Browsing by Author "Verdugo, Jaime"

Now showing 1 - 3 of 3
  • Thumbnail Image
    Publication
    Consenso de recomendaciones para tamizaje del cáncer pulmonar en Chile
    (2024) Suárez, Francisco; Saavedra, María; Roberti, Javier; Boyeras, Iris; Seijo, Mariana; Rodríguez, Ana; Silva, Claudio; Verdugo, Jaime; Sánchez, Felipe; Solé, Claudio; Valenzuela, Rubén; Jalilie, Alfredo; García, Ezequiel
    Aim: This initiative aimed to develop recommendations for lung cancer screening in Chile through an expert consensus process. Methods: A mixed approach was used in this study. A literature review was conducted to identify recommendations. A group of 18 Chilean experts was selected to form the Delphi panel. The RAND/UCLA method and evidence-based decision-making criteria were used to guide the evaluation process. Three rounds of voting and one synchronous meeting were conducted. Results: Following a literature review and expert evaluation, 25 recommendations relevant to lung cancer screening in Chile were selected. These recommendations cover the selection of the target population, the frequency and duration of the program, and the implementation and characteristics of the programs and the health institutions that would host them. Discussion: Experts expressed concerns about the feasibility and acceptability of implementing screening programs in the local context, noting possible barriers, such as lack of awareness and costs. Local evidence needs to be generated to address the regional particularities and ensure the feasibility and effectiveness of lung cancer screening programs in Chile. Objetivo: El objetivo de este estudio es desarrollar recomendaciones para el tamizaje del cáncer pulmonar (CP) en Chile mediante un proceso de consenso de expertos. Método: Se implementó un enfoque mixto. Se realizó una revisión de literatura para identificar posibles recomendaciones y luego se seleccionó un grupo de 18 expertos chilenos que conformaron un panel Delphi. Se utilizó el método RAND/UCLA y los criterios de Evidencia a Decisión para guiar el proceso de evaluación. Se realizaron tres rondas de votación y una reunión sincrónica. Resultados: Tras la revisión de la literatura y la evaluación por parte de expertos, se seleccionan 25 recomendaciones pertinentes para el tamizaje de CP en Chile. Estas recomendaciones abarcan la selección de la población objetivo, la frecuencia y duración del programa, la implementación y características de los programas y las instituciones de salud que los albergarían. Discusión: Los expertos expresan preocupaciones sobre la factibilidad y aceptabilidad de implementar programas de tamizaje en el contexto local, señalando posibles barreras como la falta de concientización y los costos. Es necesario generar evidencia local para abordar las particularidades regionales y garantizar la viabilidad y eficacia de los programas de tamizaje de CP en Chile.
  • Thumbnail Image
    Item
    Fístula nefrobronquial en paciente pediátrico. Caso clínico
    (Sociedad Argentina de Pediatría, 2014) Arriagada, Daniela; Donoso, Alejandro; Cruces, Pablo; Verdugo, Jaime
    Nephrobronchial fistula is a rare complication of kidney infections, usually occurring in adult patients with xanthogranulomatous pyelonephritis and very occasionally in children. We reported a 12-year-old girl, with a history of myelomeningocele and recurrent urinary tract infection, who presented with a four-week fever, cough and dyspnea, developing septic shock and presenting flood of airway by pus which caused cardiac arrest. A diagnosis of left perirenal extensive collection was established by abdominal computed tomography (CT). The patient first had antibiotic therapy and percutaneous drainage was performed draining pus and air. Thoracic and abdominal CT scan was performed corroborating transdiaphragmatic fistula. Total nephrectomy was performed. The patient showed gradual improvement after surgery and total regression of symptoms. Pathologic examination concluded chronic pyelonephritis. This case report illustrates a rare complication in children, the importance of early diagnosis of urinary tract infection in patients with comorbidities and of exhibiting a high index of suspicion to a potentially lethal complication.
  • Thumbnail Image
    Item
    RSNA-STR-ACR Consensus Statement for COVID-19 CT Patterns: Interreader Agreement in 240 Consecutive Patients and Association With RT-PCR Status
    (2021) Silva F., Claudio; Alegria, Julia; Ramos, Cristóbal; Verdugo, Jaime; Díaz, Juan-Carlos; Varela, Cristian; Barbe, Mario
    Purpose: The aim of this study was to study interreader agreement of the RSNA-STR-ACR (Radiological Society of North America/Society of Thoracic Radiology/American College of Radiology) consensus statement on reporting chest computed tomography (CT) findings related to COVID-19 on a sample of consecutive patients confirmed with reverse transcriptase–polymerase chain reaction (RT-PCR) for severe acute respiratory syndrome coronavirus 2. Materials and Methods: This institutional review board–approved retrospective study included 240 cases with a mean age of 47.6 ± 15.9 years, ranging from 20 to 90 years, who had a chest CT and RT-PCR performed. Computed tomography images were independently analyzed by 2 thoracic radiologists to identify patterns defined by the RSNA-STR-ACR consensus statement, and concordance was determined with weighted κ tests. Also, CT findings and CT severity scores were tabulated and compared. Results: Of the 240 cases, 118 had findings on CT. The most frequent on the RT-PCR–positive group were areas of ground-glass opacities (80.5%), crazy-paving pattern (32.2%), and rounded pseudonodular ground-glass opacities (22.9%). Regarding the CT patterns, the most frequent in the RT-PCR–positive group was typical in 75.9%, followed by negative in 17.1%. The interreader agreement was 0.90 (95% confidence interval, 0.80–0.96) in this group. The CT severity score had a mean difference of −0.07 (95% confidence interval, −0.48 to 0.34) among the readers, showing no significant differences regarding visual estimation. Conclusions: The RSNA-STR-ACR consensus statement on reporting chest CT patterns for COVID-19 presents a high interreader agreement, with the typical pattern being more frequently associated with RT-PCR–positive examinations

Implementado por OpenGeek Services