Browsing by Author "Tuma, Anton"

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    A Chair-based Abbreviated Repositioning Maneuver (ChARM) for fast treatment of posterior BPPV
    (2019) Michael, Pia; Muñoz, Daniel; Tuma, Anton; Gárate, Matías; Barraza, Cristian; Nuñez, Marcia; Breinbauer, Hayo
    Purpose: To assess the effectiveness of a variation of the Epley maneuver, which we have titled "Chair-based Abbreviated Repositioning maneuver (ChARM)", in solving cases of benign positional paroxysmal vertigo (BPPV) of the posterior canal. ChARM addresses multiple issues of highly overloaded medical centers that delay its due and timely resolution. For example it does not necessitate an examination bed/table and requires only a backed chair, and less than 3 min to be performed. In combination with a recently published abbreviated diagnostic maneuver it can solve BPPV cases within few minutes of single medical visit. Methods: Patients being diagnosed with posterior BPPV by means of an abbreviated diagnostic maneuver were recruited. Immediately after diagnosis, a single attempt of ChARM was conducted. The patient was followed for 48 h and at 1 month after these procedures to assess the persistence of symptomatology. Results: 124 patients were treated with ChARM immediately after diagnosis during their very first medical visit. 92 patients (74.2%) solved their symptomatology completely after a single attempt of ChARM. The absence of symptoms persisted during the 30 days of follow-up. Discussion: ChARM showed high success rates in solving posterior BPPV. The entire diagnostic-treatment procedure takes less than 5 min to perform and may allow direct treatment of patients, thereby avoiding unnecessary referrals or full vestibular testing. These abbreviated tools may be particularly useful in primary care settings or heavily overloaded otolaryngology or neurology departments.
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    Proyecto de negocios acerca de una Clínica Geriátrica ambulatoria en la ciudad de Santiago de Chile: Clínica Salud Mayor
    (Universidad del Desarrollo. Facultad de Ciencias de la Salud, 2020-02) Tuma, Anton; Rojas, Paulina; Grupe, Álvaro Felipe; Ardiles, Jorge; Ardiles Niada, Jorge
    El envejecimiento poblacional ha sido una temática de interés público a nivel internacional, por lo que se han desarrollado múltiples iniciativas y políticas públicas al respecto. Chile no está ajeno a dicha situación. El objetivo del proyecto es la evaluación de un nuevo centro de salud ambulatorio con atención exclusiva para adultos mayores, llamado “Clínica Salud Mayor”. Se realizó un estudio de mercado a un total de 354 encuestados (error muestral: 5,2%, intervalo de confianza: 95%), donde se estimó capacidad de pago y demanda de prestaciones. La matriz de servicios ofrecidos se definió en base a los egresos hospitalarios del mercado meta y a la oferta de prestaciones de los competidores. En base a lo anterior de definió la plaza, planta y precio de las prestaciones, así como su crecimiento histórico. El crecimiento esperado se basa en la participación de mercado y en el crecimiento de la población, logrando al mes 25 una capacidad máxima de prestaciones de 26.177 mensuales. Se realizó la estimación de inversión inicial que asciende a 11.405.084.881 pesos chilenos, y la proyección de los flujos de dinero a 10 años, con un VAN de 52.471.460.202 pesos chilenos, una TIR de 57% y un CAPM de 7,04%.
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    Resultados anatómicos y refractivos en pacientes tratados por retinopatía del prematuro
    (Elsevier, 2017) Lolas, M; Tuma, Anton; Zanolli, Mario; Agurto, Ricardo; Stevenson, Ricardo; Ossandón, Diego
    OBJECTIVE: To describe the anatomical and refractive outcomes after treatment with intravitreal bevacizumab or laser in a patient cohort with retinopathy of prematurity (ROP). METHODS: A multicentre, prospective, and observational study was performed on patients with ROP treated at Hospital Roberto del Río. Those patients with less than 6months of follow-up were excluded. Cases with posterior zone II, zone I ROP, and aggressive posterior ROP (AP-ROP) were treated with intravitreal bevacizumab. All other patients were treated with laser. Follow-up was performed every 3 months, and included fondo evaluation, refraction, and Teller tests. RESULTS: The treated group included 144 eyes of 72 patients, of whom 49 were treated with laser and 23 with intravitreal bevacizumab. One (1.4%) patient from the laser group progressed to stage 4b retinal detachment and required bilateral vitrectomy. Of the remainder, 45 cases had type 1 ROP, 16 had threshold disease, and 11 had AP-ROP. The median of gestational age was 26 weeks (range 23-30), and median of birth weight was 800g (range 405-1350). Median follow-up was 10 months (range 6-8). The Teller test median was 3.2 cycles/cm (range 0.32-13). There were 16 (22%) cases with a myopic refraction of -6 D or more. The sphere median was -1.75 D (range -16.00 to +3.50 D) and the cylindrical median was 0.00 (range -4.5 to +1.5 D). Anatomical success was achieved in 71 (98.6%) of patients. CONCLUSION: Treatment with laser or intravitreal bevacizumab is a highly successful primary treatment for ROP. Anatomical success can be achieved in most cases. Treated patients develop frequent and severe refractive defects, which should be corrected. Vision outcome, measured using the Teller preferential test, shows good results

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