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Search Results: 1 - 10 of 560972 matches for " Juan A. Carrasco O. "
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Extubación fallida en pacientes pediátricos después de cirugía de cardiopatías congénitas Failed extubation in pediatric patients after congenital heart disease surgery
Patricio Valle M.,Ricardo Ronco M.,Cristián Clavería R.,Juan A. Carrasco O.
Revista chilena de pediatría , 2005,
Abstract: La extubación fallida (EF) es una de las complicaciones frecuentes en la evolución postoperatoria de los ni os sometidos a cirugía de cardiopatías congénitas (CCC). Las tasas reportadas oscilan entre 6,7% y 22%, siendo pocas las publicaciones que identifican los factores de riesgo para EF. Objetivos: Determinar la tasa de EF después de CCC e identificar posibles factores de riesgo. Pacientes y Métodos: Estudio retrospectivo de ni os < 3 a os sometidos a CCC con circulación extracorpórea (CEC); las variables preoperatorias, del defecto cardíaco, intraoperatorias, del tipo de reparación y postoperatorias fueron recopiladas y analizadas estadísticamente. Resultados: Se estudió un total de 242 ni os sometidos a CCC; la tasa de EF fue 9,9%. Presentaron mayor incidencia de EF los pacientes en los que se usó paro cardíaco hipotérmico profundo (PCHP) (p = 0,0043, OR = 3,1) y aquellos que desarrollaron estridor laríngeo en el postoperatorio (p = 0,0006, OR = 21,6). La presencia de síndrome de Down (p = 0,009, OR = 5,7) y la edad < 6 meses (p = 0,03, OR = 3,7) fueron identificados como factores de riesgo independientes. Los pacientes con EF presentaron tiempos de ventilación mecánica (VM) más prolongados (p = 0,001) y mayor incidencia de neumonía intrahospitalaria. Conclusiones: Cerca de un 10% de los intentos de extubación fallan en pacientes sometidos a CCC con CEC y esta tasa es similar a las reportadas por otros autores. En nuestro estudio los principales factores de riesgo para EF fueron el desarrollo de estridor laríngeo después de la extubación, el uso de PCHP, la presencia de síndrome de Down y la edad < 6 meses. La EF se asoció a mayor duración de la VM y con el desarrollo de neumonía intrahospitalaria Introduction: Extubation failure (EF) is a common complication after congenital heart disease surgery (CHDS), ranging from 6.7% to 22%. There are few publications that identify risk factors associated with EF in these patients. Objective: To determine the rate of EF after CHDS and identify risk factors. Method: A 3 years retrospective chart review of children less than 3 years-old who underwent CHDS with cardiopulmonary bypass (CPB). Preoperative, operative and postoperative data was collected, including cardiac defect and type of surgery repair. Results: 242 children after CHDS were studied, with EF rate of 9.9%. Significant risk factor for EF during surgery was deep hypothermic circulatory arrest (DHCA) (p = 0,0043 OR = 3,1) and postoperative was laryngeal stridor (p = 0,0006 OR = 21,6). Down Syndrome and age less than 6 months were identified as indepen
Coqueluche en ni?os menores de seis meses de vida
Donoso F.,Alejandro; Wegner A.,Adriana; León B.,José; Ramírez A.,Milena; Carrasco O.,Juan A.;
Revista chilena de pediatría , 2001, DOI: 10.4067/S0370-41062001000400008
Abstract: objective: to analyze our experience in non-immunized or partially immunized children with bordetella pertussis infection. to describe the importance of secondary pulmonary hypertension as a cause of death in this group of children. method: analyze of all patients with bordetella pertussis infection hospitalized in the critical care unit padre hurtado hospital between may and december 2000. results: 15 patients were studied, 73% male, median age 1 month 22 days (range 15 days to 4 months 23 days). six were aged less than 1 month and median gestational age was 40 weeks (range 26-40). most frequent clinical manifestationes were cough 15/15, cyanosis 13/15, and apnoea 3/15. the median white blood count (wbc) was 19,600/mm3 (11,060-120,000) and median lymphocyte count 11,013/mm3. wbc was normal in 7. the mean stay in picu was 4 days. 4 patients needed conventional mechanical ventilation, 2 high frequency oscillatory ventilation and one inhaled nitric oxide. 2 patients died, in one autopsy confirmed pulmonary hypertension. conclusion: bordetella pertussis infection may be fatal in early life and clinical presentation may be atypical. the most serious complication is the development of cardiogenic shock secondary to pulmonary hypertension. in the course of pertussis the presence of tachycardia, hyperleucocitosis and progressive respiratory distress should alert the physician to the possibility of pulmonary hipertension. early diagnosis is essential for aggressive therapy to be instituted because otherwise the evolution is fulminant and fatal in this group of patients.
Extubación fallida en pacientes pediátricos después de cirugía de cardiopatías congénitas
Valle M.,Patricio; Ronco M.,Ricardo; Clavería R.,Cristián; Carrasco O.,Juan A.; Castillo M.,Andrés; Córdova L.,Guiliana; Rodríguez C.,José I.;
Revista chilena de pediatría , 2005, DOI: 10.4067/S0370-41062005000500004
Abstract: introduction: extubation failure (ef) is a common complication after congenital heart disease surgery (chds), ranging from 6.7% to 22%. there are few publications that identify risk factors associated with ef in these patients. objective: to determine the rate of ef after chds and identify risk factors. method: a 3 years retrospective chart review of children less than 3 years-old who underwent chds with cardiopulmonary bypass (cpb). preoperative, operative and postoperative data was collected, including cardiac defect and type of surgery repair. results: 242 children after chds were studied, with ef rate of 9.9%. significant risk factor for ef during surgery was deep hypothermic circulatory arrest (dhca) (p = 0,0043 or = 3,1) and postoperative was laryngeal stridor (p = 0,0006 or = 21,6). down syndrome and age less than 6 months were identified as independent risk factors. finally, ef was associated with longer mechanical ventilation and higher incidence of pulmonary infections. conclusions: around 10% of extubation trials failed in patients with chds and cpb, a rate that is similar to the ones reported in other clinical reviews. in our study, the main risk factors for ef were laryngeal stridor after extubation, dhca, down syndrome and age less than 6 months. the ef was associated with longer mechanical ventilation and lung infection
Derrame Pericárdico, Enfrentamiento Clínico
CLAVERíA R,CRISTIáN; VERGARA G,LUIS; NEGRóN M,SANDRA; LóPEZ L,CARMEN LUZ; ZELADA P,PAMELA; CARRASCO O,JUAN ANDRéS;
Revista chilena de pediatría , 2009, DOI: 10.4067/S0370-41062009000300009
Abstract: pericardial effusion is the main complication of pericarditis, and can create serious consequences depending on the speed of development and etiology. the most common causes are neoplasms and idiopathic, even though viral etiology is a frequently underestimated cause because of the difficulty in its confirmation. in cases of significant pericardial effusion, pericardiocenthesis has demonstrated to be an effective and safe procedure. we present a clinical case of a 14 year old adolescent who complained of persistent abdominal pain, and whose study showed significant pericardial effusion. pericardiocenthesis was performed, along with installation of a pigtail catheter which drained 500 ml of serohematic pericardial effusion. the etiologic study included an pcr (polymerase chain reaction) positive for enterovirus. the patient recovered favorably and was dismissed from the hospital in good condition. the objective of this report is to expose a current revision of the clinical management of pericardial effusion and the technical skills of pericardiocenthesis. knowledge of the technique is fundamental in the treatment of pericardial effusion, especially in situations associated with hemodynamic compromise.
Estudio clínico y determinación de la parasitemia en un grupo de pacientes infectados por Trypanosoma cruzi de la región de Atacama, Chile
Carrasco V,Mauricio; Andrade L,Winston; Jercic L,María Isabel; Fernández O,Jorge; Miranda C,Claudio; Rivera Q,Juan; González V,Jorge; González A,Luis; Ramírez V,Eugenio;
Revista médica de Chile , 2003, DOI: 10.4067/S0034-98872003000800007
Abstract: trypanosoma cruzi infection is endemic in northern/central chile. aim: to perform a clinical assessment of patients infected with trypanosoma cruzi. patients and methods: two hundred sixty three subjects with a positive serology for trypanosoma cruzi, were invited by mail to a clinical assessment in a regional hospital. in a subsample of these, a polymerase chain reaction for trypanosoma cruzi, was done. results: of all the invited subjects, 183 responded and were assessed at the hospital. of these, 60 had cardiac affections, 52 had colon problems and 17, esophageal disease. seventy four were asymptomatic. of the 64 patients in whom polymerase chain reaction was done, 35 had a positive result. conclusions: a high percentage of subjects infected with trypanosoma cruzi, had clinical consequences of the infection. polymerase chain reaction showed persistency of the parasite in more than half of the infected patients (rev méd chile 2003; 131: 881-6)
Socio-Spatial Inequality in Education Facilities in the Concepción Metropolitan Area (Chile)  [PDF]
Helen De la Fuente, Carolina Rojas, María Jesús Salado, Juan Antonio Carrasco, Tijs Neutens
Current Urban Studies (CUS) , 2013, DOI: 10.4236/cus.2013.14013
Abstract: In Concepción Metropolitan Area (CMA), the uneven geographical distribution of population, exacerbated by the recent spread of urban growth, has promoted a clear spatial inequity in the provision of quality educational facilities. The objective of this research is to systematically compare the 493 schools of existing educational opportunities in the CMA with the aim to evaluate the spatial equity in order to improve a most inclusive urban planning. Statistical and graphical analysis revealed that nearest units to the center of the metropolitan area (Concepción) had better conditions than the farthest with respect to students-teacher ratio, teaching quality and academic outcomes assessment. This center-periphery pattern shows clearly the challenges to be faced in the CMA with respect to equitable access to quality educational resources.
Development of Peptide-Based Lineage-Specific Serology for Chronic Chagas Disease: Geographical and Clinical Distribution of Epitope Recognition
Tapan Bhattacharyya ,Andrew K. Falconar,Alejandro O. Luquetti,Jaime A. Costales,Mario J. Grijalva,Michael D. Lewis,Louisa A. Messenger,Trang T. Tran,Juan-David Ramirez,Felipe Guhl,Hernan J. Carrasco,Patricio Diosque,Lineth Garcia,Sergey V. Litvinov,Michael A. Miles
PLOS Neglected Tropical Diseases , 2014, DOI: 10.1371/journal.pntd.0002892
Abstract: Background Chagas disease, caused by infection with the protozoan Trypanosoma cruzi, remains a serious public health issue in Latin America. Genetically diverse, the species is sub-divided into six lineages, known as TcI–TcVI, which have disparate geographical and ecological distributions. TcII, TcV, and TcVI are associated with severe human disease in the Southern Cone countries, whereas TcI is associated with cardiomyopathy north of the Amazon. T. cruzi persists as a chronic infection, with cardiac and/or gastrointestinal symptoms developing years or decades after initial infection. Identifying an individual's history of T. cruzi lineage infection directly by genotyping of the parasite is complicated by the low parasitaemia and sequestration in the host tissues. Methodology/Principal Findings We have applied here serology against lineage-specific epitopes of the T. cruzi surface antigen TSSA, as an indirect approach to allow identification of infecting lineage. Chagasic sera from chronic patients from a range of endemic countries were tested by ELISA against synthetic peptides representing lineage-specific TSSA epitopes bound to avidin-coated ELISA plates via a biotin labelled polyethylene glycol-glycine spacer to increase rotation and ensure each amino acid side chain could freely interact with their antibodies. 79/113 (70%) of samples from Brazil, Bolivia, and Argentina recognised the TSSA epitope common to lineages TcII/TcV/TcVI. Comparison with clinical information showed that a higher proportion of Brazilian TSSApep-II/V/VI responders had ECG abnormalities than non-responders (38% vs 17%; p<0.0001). Among northern chagasic sera 4/20 (20%) from Ecuador reacted with this peptide; 1/12 Venezuelan and 1/34 Colombian samples reacted with TSSApep-IV. In addition, a proposed TcI-specific epitope, described elsewhere, was demonstrated here to be highly conserved across lineages and therefore not applicable to lineage-specific serology. Conclusions/Significance These results demonstrate the considerable potential for synthetic peptide serology to investigate the infection history of individuals, geographical and clinical associations of T. cruzi lineages.
Oral Pharmacokinetics of Mirodenafil in Mexican Healthy Volunteers  [PDF]
Miriam del Carmen Carrasco-Portugal, Francisco Javier Flores-Murrieta, Juan Gerardo Reyes-García, Noemí Santos-Caballero
Pharmacology & Pharmacy (PP) , 2014, DOI: 10.4236/pp.2014.51016
Abstract:

Mirodenafil is a 5-phosphodiesterase inhibitor that is currently marketed in Korea for the treatment of erectile dysfunction; however, no information in other populations is available. It has been described that Mirodenafil is metabolized by CYP3A4, a metabolic pathway in which interethnic differences have been reported. The purpose of this study was to characterize the oral pharmacokinetics of Mirodenafil in Mexicans. Seventeen male healthy volunteers were enrolled in this study. After an overnight fast, volunteers received an oral 100 mg dose and blood samples were collected at selected times during 24 h. Plasma was stored frozen and analyzed by an HPLC method. Pharmacokinetic parameters obtained were: Cmax 331.129 ± 32.689 ng/mL, tmax 1.574 ± 0.293 h, AUC24h 883.293 ± 104.088 ng·h/mL, AUC 976.477 ± 108.812 ng·h/mL and t1/2 1.807 ± 0.171 h. Parameter values observed in this study are similar to those reported in Koreans. Since efficacy and safety studies of Mirodenafil have been conducted in Koreans, it is expected that dosage regime to employ in Mexicans should be similar to the approved for Korean population.

Terapia génica como herramienta molecular para regenerar células ciliadas
Maass O,Juan Cristóbal; Carrasco M,Loreto; Dentone S,Luis; Kukuljan P,Manuel;
Revista de otorrinolaringología y cirugía de cabeza y cuello , 2009, DOI: 10.4067/S0718-48162009000100011
Abstract: hearing loss is a major public health problem. a frequent type of damage, common in mammals, is the irreversible loss of cochlear hair cells, with preservation of the supporting cells. current therapies are not oriented to solve the fundamental problem. the literature shows that in vivo regeneration of hair cells with auditory thresholds improvement is possible, using overexpression of atohl (a key gene in the development and differentiation of hair cells) in the organ of corti supporting cells. experimental evidence shows that a decrease in the expression of genes that have the opposite effect may stimulate proliferation and posterior differentiation of supporting cells into hair cells. research on this field will contribute to our understanding of the development and functioning of the mammal inner ear, and to the future use of this type of therapeutic intervention in deaf patients.
Mastitis granulomatosa idiopática: Diagnóstico y tratamiento en 14 casos Idiopathic granulomatous mastitis: Report of 14 cases
JUAN ANTONIO PéREZ P,JOHN BOHLE O,GONZALO SáNCHEZ C,CRISTIAN CARRASCO L
Revista Chilena de Cirugía , 2007,
Abstract: Introducción: La mastitis granulomatosa idiopática es una enfermedad inflamatoria benigna, infrecuente, de etiología desconocida. Puede simular carcinoma mamario, por lo cual su diagnóstico definitivo es histopatológico. No existe consenso respecto a su tratamiento. Realizamos una caracterización clínica de esta patología considerando su forma de presentación, métodos diagnósticos y tratamiento con especial énfasis en la efectividad de la corticoterapia. Material y método: Estudio retrospectivo realizado mediante protocolo tipo. Se revisaron los registros y fichas clínicas de los pacientes manejados con diagnóstico de mastitis granulomatosa idiopática en el Hospital Regional Valdivia entre los a os 1995-2006. Resultados: La serie corresponde a 14 pacientes de sexo femenino. El promedio de edad fue de 31,6 a os. La presentación clínica más frecuente fue absceso mamario en 9/14. Se realizó estudio imagenológico en 11/ 14 casos mediante mamografía en 7/14 y ecotomografía en 10/14. Las muestras para estudio histopatológico fueron obtenidas por biopsia percutánea en 8/14 y quirúrgica en 6/14. Se realizó tratamiento corticoidal con prednisona en 12/14 pacientes logrando buena respuesta en todos los casos. Se presentaron 2 recidivas durante el seguimiento que comprende un promedio de 28 meses. Conclusiones: La presentación clínica de las mastitis fue similar a la reportada en la literatura. La respuesta al tratamiento corticoesteroidal logró el control de la enfermedad en todos los casos. Las reacciones adversas al tratamiento fueron menores y las 2 recidivas fueron de menor magnitud y duración respecto al cuadro inicial Background: Idiopathic granulomatous mastitis is a benign and uncommon inflammatory disease of the breast, of unknown etiology. It can resemble a carcinoma, therefore the diagnosis is pathological. Aim: To perform a clinical characterization of idiopathic granulomatous mastitis. Material and methods: Retrospective review of medical records of 14 female patients aged 21 to 47 years with idiopathic granulomatous mastitis, treated in a regional hospital between 1995 and 2006. Results: The most common clinical presentation was a breast abscess in nine patients. A mammography was done in seven patients an breast ultrasound in 10. Samples for pathological studies were obtained percutaneously in eight and surgically in six. Twelve patients were treated with prednisone, with good results in all. In a mean follow up of 28 months, two patients had a relapse. Conclusions: Steroid treatment was effective for the treatment of granulomatous mastitis. The tw
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