Browsing by Author "Castillo, Alvaro"

Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    Covid-19 in hospitalized kidney transplant recipients: analysis of the multicenter registry during the first wave of the pandemic in Chile
    (2024) Pefaur, Jacqueline; Toro, Luis; Badilla, Ximena; Ardiles, Leopoldo; Boltansky, Andres; Rosatti, Pia; Tapia, Beatriz; Rocca, Ximena; Mur, Paola; Fernandez, Alicia; Castillo, Alvaro; Diaz, Carolina; Elgueta, Leticia; Garcia, Francisco; Mueller, Hans; Mansilla, Rodrigo; Munoz, Carolina; Salvatici, Marcelo; Selame, Maria Esperanza; Valenzuela, Marcela; Zamora, Daniela; Enciso, Giovanni; Panace, Rita; Cabrera, Sebastian; Ortiz, Ana Mireya; Mardones, Sandra; Oshiro, Carolina; Sanchez, Juan Eduardo; Lorca, Eduardo; Torres, Ruben
    Introduction: The severity of COVID-19 infection in kidney transplant patients has been well -documented. Objectives : This study aims to determine the epidemiological and clinical data and identify predictors of poor prognosis during the epidemic's early stages. Material and methods : This is a national semi -prospective, multicenter study of subjects with functioning grafts who were infected during the first wave of the pandemic in Chile between March 1 and September 31, 2020. Results : during this period, we recorded the hospitalization of 97 adult patients throughout the entire national territory. The average age was 52.5 years, 62% men, 45% hypertensive, 11% coronary, 10% diabetic, and 5% with chronic obstructive pulmonary disease, with an average post -transplant follow-up of 7.2 years and an average previous renal function of 47.7ml/min/1.7m2 (CKD-EPI formula). Between the onset of symptoms and diagnosis, there was an average period of 4.8 days, with a predominance of cough (44%), dyspnea (42%), and fever (42%). 34% developed acute kidney injury, and 36% of them required dialysis support. The lethality was 30%, prevailing in those with multiple organ failure (80%) and those who required invasive mechanical ventilation (52%). In the multivariate analysis, the best predictors of mortality were older age (OR: 2.92) and living in a low-income commune (OR: 2.35). Conclusions : This national project of the Chilean Society of Nephrology provided valuable information for monitoring the epidemiological evolution of the pandemic. It also helped to propose priority vaccination strategies, adjust immunosuppressive therapy, and design logistical aspects to reduce the risks for transplant patients.
  • No Thumbnail Available
    Item
    Firewood certification programs: Key attributes and policy implications
    (2020) Vasquez Lavin, Felipe; Barrientos, Manuel; Castillo, Alvaro; Herrera, Ivan; Ponce Oliva, Roberto D.
    Evidence from south-central Chile shows that the concentration limits for PM10 and PM2.5, defined by both the World Health Organization and national standards, are systematically exceeded, affecting approximately 10 million people. Among the sources of this pollution, firewood use accounts for the largest share. This study assesses whether consumers value environmental, social, and legal attributes associated with the firewood certification programs. We used a discrete choice model based on a sample of 500 households. According to our results, the price premium for certified firewood is about 10% in the most likely scenario, with those attributes closely related to private benefits having a higher value, compared to those of social benefits. We identify significant heterogeneity among respondents belonging to two different consumer classes: 1) those who are less price sensitive and are willing to pay for attributes related to certification; 2) those who are sensitive to prices and are not willing to pay for attributes related to certification. Since the second class includes about 46% of the sample, the implementation of certification programs could be jeopardized. Therefore, knowing this information helps us determine whether a certification system can foster the firewood industry transition to a more sustainable model.
  • Thumbnail Image
    Item
    Survival study and factors associated with mortality in Chilean patients on peritoneal dialysis infected with SARS-CoV-2
    (2022) Ortiz, Ana M.; Sepulveda Palamara, Rodrigo Andres; Torres, Ruben; Clavero, Rene; Toro, Luis; Albornoz, Miguel; Aldunate, Tatiana; Arce, Ingrid; Arevalo, Juan; Arriagada, Andres; Becker, Julieta; Gonzalez, Sonia C.; Bernales, Waldo; Briones, Eduardo; Castillo, Alvaro; Fuentes, Agustin; Gomez, Esteban; Jaramillo, Hernan; Lillo, Mario; Lorca, Eduardo; Machuca, Eduardo; Mansilla, Rodrigo; Menendez, Serwin; Moya, Carlos; Munoz, Carolina; Neilson, William; Orozco, Rodrigo; Padrino, Maria; Pais, Edgard; Ramirez, Gonzalo; Sanhueza, Maria E.; Schneider, Herman; Solis, Ruth; Troncoso, Jaime; Ursu, Marcela; Valenzuela, Marcela
    The Covid-19 pandemic has been responsible for millions of deaths worldwide. Patients with comorbidities- such as those on peritoneal dialysis (PD)- present higher morbidity and mortality than the general population. We prospectively evaluated all Chilean patients on PD (48 centres) and followed those who had Covid-19 from the beginning of the Covid-19 pandemic in Chile (March 2020) to January 2021 (start of vaccination campaign). We described demographic history, comorbidities, factors related to infection, need for hospitalisation and death due to Covid-19. During the study period, 106 adults on PD were infected by SARS-CoV-2, with a mean age of 53.1 (+/- 16.3) and of which 53.9% were female. From that group, 54.8% required hospitalisation and 24.5% (n = 26) died due to Covid-19. Most of the patients (63.4%) were infected at home and 22.8% during hospitalisation for other reasons. There was a significant association for Covid-19 mortality with: being >= 60 years old, diabetes, time on PD >= 5 years, need for hospitalisation and hospital-acquired infection. At 90 days of follow-up, all deaths associated to Covid-19 occurred before 40 days. We conclude that patients on PD without Covid-19 vaccination have a high mortality and need for hospitalisation associated to Covid-19. To avoid this negative outcome, it is necessary to intensify strategies to avoid contagion, especially in those >= 60 years old, with diabetes and/or >= 5 years spent on PD.