Cecilia Pacheco | Clinica Alemana De Chile (original) (raw)
Uploads
Papers by Cecilia Pacheco
Revista Chilena de Medicina Familiar, 2005
Studies that appear in electronic databases are just the “iceberg’s top”. Only a few of the enorm... more Studies that appear in electronic databases are just the “iceberg’s top”. Only a few of the enormous amount received by journal editors are selected to be published in scientific publications. Journals which have higher impactfactor receive thousands of them, which mostly rejected even without any revision from editors. After that, authors use to apply to another journal withlower impact factor and so on, hoping to be finally published. Hand searching was designed to recover some of these studies; perhaps it could be valuable and unknown information, not considered in a database or maybeavailable only in printed form, which is what happens with the oldest ones.Mesh: Information Storage and Retrieval/methods; Abstracting and Indexing as Topic/methods; Randomized Control Trial ; CENTRAL Cochrane; Systematic Review[pt]
AbstractThe first printed medical database was the Index Medicus, of the USA National Library of ... more AbstractThe first printed medical database was the Index Medicus, of the USA National Library of Medicine, 12 vol. published in 1879 with 20.169 articles. With the development and growth of research, necessary for the advance of medicine,an increasing number of publications that disclose their results have appeared. Thus, we can find thousands of electronic articles on the Internet and in medical databases which will make truly difficult to get accurately and quickly the information we are looking for. The challenge is how to get a quick answer to the question. To find it in that huge amount of information is not an easy job. It is highly necessary for researchers to plan a strategy work to have success.Since a couple of decades, with the emergence of the term “evidence-based medicine”, the need of how and where to find scientific support that ensures us the validity of the information also appeared. Even though the physicianmust find an answer to clinical or research questions, the...
Horizonte de enfermeria, 2018
RESUMEN Objetivo: Definir el mejor diseño de investigación para la práctica de enfermería. Metodo... more RESUMEN Objetivo: Definir el mejor diseño de investigación para la práctica de enfermería. Metodología: se realiza una revisión narrativa con los términos MeSH: Alfabetización Informacional, Estudios Epidemiológicos, Medicina Basada en la Evidencia, Enfermería basada en evidencia en las bases de datos PUBMED, ProQuest, Ebsco, Ovid. Síntesis del contenido: Se realiza una síntesis de los diseños de investigación disponibles y su utilidad al momento de responder una pregunta de investigación. Conclusiones: La mejor evidencia disponible son las revisiones sistemáticas y el enfoque de investigación mixto. Su uso para práctica basada en evidencia asegura que podamos sustentar nuestros cuidados de manera eficiente y segura.
CHEST Journal, 2012
ABSTRACT SESSION TYPE: Bronchology Global Case Report PostersPRESENTED ON: Tuesday, October 23, 2... more ABSTRACT SESSION TYPE: Bronchology Global Case Report PostersPRESENTED ON: Tuesday, October 23, 2012 at 01:30 PM - 02:30 PMINTRODUCTION: Many patients with advanced emphysema have intolerable breathlessness even receiving medical treatment. Lung-volume reduction surgery (LVRS) can improve lung function and quality of life, but clinical limitation should be considered because of high surgical mortality and morbidity. Bronchoscopic lung volume reduction (BLVR) with endobronchial valve (EBV) implantation is a safer alternative for LVRS. One patient was received the EBV implantation, evaluation after procedure, and mechanism of BLVR was analyzed.CASE PRESENTATION: A 50 year old male patient had a severe dyspnea on exertion for 4 years, with MRC 4 scales, FEV1 0.63L (17.9% pred) , FVC 2.24L (51.14%pred), RV 7.61L (354.1% pred), TLC 7.93L (142.5%pred) and 6 minute walking ( 6MWT) distance 60m. He smoked of 40 pack years and ceased smoking for 2 years. Quantative CT scan and lung ventilation scintigraphy showed heterogeneous emphysema in right upper lobe (RUL) with complete fissure, and emphysema percentage was the highest in all lobes. After 3-week inhaling medicine treatment and physiotherapy, RV decreased to 6.00L (279% pred), 6MWT distance increased to 120m, but FEV1 didn't improve ( 0.66L, 18.6% pred), and RUL ventilation scintigraphy was still high. Chartis assessment showed absence of collateral ventilation between RUL and other lobes. Three Zephyr EBVs were placed in three bronchus of RUL. RUL atelectasis was confirmed on chest X ray and CT scan on day three and the following day. At 1 week post procedure, FEV1, FVC and TLC increased to 1.14L (32.2% pred), 3.18L (72.60%pred) and 8.43L (123.6%pred) respectively, and RV reduced to 5.12L (238.3% pred). 6MWT distance increased to 410m and MRC increased to 2 scales after 1 month. Meanwhile, CT scan showed emphysema percentage was decreased in right middle lobe and right lower lobe, meanwhile the lung volume increased both of that two lobes. Lung ventilation scintigraphy was improved in bilateral lung. No severe adverse event was reported.DISCUSSION: BLVR was successful by placement of Zephyr endobronchial valves in RUL. The patient achieved an impressive 72.72% improvement in FEV1 and a 14.67% reduction in RV, with 6MWT distance increasing 241.7%. Unilateral lung volume reduction may improve the ventilation and lung volume in other lobes after atelectasis in one lobe. Inhaled bronchial dilator and corticosteroid improve the exercise capacity and decreased the RV, but no effect on FEV1.CONCLUSIONS: BLVR with Zephy EBV implantation induced improvements in lung function, exercise tolerance and symptoms, with relatively less complications. Mechanism may relate to improvement of ventilation in other lobes of bilateral lung.1) National emphysema treatment study group. A randomized study comparing lung-volume-reduction surgery with medical therapy for severe emphysema. N Engl J Med, 2003; 348 (21):2059-2073.2) Sciurba FC, Ernst A, Herth FJF, et al. A randomized study of endobronchial valves hfor advanced emphysema. N Engl J Med, 2010; 363:1233-44.3) Gevenois PA, De Vuyst P, de Maertelaer V, et al. Comparison of computed densityand microscopic morphometry in pulmonary emphysema. Am J Respir Crit Care Med. 1996;154:187-192.DISCLOSURE: The following authors have nothing to disclose: Nan Li, Jianxing Qiu, Wei Zhang, Hong Zhang, Xuchu Zhang, Chengli Que, Guangfa WangNo Product/Research Disclosure InformationPeking University First Hospital, Division of Pulmonary and Critic Care Medicine, Beijing, China.
Respiration, 2019
Background: Spiration Valve System (SVS) is an alternative for patients with severe heterogeneous... more Background: Spiration Valve System (SVS) is an alternative for patients with severe heterogeneous emphysema; however, data about efficacy from randomized controlled trials (RCT) are unclear. Objectives: To explore both efficacy and safety of SVS in patients with severe emphysema and hyperinflation. Methods: We included PubMed, EMBASE, Cochrane database. All searches were performed until August 2019. Only RCTs were included for analysis. Risk of bias was assessed using Cochrane risk of bias tool. A meta-analysis evaluated change in forced expiratory volume in 1 s (FEV1), 6-min walking test (6MWT), residual volume, modified medical research council (mMRC) and Saint George respiratory questionnaire (SGRQ), all-cause mortality, risk of pneumothorax, and risk of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Quality of the evidence was rated using GRADE approach. Results: Four RCTs including 629 subjects were included. SVS showed an overall change of 0.03 L (–0.07...
Cochrane Database of Systematic Reviews, 2019
Therapeutic vaccines for advanced non-small cell lung cancer.
Revista médica de Chile, 2004
Página 0de 52Resumen de conclusiones para carcinoma hepatocelular (EtD GRADE DECIDE)
Este documento contiene los resultados de la evaluación rápida de tecnología sanitaria sobre segu... more Este documento contiene los resultados de la evaluación rápida de tecnología sanitaria sobre seguridad y eficacia de atezolizumab para carcinoma hepatocelular metastásico. El contenido de este documento es responsabilidad de los autores. Cualquier referencia a este documento debe citarse como: Mario Tristan, Lizbeth Rondon , Flor Rosado, Franz Biehl, Cecilia Pacheco y Yuri Baidal. “Evaluación rápida de tecnología sanitaria sobre seguridad y eficacia de atezolizumab para carcinoma hepatocelular metastásico; en comparación con terapia estándar y otras inmunoterapias de uso en Costa Rica.”. 2021
Revista médica de Chile, 2004
La medicina ha sufrido un rápido proceso de cambio en los últimos años fundamentalmente debido a ... more La medicina ha sufrido un rápido proceso de cambio en los últimos años fundamentalmente debido a dos elementos: por un lado la presión asistencial y la escasez de tiempo derivada de ésta, son cada vez mayores y, por otra parte, la cantidad de información crece en ...
Revista Chilena de Medicina Familiar, 2005
Studies that appear in electronic databases are just the “iceberg’s top”. Only a few of the enorm... more Studies that appear in electronic databases are just the “iceberg’s top”. Only a few of the enormous amount received by journal editors are selected to be published in scientific publications. Journals which have higher impactfactor receive thousands of them, which mostly rejected even without any revision from editors. After that, authors use to apply to another journal withlower impact factor and so on, hoping to be finally published. Hand searching was designed to recover some of these studies; perhaps it could be valuable and unknown information, not considered in a database or maybeavailable only in printed form, which is what happens with the oldest ones.Mesh: Information Storage and Retrieval/methods; Abstracting and Indexing as Topic/methods; Randomized Control Trial ; CENTRAL Cochrane; Systematic Review[pt]
AbstractThe first printed medical database was the Index Medicus, of the USA National Library of ... more AbstractThe first printed medical database was the Index Medicus, of the USA National Library of Medicine, 12 vol. published in 1879 with 20.169 articles. With the development and growth of research, necessary for the advance of medicine,an increasing number of publications that disclose their results have appeared. Thus, we can find thousands of electronic articles on the Internet and in medical databases which will make truly difficult to get accurately and quickly the information we are looking for. The challenge is how to get a quick answer to the question. To find it in that huge amount of information is not an easy job. It is highly necessary for researchers to plan a strategy work to have success.Since a couple of decades, with the emergence of the term “evidence-based medicine”, the need of how and where to find scientific support that ensures us the validity of the information also appeared. Even though the physicianmust find an answer to clinical or research questions, the...
Horizonte de enfermeria, 2018
RESUMEN Objetivo: Definir el mejor diseño de investigación para la práctica de enfermería. Metodo... more RESUMEN Objetivo: Definir el mejor diseño de investigación para la práctica de enfermería. Metodología: se realiza una revisión narrativa con los términos MeSH: Alfabetización Informacional, Estudios Epidemiológicos, Medicina Basada en la Evidencia, Enfermería basada en evidencia en las bases de datos PUBMED, ProQuest, Ebsco, Ovid. Síntesis del contenido: Se realiza una síntesis de los diseños de investigación disponibles y su utilidad al momento de responder una pregunta de investigación. Conclusiones: La mejor evidencia disponible son las revisiones sistemáticas y el enfoque de investigación mixto. Su uso para práctica basada en evidencia asegura que podamos sustentar nuestros cuidados de manera eficiente y segura.
CHEST Journal, 2012
ABSTRACT SESSION TYPE: Bronchology Global Case Report PostersPRESENTED ON: Tuesday, October 23, 2... more ABSTRACT SESSION TYPE: Bronchology Global Case Report PostersPRESENTED ON: Tuesday, October 23, 2012 at 01:30 PM - 02:30 PMINTRODUCTION: Many patients with advanced emphysema have intolerable breathlessness even receiving medical treatment. Lung-volume reduction surgery (LVRS) can improve lung function and quality of life, but clinical limitation should be considered because of high surgical mortality and morbidity. Bronchoscopic lung volume reduction (BLVR) with endobronchial valve (EBV) implantation is a safer alternative for LVRS. One patient was received the EBV implantation, evaluation after procedure, and mechanism of BLVR was analyzed.CASE PRESENTATION: A 50 year old male patient had a severe dyspnea on exertion for 4 years, with MRC 4 scales, FEV1 0.63L (17.9% pred) , FVC 2.24L (51.14%pred), RV 7.61L (354.1% pred), TLC 7.93L (142.5%pred) and 6 minute walking ( 6MWT) distance 60m. He smoked of 40 pack years and ceased smoking for 2 years. Quantative CT scan and lung ventilation scintigraphy showed heterogeneous emphysema in right upper lobe (RUL) with complete fissure, and emphysema percentage was the highest in all lobes. After 3-week inhaling medicine treatment and physiotherapy, RV decreased to 6.00L (279% pred), 6MWT distance increased to 120m, but FEV1 didn't improve ( 0.66L, 18.6% pred), and RUL ventilation scintigraphy was still high. Chartis assessment showed absence of collateral ventilation between RUL and other lobes. Three Zephyr EBVs were placed in three bronchus of RUL. RUL atelectasis was confirmed on chest X ray and CT scan on day three and the following day. At 1 week post procedure, FEV1, FVC and TLC increased to 1.14L (32.2% pred), 3.18L (72.60%pred) and 8.43L (123.6%pred) respectively, and RV reduced to 5.12L (238.3% pred). 6MWT distance increased to 410m and MRC increased to 2 scales after 1 month. Meanwhile, CT scan showed emphysema percentage was decreased in right middle lobe and right lower lobe, meanwhile the lung volume increased both of that two lobes. Lung ventilation scintigraphy was improved in bilateral lung. No severe adverse event was reported.DISCUSSION: BLVR was successful by placement of Zephyr endobronchial valves in RUL. The patient achieved an impressive 72.72% improvement in FEV1 and a 14.67% reduction in RV, with 6MWT distance increasing 241.7%. Unilateral lung volume reduction may improve the ventilation and lung volume in other lobes after atelectasis in one lobe. Inhaled bronchial dilator and corticosteroid improve the exercise capacity and decreased the RV, but no effect on FEV1.CONCLUSIONS: BLVR with Zephy EBV implantation induced improvements in lung function, exercise tolerance and symptoms, with relatively less complications. Mechanism may relate to improvement of ventilation in other lobes of bilateral lung.1) National emphysema treatment study group. A randomized study comparing lung-volume-reduction surgery with medical therapy for severe emphysema. N Engl J Med, 2003; 348 (21):2059-2073.2) Sciurba FC, Ernst A, Herth FJF, et al. A randomized study of endobronchial valves hfor advanced emphysema. N Engl J Med, 2010; 363:1233-44.3) Gevenois PA, De Vuyst P, de Maertelaer V, et al. Comparison of computed densityand microscopic morphometry in pulmonary emphysema. Am J Respir Crit Care Med. 1996;154:187-192.DISCLOSURE: The following authors have nothing to disclose: Nan Li, Jianxing Qiu, Wei Zhang, Hong Zhang, Xuchu Zhang, Chengli Que, Guangfa WangNo Product/Research Disclosure InformationPeking University First Hospital, Division of Pulmonary and Critic Care Medicine, Beijing, China.
Respiration, 2019
Background: Spiration Valve System (SVS) is an alternative for patients with severe heterogeneous... more Background: Spiration Valve System (SVS) is an alternative for patients with severe heterogeneous emphysema; however, data about efficacy from randomized controlled trials (RCT) are unclear. Objectives: To explore both efficacy and safety of SVS in patients with severe emphysema and hyperinflation. Methods: We included PubMed, EMBASE, Cochrane database. All searches were performed until August 2019. Only RCTs were included for analysis. Risk of bias was assessed using Cochrane risk of bias tool. A meta-analysis evaluated change in forced expiratory volume in 1 s (FEV1), 6-min walking test (6MWT), residual volume, modified medical research council (mMRC) and Saint George respiratory questionnaire (SGRQ), all-cause mortality, risk of pneumothorax, and risk of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Quality of the evidence was rated using GRADE approach. Results: Four RCTs including 629 subjects were included. SVS showed an overall change of 0.03 L (–0.07...
Cochrane Database of Systematic Reviews, 2019
Therapeutic vaccines for advanced non-small cell lung cancer.
Revista médica de Chile, 2004
Página 0de 52Resumen de conclusiones para carcinoma hepatocelular (EtD GRADE DECIDE)
Este documento contiene los resultados de la evaluación rápida de tecnología sanitaria sobre segu... more Este documento contiene los resultados de la evaluación rápida de tecnología sanitaria sobre seguridad y eficacia de atezolizumab para carcinoma hepatocelular metastásico. El contenido de este documento es responsabilidad de los autores. Cualquier referencia a este documento debe citarse como: Mario Tristan, Lizbeth Rondon , Flor Rosado, Franz Biehl, Cecilia Pacheco y Yuri Baidal. “Evaluación rápida de tecnología sanitaria sobre seguridad y eficacia de atezolizumab para carcinoma hepatocelular metastásico; en comparación con terapia estándar y otras inmunoterapias de uso en Costa Rica.”. 2021
Revista médica de Chile, 2004
La medicina ha sufrido un rápido proceso de cambio en los últimos años fundamentalmente debido a ... more La medicina ha sufrido un rápido proceso de cambio en los últimos años fundamentalmente debido a dos elementos: por un lado la presión asistencial y la escasez de tiempo derivada de ésta, son cada vez mayores y, por otra parte, la cantidad de información crece en ...