Browsing by Author "Cavada, Gabriel"
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- ItemConfección de un modelo predictor para infección de herida operatoria en pacientes adultos intervenidos de artroplastía total de cadera en un hospital de alta complejidad, años 2012 y 2014(2019) Lara, Cristián; Cárcamo, Marcela; Cerón Araya, Inés María; Adasme Jeria, Rodrigo Sebastián; Urquidi, Cynthia; Cavada, Gabriel
- ItemEvaluación del consumo de antimicrobianos en una Unidad de Neonatología: un trabajo en equipo para promover el uso racional de antimicrobianos(2017) Jiménez, Elisa; Valls, Nicolás; Astudillo, Patricio André; Valls Jiménez, Cristián; Cavada, Gabriel; Sandoval, Alejandra; Alegría, Angélica; Ortega, Gabriela; Núñez, Daniela; Mena Nannig, Patricia Isabel
- ItemEvaluation of antimicrobial consumption in a Neonatology Unit: a team work to promote the rational use of antibiotics(SOC CHILENA INFECTOLOGIA, 2017) Jimenez, Elisa; Valls, Nicolas; Astudillo, Patricio; Valls, Cristian; Cavada, Gabriel; Sandoval, Alejandra; Alegria, Angelica; Ortega, Gabriela; Nunez, Daniela; Mena, PatriciaBackground: Antibiotics (ATB) are drugs widely used in hospitalized newborns. The indiscriminate use of ATBs promote the rise of resistant bacteria to the most commonly indicated antimicrobials. In addition, ATB prescription presents associations to morbidity, such as bronchopulmonary dysplasia, necrotizing enterocolitis, late sepsis and even death. All of the above leads to an increase in health care costs. Aim: To record and to evaluate trends of antibiotic use over time in hospitalized NB in the Neonatology Unit at Dr. Sotero del Rio Hospital, in order to objectify the changes in the usual practice of the ATM indication. A secondary objective was to assess its impact on antimicrobial resistance. Methods: Cohort, observational, prospective unicenter study which included all hospitalized patients between January 2011 and December 2014. Birth weight, hospitalization days, ATB indication and days of ATB use were recorded for each patient. The use of ATB was quantified by means of different rates; days of indication of one or more ATBs for global consumption (RUA), total sum of days of use (TSUA) and for the most frequently used ATBs. Each calculated rate for 100 days hospitalized. In addition, the antimicrobial susceptibility of the most frequently isolated bacteria in our service: coagulase-negative Staphylococcus (SCN) and Gram-negative bacilli (BGN) were recorded continuously. Results: The 34.7% of the hospitalized patients received some type of antimicrobial agent. ATBs were 32.3% of medicines used. The most widely used was ampicillin (with 20.2% of the total) and cefadroxyl (with 11.6%). The RUA did not change during the study time, but STUA decreased by 10.7% between 2011 and 2014 with p < 0.05. When subgroup analyzes were divided by weight ranges, in the < 750 g group, the use of vancomycin decreased in use by 9.9% and an increase of 18.8% for metronidazole was observed. On the other hand, there was an increase in the use of the piperacillin-tazobactam regimen in the range > 1,500 g. When evaluating antimicrobial susceptibility, there was a decrease in susceptibility for oxacillin in SCN between 2011 and 2014 from 27% to 10.3% respectively. In addition, for Gram negative there was a decrease from 76.9% to 40.5% in susceptibility to third generation cephalosporins, mainly due to Klebsiella pneumoniae, which became the predominantly isolated BGN with an increase of 6.7% to 50% between 2011 and 2014, respectively. For K. pneumoniae the loss of susceptibility to third generation cephalosporins decreased from 77% to 22%. Finally, amikacin showed an activity over 85% in all BGNs between 2011 and 2014. Conclusions: It is advisable to plan and to maintain a continuous record of ATB consumption, as well as therapy and prophylaxis, being categorized by ATB type and range of newborn weight. It is of considerable importance to analyze and to evaluate the susceptibility of microorganisms. It is essential that an interdisciplinary team prepare this recording, and to continuously provide feedback to professionals who maintain the functioning of neonatal care units.
- ItemExtended Lymphadenectomy Is Required for Incidental Gallbladder Cancer Independent of Cystic Duct Lymph Node Status(2018) Vega P., Eduardo; Viñuela Fawaz, Eduardo Andrés; Yamashita, Suguru; Sanhueza García, Marcel Paolo; Cavada, Gabriel; Díaz, Cristián; Aloia, Thomas A.; Chun, Yun Shin; Tzeng, Ching-Wei D.; Okuno, Masayuki
- ItemIn-hospital mortality after ST-segment elevation myocardial infarction according to reperfusion therapy(2008) Prieto, Juan Carlos; Sanhueza, Consuelo; Martinez, Nicolas; Nazzala, Carolina; Corbalan, Ramon; Cavada, Gabriel; Lanas, Fernando; Bartolucci, Jorge; Campos, PablaBackground: Primary angioplasty is considered the best repefusion therapy in The treatment of ST-segment elevation))myocardial infarction (STEMI). However, thrombolysis the reperfusion, method most commonly used, due to its wide availability reduced costs and case of administration. Aim To compare in-hospital mortality, in STEMI patients according to repefusion therapy. Material and Methods. Patients admitted to Chilean hospitals participating in the GEMI network,from. 2001 to 2005, with STEMI were included. They were divided in three groups: a) treated with thrombolytics, b) treated with primary angioplasty, c) without reperfusion procedure. In-hospital mortality according to gender, was analized in each group, using a logistic regression method, to assess risk factors associated with mortality. Results: We included 3,255 patients. Global mortality was 9.9% (75% in men and 16.7% in women, p < 0.001). Mortality in patients treated with thrombolytics, was 10.2% (76% in men and 18.7% in women, p < 0.01). The figure for patients treated with primary angioplasty, was 4.7% (2.5% in men and 13% in women, p < 0.01), and in patients without reperfusion, was 11.6% (9.8% in men and in 15.4% women, p < 0.01). In each group women were older, had a higher prevalence of hypertension and a higher percentage of Killip 3-4 infarctions. Logistic regression showed that angioplasty) compared with no repefusion, was associated with a reduced mortality only in men. The use of thrombolytics in women was associated with a higher mortality. Conclusions: Primary angioplasty was the reperfusion therapy associated to the lower mortality in STEMI. Use of thrombolytics in women was associated with a higher mortality rate than in non reperfused women
- ItemIncidence of Congenital Hypothyroidism Is Increasing in Chile(2025) Grob Lunecke, Francisca; Cavada, Gabriel; Lobo, Gabriel; Valdebenito, Susana; Pérez, María Virginia; Donoso, GildaCongenital hypothyroidism (CH) is a leading preventable cause of neurocognitive impairment. Its incidence appears to be rising in several countries. We analysed 27 years of newborn-screening data (1997–2023) from the largest Chilean screening centre, covering 3,225,216 newborns (51.1% of national births), to characterise temporal trends and potential drivers of CH incidence. Annual CH incidence was modelled with Prais–Winsten regression to correct for first-order autocorrelation; additional models assessed trends in gestational age, sex, biochemical markers, and aetiological subtypes. We identified 1550 CH cases, giving a mean incidence of 4.9 per 10,000 live births and a significant yearly increase of 0.067 per 10,000 (95 % CI 0.037–0.098; p < 0.001). Mild cases (confirmation TSH < 20 mU/L) rose (+0.89 percentage points per year; p = 0.002). The program’s recall was low (0.05%). Over time, screening and diagnostic TSH values declined, total and free T4 concentrations rose, gestational age at diagnosis fell, and a shift from thyroid ectopy toward hypoplasia emerged; no regional differences were detected. The sustained increase in CH incidence, alongside falling TSH thresholds and growing detection of in situ glands, suggests enhanced recognition of milder disease. Ongoing surveillance should integrate environmental, iodine-nutrition, and genetic factors to clarify the causes of this trend.
- ItemIncidental Gallbladder Cancer: Residual Cancer Discovered at Oncologic Extended Resection Determines Outcome: A Report from High- and Low-Incidence Countries(2017) Viñuela, E.; Vega P., Eduardo; Yamashita, Suguru; Sanhueza García, Marcel Paolo; Mege, Rosemarie; Cavada, Gabriel; Aloia, Thomas A.; Chun, Yun Shin; Lee, Jeffrey E.; Vauthey, Jean-Nicolas; Conrad, Claudius
- ItemLeuprolide acetate-stimulated androgen response during female puberty(2015) Hernández, María Isabel; Martínez Aguayo, Alejandro Gregorio; Cavada, Gabriel; Avila, Alejandra; Iñiguez, German; Mericq, Veronica
- ItemPrevalence of hypertension in school age children and its association with obesity(SOC MEDICA SANTIAGO, 2011) Bancalari, Rodrigo; Diaz, Carlos; Martinez Aguayo, Alejandro; Aglony, Marlene; Zamorano, Juanita; Cerda, Veronica; Fernandez, Manuel; Garbin, Flabia; Cavada, Gabriel; Valenzuela, Maria; Garcia, HernanBackground: Hypertension in children is a frequently overlooked problem that is an important cardiovascular risk factor. Aim: To determine the prevalence of hypertension among school age children. Material and Methods: Cross-sectional study of 2980 children aged 10 +/- 2 years (48% females) from 10 schools of middle and lower class in Metropolitan Santiago. Blood pressure (BP) was measured in the sitting position on three occasions after a rest period, using a mercury sphygmomanometer with appropriate cuff arm diameter, averaging the results of the measurements. Systolic and diastolic hypertension were defined as blood pressure values over 95 percentile for age, sex and height. Results: The overall prevalence of hypertension was 12.2% in women and 15% in men (p < 0.05). According to nutritional status, the prevalence was 6.7, 8.9, 13.6 and 26% in underweight, eutrophic, overweight and obese children, respectively (p < 0.01). Compared with normal weight children, the risk of being hypertensive for overweight children was 1.6 (95% confidence intervals (CI) 1.2-2.3) and for obese children was 3.6 (95% CI 2.8-4.7). Conclusions: The studied children had a high prevalence of hypertension, that was directly related to a higher body mass index. (Rev Med Chile 2011; 139: 872-879).
- ItemLa razón cintura estatura en escolares no varía con el género, la edad ni la maduración puberal(2014) Arnáiz Gómez, Pilar; Grob Lunecke, Francisca Andrea; Cavada, Gabriel; Domínguez de Landa, María Angélica; Bancalari, Rodrigo; Cerda, Verónica; Zamorano, Juanita; Fernández, Manuel; García Bruce, Hernán
- ItemSwimming versus running : effects on exhaled breath condensate pro-oxidants and pH(2018) Araneda, Oscar F.; Contreras Briceño, Felipe; Cavada, Gabriel; Viscor, Ginés