osteoarticulares en población pediátrica: clínica y microbiología de los últimos 15 años(2022) Cañete Campos, Ismael Ignacio; Moller Macherone, Francesca Andrea; Figueroa Gatica, María Jesús; Monge Iriarte, Marcela María; Le Corre Pérez, Monique Nicole; Vizcaya Altamirano, María Cecilia; Hodgson Ovalle, Felipe Andrés; Ibáñez León, María AngélicaResumen Introducción: El diagnóstico y tratamiento oportuno de las infec- ciones osteoarticulares (IOA) pediátricas son imperativos para evitar complicaciones y secuelas, siendo relevante conocer la microbiología local. Objetivo: Describir las características de las IOA pediátricas tratadas en nuestro centro. Pacientes y Métodos: Estudio observacional descriptivo. Se analizaron pacientes bajo 15 años de edad tratados por IOA entre los años 2004 y 2020. Se evaluaron características clínicas, de laboratorio, microbiología y tratamiento. Resultados: Se incluyeron 126 pacientes (63,5% hombres), con una mediana de edad de 5,09 años (rango: 0,5-14,6 años); 61,1% artritis séptica (AS), 38,9% osteomielitis (OM). Un 92,9% presentó dolor y 68,3% fiebre. La localización más frecuente en AS fue rodilla (33,7%) y en OM tibia (30,6%) y fémur (30,6%). Se identificó agente en 77 pacientes (61,1%), siendo más frecuentes Staphylococcus aureus (n = 44), Kingella kingae (n = 13) y Streptococcus pyogenes (n = 8). Los cuatro pacientes con reacción de polimerasa en cadena (RPC) universal positiva para K. kingae no fueron detectados por otros métodos. Conclusión: El agente más frecuente sigue siendo S. aureus, observándose un aumento en la resistencia de éste en comparación con series nacionales anteriores, y, por primera vez en nuestro medio, se comunica la detección de K. kingae, específicamente relacionada al uso de técnicas moleculares. Palabras clave: Infecciones osteoarticulares; osteomielitis; artritis séptica; pediatría; diagnóstico.
- ItemRecomendaciones en enfermedad hepática crónica y trasplante hepático durante COVID-19 en pediatría(2020) Godoy, M.; Zuloaga, N.; Navarro Tapia, Edith Sandra; Soriano Brucher, Humberto Eduardo; Vizcaya Altamirano, María Cecilia; Rodríguez, G., Lorena; Juanet, J. I.; Faundez, R.; Gana Ansaldo, Juan Cristóbal
- ItemReduced 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, BrunoBackground 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.
- ItemResponse to bronchodilator in infants with bronchiolitis can be predicted from wheeze characteristics(WILEY, 2005) Sánchez Díaz, Ignacio; Vizcaya Altamirano, María Cecilia; Garcia, Daniela; Campos M., Eugenia