Browsing by Author "Saldias, Fernando"

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    C-Reactive protein levels in patients with chronic obstructive pulmonary disease
    (SOC MEDICA SANTIAGO, 2012) Diaz, Orlando; Parada, Alejandra; Ramos, Cristobal; Klaassen, Julieta; Carlos Diaz, Juan; Andresen, Max; Lisboa, Carmen; Saldias, Fernando
    Background: Patients with chronic obstructive pulmonary disease (COPD) have elevated serum levels of ultrasensitive C reactive protein (CRPus). This raise may be related directly to COPD and its associated systemic inflammation or secondary to other factors such as smoking status, disease severity, acute exacerbations, or associated complications. Aim: To evaluate the potential causes of raised levels of CRPus in stable COPD patients. Patients and Methods: Cohorts of 133 mild-to-very severe COPD patients (41 current smokers), 31 never-smokers, and 33 current smoker controls were compared. Clinical assessments included body mass index (BMA fat (FM) and fat-free mass (FFM) measurement by DEXA, forced expiratory volume in one second (FEV1), arterial oxygen tension (PaO2), six-minute walking test (SMWT), emphysema (EMPH) and right thigh muscle cross-sectional area (TMCSA), both quantified by high resolution computed tomography. Results: Serum CRPus levels were significantly higher in COPD patients than in controls (7 +/- 4.2 and 3.7 +/- 2.7 mg/L, respectively; p < 0.0001). Being smoker did not influence CRPus levels. These levels were significantly correlated with FM (r = 0.30), BMI (r = 0.21), FEV1 (r = -0.21), number of acute exacerbations of the disease in the last year (r = 0.28), and PaO2 (r = -0.27). Using multivariate analysis FM, PaO2, and number of acute exacerbations of the disease in the last year had the strongest association with CRPus levels. Conclusions: CRPus is elevated in COPD patients, independent of smoking status. It is weakly associated with fat mass, arterial oxygen tension and frequency of exacerbations. (Rev Med Chile 2012; 140: 569-578).
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    Etiology of community-acquired pneumonia in hospitalized patients in Chile - The increasing prevalence of respiratory viruses among classic pathogens
    (ELSEVIER SCIENCE BV, 2007) Diaz, Alejandro; Barria, Paulina; Niederman, Michael; Restrepo, Marcos I.; Dreyse, Jorge; Fuentes, Gino; Couble, Bernardita; Saldias, Fernando
    Background and study objectives: The range and relative impact of microbial pathogens, particularly viral pathogens, as a cause of community-acquired pneumonia (CAP) in hospitalized adults has not received much attention. The aim of this study was to determine the microbial etiology of CAP in adults and to identify the risk factors for various specific pathogens.
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    Predictive value of history and physical examination for the diagnosis of community-acquired pneumonia in adults
    (2007) Saldias, Fernando; Cabrera, Daniel; de Solminihac, Ignacio; Hernandez, Pamela; Gederlini, Alessandra; Diaz, Alejandro
    Background- Community-acquired pneumonia in adults is a serious health problem in the ambulatory care setting. Aim To define clinical variables associated with the presence of pneumonia in adult patients presenting with fever or respiratory symptoms to the emergency department. Material and methods: Prospective study carried out in the emergency department from the Catholic University Hospital in Santiago, Chile. Three hundred twenty-five patients (53 22 years) presenting fever or acute respiratory symptoms were included. After obtaining a clinical history and physical examination, the physician established a tentative diagnosis. Subsequently, a definitive diagnosis was made with the chest X rays. Results: Thirty-four percent of the patients had pneumonia. The clinical diagnosis of pneumonia before X-ray examination, was variable among emergency physicians (positive likelihood ratio 1.5-4.8) and showed only moderate sensitivity (79%) and specificity (66%). The clinical variables significantly associated with the presence of pneumonia were: advanced age (over 75 years), cardiovascular disease, fever, chills, sputum production, orthopnea, altered mental status, cyanosis, dullness on percussion, bronchial breath sounds, crackles, any abnormal vital sign (heart rate >= 100 beats/min, respiratory rate >= 20 breaths/min or temperature >= 38 degrees C) and oxygen. saturation below 90% breathing air Conclusions: Clinical judgment prior to observation. of chest X rays had moderate sensitivity and specificity for the diagnosis of pneumonia. There were no individual clinical findings, or combination of findings, that could confirm or exclude the diagnosis of pneumonia for a patient suspected of having this illness.