Browsing by Author "Sanhueza, Gabriel"

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    Barreras y facilitadores para el control prenatal en adolescentes: resultados de un estudio cualitativo en Chile
    (Instituto Nacional de Salud Pública de Mexico, 2013) Poffald, Lucy; Hirmas, Macarena; Aguilera, Ximena; Vega, Jeanette; González, María; Sanhueza, Gabriel
    OBJECTIVE: Analyze barriers and facilitators of access to prenatal care in pregnant urban adolescents between 15-19 years of age in Santiago, Chile. MATERIALS AND METHODS: Qualitative study based on grounded theory with 17 adolescent mothers. Eleven semi-structured interviews and one focus group were conducted. RESULT: . The denial and concealment of pregnancy is the main barrier to start the prenatal care in the "delayed access group". This group does not identify facilitators. For maintenance in antenatal care, all participants identified a support figure as a facilitator. Family and social vulnerabilities explain why some adolescents start the prenatal care late. CONCLUSION: The presence of facilitators is crucial for both, the timely entry and the maintenance in antenatal care because they reduce or nullify the effect of barriers. The health system must become a facilitator to accompany adolescents and promote a bond of trust and respect.
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    Características clínicas y factores pronósticos de la enfermedad meningocóccica: un estudio de serie de casos en Chile durante el brote 2012-2013
    (Sociedad Chilena de Infectología, 2015) Matute, Isabel; Olea, Andrea; López, Darío; Loayza, Sergio; Nájera, Manuel; González, Claudia; Poffald, Lucy; Hirmas, Macarena; Delgado, Iris; Pedroni, Elena; Alfaro, Tania; Gormaz, Ana María; Sanhueza, Gabriel; Vial, Pablo; Dabanch, Jeannette; Gallegos, Doris; Aguilera, Ximena
    Introduction: Meningococcal disease (MD) is a major global problem because of its case fatality rate and sequels. Since 2012 cases of serogroup W have increased in Chile, with nonspecific clinical presentation, high case fatality rate and serious consequences. Objective: To characterize the evolution and outcome of MD cases between January 2012 and March 2013 in Chile. Material and Methods: Case series considering149 MD cases of 7 regions. A questionnaire was applied and clinical records were reviewed, including individual, agent, clinical course and healthcare process variables. The analysis allowed to obtain estimates of the OR as likelihoodof dying. Results: 51.5% was meningococcemia, the case fatality rate reached 27%, prevailing serogroup W (46.6%). Factors that increased the probability of dying: > age, belonging to indigenous people, having lived a stressful event, having diarrhea, impaired consciousness, cardiovascular symptoms, low oxygen saturation and low Glasgow coma scale score. Discussion: The case fatality rate exceeded normal levels and was higher in serogroup W. Increasing in this serogroup, associated to the increased presence of nonspecific symptoms or rapid progression to septicemia, hit a health system accustomed to more classic meningococcal disease presentation, which could partly explain the observed increased fatality rate.

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