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Publicación
Effect of Combination Antibiotic Empirical Therapy on Mortality in Neutropenic Cancer Patients with Pseudomonas aeruginosa Pneumonia
(2022) Albasanz-Puig, Adaia; Durà-Miralles, Xavier; Laporte-Amargós, Júlia; Mussetti, Alberto; Ruiz-Camps, Isabel; Puerta-Alcalde, Pedro 5, Edson Abdala 6, Chiara Oltolini 7, Murat Akova 8,; Abdala, Edson 6, Chiara Oltolini 7, Murat Akova 8,; Oltolini, Chiara; Akova, Murat; Montejo ,José Miguel; Malgorzata, Mikulska; Martín-Dávila, Pilar; Herrera, Fabián; Gasch, Oriol; Drgona, Lubos; Paz Morales, Hugo Manuel; Brunel, Anne-Sophie; García, Estefanía; Isler, Burcu; Kern, Winfried V.; Retamar-Gentil, Pilar; Aguado, José María; Montero, Milagros; Kanj, Souha S.; Sipahi, Oguz R.; Calik, Sebnem; Márquez-Gómez, Ignacio; Marín, Jorge I.; Gomes, Marisa Z.R.; Hemmati, Philipp; Araos Bralic, Rafael Ignacio; Peghin, Magdalena; Pozo, José Luis del; Yáñez, Lucrecia; Tilley, Robert; Manzur, Adriana; Novo, Andres; Pallarès, Natàlia; Bergas, Alba; Carratalà, Jordi; Gudiol, Carlota; The Ironic Study Group
To assess the effect of combination antibiotic empirical therapy on 30-day case-fatality rate in neutropenic cancer patients with Pseudomonas aeruginosa (PA) bacteremic pneumonia. This was a multinational, retrospective cohort study of neutropenic onco-hematological patients with PA bloodstream infection (BSI) (2006−2018). The effect of appropriate empirical combination therapy, appropriate monotherapy and inappropriate empirical antibiotic therapy [IEAT] on 30-day case-fatality was assessed only in patients with PA bacteremic pneumonia. Among 1017 PA BSI episodes, pneumonia was the source of BSI in 294 (28.9%). Among those, 52 (17.7%) were caused by a multidrug-resistant (MDR) strain and 68 (23.1%) received IEAT, mainly when the infection was caused by an MDR strain [38/52 (73.1%) vs. 30/242 (12.4%); p < 0.001]. The 30-day case-fatality rate was higher in patients with PA bacteremic pneumonia than in those with PA BSI from other sources (55.1% vs. 31.4%; p < 0.001). IEAT was associated with increased 30-day case-fatality (aHR 1.44 [95%CI 1.01−2.03]; p = 0.042), whereas the use of appropriate combination empirical treatment was independently associated with improved survival (aHR 0.46 [95%CI 0.27−0.78]; p = 0.004). Appropriate empirical monotherapy was not associated with improved overall survival (aHR 1.25 [95%CI 0.76−2.05]; p = 0.39). Combination antibiotic empirical therapy should be administered promptly in febrile neutropenic patients with suspected pneumonia as the source of infection.
Publicación
Consumo actual de cigarrillos electrónicos entre estudiantes de secundaria que nunca han fumado
(2022) Peruga, Armando; Martínez, Cristina; Fu, Marcela; Ballbè, Montse; Tigova, Olena; Carnicer-Pont, Dolors; Fernández, Esteve
Objetivo:
Examinar si en España el uso de los cigarrillos electrónicos está asociado a la iniciación del consumo de nicotina entre los estudiantes de secundaria.
Método:
Análisis secundario de datos de la encuesta ESTUDES 2019, estudio transversal realizado a una muestra representativa de estudiantes entre 14 y 18 años. Seleccionamos los alumnos que nunca habían fumado (n=16.705). Calculamos la prevalencia y estimamos los factores asociados al consumo de cigarrillos electrónicos al menos una vez en el mes anterior a la entrevista, con y sin nicotina.
Resultados:
La prevalencia de consumo actual de cigarrillos electrónicos entre estudiantes que nunca han fumado es del 2,5% (intervalo de confianza del 95% [IC 95%]: 2,2-2,9). El 0,1% (IC 95%: 0,08-0,2) reportó haber utilizado alguna vez líquidos con nicotina y el 2,4% (IC 95%: 2,1-2,8) siempre sin nicotina. Ser varón, menor de 17 años, hacer botellón y tener amigos habituales que consumen cannabis aumenta la probabilidad de consumo actual de cigarrillos electrónicos. Estas dos últimas variables parecen actuar como variables contextuales asociadas al consumo de cigarrillos electrónicos.
Conclusiones:
El porcentaje de estudiantes españoles que nunca han fumado, pero que consumen cigarrillos electrónicos actualmente, es menor que en los países de nuestro entorno, a excepción del Reino Unido. Solo uno de cada 1000 estudiantes españoles de secundaria que nunca han fumado se inicia en el consumo actual de nicotina con un cigarrillo electrónico. No obstante, debemos vigilar cómo evoluciona este indicador.
Publicación
Editorial: Free Fatty Acids as Signaling Molecules: Role of Free Fatty Acid Receptors and CD36
(2022) Puebla, Carlos; Morselli, Eugenia; Khan, Naim Akhtar; Retamal, Mauricio A.
Publicación
Serological study of CoronaVac vaccine and booster doses in Chile: immunogenicity and persistence of anti-SARS-CoV-2 spike antibodies
(2022) Vargas, Leonardo; Valdivieso, Nicolás; Tempio, Fabián; Simon, Valeska; Sauma, Daniela; Valenzuela, Lucía; Beltrán, Caroll; Castillo- Delgado, Loriana; Contreras-Benavides, Ximena; Acevedo, Mónica L.; Acevedo, Johanna; Gonzalez, Rafael I.; Valiente-Echeverría, Fernando; Soto-Rifo, Ricardo; Rosemblatt, Mario; López, Mercedes; Osorio, Fabiola; Bono, María Rosa
Background: Chile was severely affected by COVID19 outbreaks but was also one of the first countries to start a nationwide program to vaccinate against the disease. Furthermore, Chile became one of the fastest countries to inoculate a high percentage of the target population and implemented homologous and heterologous booster schemes in late 2021 to prevent potential immunological waning. The aim of this study is to compare the immunogenicity and time course of the humoral response elicited by the CoronaVac vaccine in combination with homologous versus heterologous boosters.
Methods: We compared the immunogenicity of two doses of CoronaVac and BNT162b2 vaccines and one homologous or heterologous booster through an ELISA assay directed against the ancestral spike protein of SARS-CoV-2. Sera were collected from individuals during the vaccination schedule and throughout the implementation of homologous and heterologous booster programs in Chile.
Results: Our findings demonstrate that a two-dose vaccination scheme with CoronaVac induces lower levels of anti-SARS-CoV-2 spike antibodies than BNT162b2 in a broad age range (median age 42 years; interquartile range (IQR) 27-61). Furthermore, antibody production declines with time in individuals vaccinated with CoronaVac and less noticeably, with BNT162b2. Analysis of booster schemes revealed that individuals vaccinated with two doses of CoronaVac generate immunological memory against the SARS-CoV-2 ancestral strain, which can be re-activated with homologous or heterologous (BNT162b2 and ChAdOx1) boosters. Nevertheless, the magnitude of the antibody response with the heterologous booster regime was considerably higher (induction fold BNT162b2: 11.2x; ChAdoX1; 12.4x; CoronaVac: 6.0x) than the responses induced by the homologous scheme. Both homologous and heterologous boosters induced persistent humoral responses (median 122 days, IQR (108-133)), although heterologous boosters remained superior in activating a humoral response after 100 days.
Conclusions: Two doses of CoronaVac induces antibody titers against the SARS-CoV-2 ancestral strain which are lower in magnitude than those induced by the BNT162b2 vaccine. However, the response induced by CoronaVac can be greatly potentiated with a heterologous booster scheme with BNT162b2 or ChAdOx1 vaccines. Furthermore, the heterologous and homologous booster regimes induce a durable antibody response which does not show signs of decay 3 months after the booster dose.
Persona
Publicación
Cuatro aproximaciones a la experiencia subjetiva desde la metodología de investigación fenomenológica hermenéutica
(2022) Pacheco Pacheco, Cristóbal; Fossa, Pablo
En el presente artículo se realizó una aproximación a los planteamientos centrales a la metodología fenomenológica hermenéutica, como modo de acercamiento a la vivencia subjetiva particular. Es sobre la base de los planteamientos de filósofos tales como Husserl (2012), Heidegger (2020) y Merleau-Ponty (1945), que han urgido posibilidades de acercamiento a la construcción propia de la realidad a nivel particular, lo cual reviste un interesante campo de estudio. Este estudio realiza una revisión sistemática de cuatro formas de aproximación a la experiencia particular desde una dimensión fenomenológica y hermenéutica. Las metodologías consideradas son las siguientes: el paradigma de las ciencias humanas para el estudio fenomenológico de Max Van Manen (1990); el método descriptivo fenomenológico en psicología de Amedeo Giorgi (1986, 2009); la entrevista microfenomenológica de Claire Petitmengin (2006) y el Interpretative Phenomenological Analysis (IPA) de Jonathan Smith y Mike Osborn (2003). Como conclusiones del presente estudio, se visualiza la necesidad de lograr una mayor estructuración metodológica que respete, a la vez, la tradición de un acercamiento desprejuiciado al estudio de los fenómenos, propios de la fenomenología y hermenéutica.
Persona
Publicación
Seroprevalence and estimation of the impact of SARS-CoV-2 infection in older adults residing in Long-term Care Facilities in Chile
(2022) Rubilar, Paola; Hirmas Adauy, Macarena; Matute, María Isabel; Browne, Jorge; Little, Cedric; Ruz, Gonzalo; Aguilera, Ximena; Avila, Carlos; Vial, Pablo; Gutknecht Mackenzie, Tania
Introduction
Older adults are at a higher risk of severe illness and death from COVID-19. This vulnera bility increases in those who live in long-term care facilities due to overcrowding, greater
physical dependence, and contact with health workers. Evidence on the impact of the pan demic on these establishments in low- and middle-income countries has been scant. This
study aims to determine the seroprevalence of SARS-CoV-2 in older people residing in
long-term care facilities and estimate the impact of infection after the first wave of the
pandemic.
Methods
A cross-sectional design with 2099 residents in three regions of Chile was carried out be tween September and November 2020. Measurement of antibodies was performed with a
rapid test. The impact of SARS-CoV-2 infection was estimated with seropositive residents,
those who had a history of positive polymerase chain reaction tests, and those who died
from COVID-19. Bivariate analysis with the region, sex, age, history of COVID-19, physical
dependence, and serological results were performed. In addition, we performed a correla tion analysis between the seroprevalence of the centers by the municipality and the rate of
confirmed cases.
Results
The seroprevalence of SARS-CoV-2 antibodies in the three regions was 14.7% (95% confi dence interval: 13.2 to 16.3%), the infection impact was 46.4%, and the fatality rate was
19.6%. A significant correlation was found between the seroprevalence of older adults re siding in long-term care facilities and the cumulative incidence by municipalities.
Conclusions
The seroprevalence of older adults residing in long-term care facilities was higher than the
general population. The high impact of infection among this population at the end of the
first wave of the COVID-19 pandemic is similar to other countries. The centers' environ ment is directly related to COVID-19 infection. Morbidity and mortality monitoring sys tems should be implemented promptly to establish prevention and control measur
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