Browsing by Author "Carrasco, Marcela"

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    Impact of Delirium on Short-Term Mortality in Elderly Inpatients: A Prospective Cohort Study
    (ELSEVIER SCIENCE INC, 2009) Gonzalez, Matias; Martinez, Gabriel; Calderon, Jorge; Villarroel, Luis; Yuri, Francisca; Rojas, Carlos; Jeria, Alvaro; Valdivia, Gonzalo; Marin, Pedro Paulo; Carrasco, Marcela
    Background: Delirium is an important problem especially in older medical inpatients. Objective: The authors asked whether delirium and its duration are associated with higher mortality in a 3-month follow-up period. Method: In this prospective cohort study, inpatients age 65 and older were assessed every 48 hours with the Confusion Assessment Method. Results: Of 542 patients enrolled, 192 (35.4%) developed delirium. After 3 months, mortality in the delirium cohort was 25.9%, and in the nondelirium cohort was 5.8%. Delirium was independently associated with mortality, and increased by 11% for every 48 hours of delirium. Conclusion: Delirium and increased delirium durations are significantly associated with higher mortality. (Psychosomatics 2009; 50: 234-238)
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    Intraoperative electroencephalographic marker of preoperative frailty: a prospective cohort study
    (2023) Boncompte, Gonzalo; Sun, Haoqi; Elgueta Le-Beuffe, María Francisca; Benavides, Javiera; Carrasco, Marcela; Morales, María I.; Calderón, Natalia; Contreras, Victor; Westover, M. Brandon; Cortínez, Luis I.; Akeju, Oluwaseun; Pedemonte Trewhela, Juan Cristóbal
    Frailty was common in elderly patients undergoing non cardiac surgery. Electroencephalogram alpha-band power does not predict preoperative frailty above patients' age. Frailty predictions by machine learning algorithms, were not improved by the addition of electroencephalogram features. Frailty might be different to the concept of brain vulnerability, accounting for a possible brain-body dissociation.
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    Morphological and molecular identification of canine filariae in a semi-rural district of the Metropolitan Region in Chile
    (SOC CHILENA INFECTOLOGIA, 2012) Lopez, Javier; Valiente Echeverria, Fernando; Carrasco, Marcela; Mercado, Ruben; Abarca, Katia
    Introduction: To date, there has been no definitive confirmation of the presence of zoonotic dirofilariasis in dogs in Chile. Objectives: To study the presence of dirofilarias in blood samples from dogs collected in a semi-rural district near Santiago and to compare their frequency in dogs with and without dermatological manifestations. Methods: We examined 100 blood samples for dog filariae infections using microscopic methods (modified Knott technique). 50 dogs presented dermatological symptoms or signs compatible with filarial infections and 50 were asymptomatic. ITS-2 and 12s rDNA gene amplification by PCR and sequencing were performed in samples microscopically positive for microfilariae. Results. We observed microfilariae in 22 dogs (22%). Of these, 16/50 (32%) were symptomatic and 6/50 (12%) were asymptomatic (p = 0.02). Morphologically, the majority of microfilariae were similar to Dirofilaria repens, although many had a bigger size than previously described. Nucleotide sequencing of the amplified genes showed no more than 95% homology with the D. repens sequences available for comparison. D. reconditum and D. dracunculoides infections were also identified. Conclusions: These features might indicate the presence of new species of Dirofilaria or a D. repens close related variant in Chile.
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    Predictors of Unmet Needs in Chilean Older People with Dependency: A Cross-Sectional Study
    (2023) Carvacho, Raffaela; Carrasco, Marcela; Fernández, María Beatriz; Miranda-Castillo, Claudia
    Approximately one in five Chilean older adults has some degree of dependency. Limited evidence is available on self-perceived needs in Latin-American older people. The main aim of this study was to identify predictors of unmet needs of dependent older persons without cognitive impairment, considering personal and primary informal caregivers’ factors. This cross-sectional study was conducted with a sample of 77 dyads of older people with dependency and their caregivers. A survey was administered, evaluating sociodemographic characteristics, anxious and depressive symptomatology, health-related quality of life, and social support. Older people’s self-reported met and unmet needs and caregivers’ burden and self-efficacy were also assessed. To determine predictors of unmet needs, a multiple regression analysis was carried out. Most participants had mild to moderate levels of dependency. The most frequent unmet needs were “daytime activities” (33.8%), “company” (23.4%), “benefits” (23.4%), and “psychological distress” (24.7%). Older people’s higher level of dependency and anxious symptomatology were predictors of a higher number of unmet needs, with a model whose predictive value was 31%. The high prevalence of anxious symptomatology and its relationship with the presence of unmet needs highlight the importance of making older people’s psychological and social needs visible and addressing them promptly.
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    Prehabilitation for Chilean frail elderly people - pre-surgical conditioning protocol - to reduce the length of stay: randomized control trial
    (2024) Contreras Ibacache, Víctor; Elgueta Le-beuffe, María Francisca; Balde Sepulveda, Detlef Peter Mario; Astaburuaga Jorquera, Paula Daniela; Carrasco, Marcela; Pedemonte Trewhela, Juan Cristobal; Nicoletti Santoni, Maria Natalia; Medina Díaz, René; Figueroa, Constanza; Alamos Ramirez, Mirelly De Los Angeles; Cuzmar Benítez, Valeria; Vargas Moreno, Benjamin Ignacio; Barraza Mendizabal, Benjamin Juan Pablo; Retamal, Claudio; Cortinez Fernandez, Luis Ignacio; Franco, Sebastián; Agurto, Raul; Vivanco, Catherin
    Background: Frail elderly patients have a higher risk of postoperative morbidity and mortality. Prehabilitation is a potential intervention for optimizing postoperative outcomes in frail patients. We studied the impact of a prehabilitation program on length of stay (LOS) in frail elderly patients undergoing elective surgery.Methods: An RCT study was conducted. Frail patients scheduled for elective surgery were randomized to receive either pre-surgical conditioning protocol (PCP) or standard preoperative care. PCP included nursing, anesthetic, and geriatric assessment, nutritional intervention, and physical training for 4-weeks preoperatively. A nurse followed both groups until discharge criteria were met. The primary outcome was postoperative LOS. Secondary outcomes were nutritional status, preoperative frailty status (frailty phenotype-FP) after PCP, and postoperative complications up to three months categorized according to the Clavien-Dindo Classification. Means and medians between the control and intervention groups were compared, with statistical significance set at α=5%.Results: Thirty-four patients were to intervention and Thirty-seven to the control group. In the intervention group, adherence to prehabilitation was 90%. The median LOS after surgery was three days in both groups, without finding statistically significant differences between groups (P=0.754), although there was a trend towards lower LOS in the urologic surgery subgroup. We found a significant reduction in frailty status after PCP (FPpre=2.4±0.5 and FPpost=1.7±0.5, P<0.001). Nutritional status significantly improved in frail patients after prehabilitation (MNAbasal=9.0±2.5 and MNApost=10.6±2.6), P=0.028. The intervention group had less severe postoperative complications, which were not statistically significant.Conclusions: The PCP conducted both in-person and online, for older frail patients undergoing elective colorectal and urological surgery was not associated with shorter LOS. However, frailty status significantly improved after completing PCP.