Jaime Manalich | Universidad de Chile (original) (raw)
Papers by Jaime Manalich
PubMed, Dec 1, 1995
The cost of alternative dialysis modalities for the treatment of end-stage renal disease (ESRD) w... more The cost of alternative dialysis modalities for the treatment of end-stage renal disease (ESRD) was evaluated, using a societal viewpoint, in a regional nephrology program in south-western Ontario. The dialysis treatments compared were hospital hemodialysis, home hemodialysis, self-care hemodialysis, and continuous ambulatory peritoneal dialysis (CAPD). The participants were all patients treated by the same dialysis modality for the fiscal year April 1990 to March 1991. Fully allocated costs are expressed in 1993 Canadian dollars. The average costs per patient year were 88,585forhospitalhemodialysis,88,585 for hospital hemodialysis, 88,585forhospitalhemodialysis,55,593 for self-care hemodialysis, 44,790forCAPD,and44,790 for CAPD, and 44,790forCAPD,and32,570 for home hemodialysis. The dialysis treatment costs were 54,929forhospitalhemodialysis,54,929 for hospital hemodialysis, 54,929forhospitalhemodialysis,43,313 for self-care hemodialysis, 31,918forCAPD,and31,918 for CAPD, and 31,918forCAPD,and26,048 for home hemodialysis. These data quantify the magnitude of the differences between fully-allocated costs among the dialysis modalities in a regional nephrology program in Canada. The methodology used in this economic analysis can be applied to programs which differ in structure and scale. The breakdown of dialysis treatment costs into overhead, support department, personnel, supplies, and medication identifies potential areas for cost reduction strategies.
Revista Medica De Chile, 2020
Medición de la calidad del trato al usuario tras la introducción del asistente-alumno en centros ... more Medición de la calidad del trato al usuario tras la introducción del asistente-alumno en centros de salud familiar en Chile marceLo concha i. a , aLan hirschBerg g. a , nicoLás arraño r. a , marceLa cárcamo i. 1,b , Jaime mañaLich m. 1 Effect of the presence of student-assistants on the quality of care perception by ambulatory patients Background: The time dedicated to patients and how they are treated are crucial in the evaluation of health care quality. Medical students acting as medical assistants could improve the perception of a good quality of care among ambulatory patients. Aim: To evaluate if the presence of Student-Assistants improves the patients' perception of health care quality in ambulatory primary care. Patients and Methods: Quasi-experimental exploratory study. In two health care centers, patients answered a questionnaire about their perception of how they were treated at baseline and after an intervention period. In one center, prior to the appointment of the patient with the doctor, the student interviewed patients focusing on chief complaints and registered their vital signs, orally presenting this information to the clinician. In the other center, there was no student intervention. Patients answered the questionnaire at the end of appointments. Results: At baseline 103 patients answered the questionnaire (58 in the experimental and 45 in the control center). After the intervention, 121 patients answered it (56 in the experimental and 65 in the control center). Basal scores were 6,25 and 6,06 in experimental and control center, respectively (p = NS). After the intervention, the scores were 6,49 and 6,15, respectively (p = 0,01). Conclusions: These data support the hypothesis that the presence of a Student-Assistant could improve the perception of patients about how they are treated at primary health care centers.
Revista chilena de pediatría, 2017
Background: Bronchial asthma is the most prevalent chronic disease in children. Every year an imp... more Background: Bronchial asthma is the most prevalent chronic disease in children. Every year an important number of asthmatic children is hospitalized for asthma crisis. The magnitude of this problem in Chile is unknown. Objective: To evaluated the asthma hospitalization rate in 5-15 year-old children and evaluate their evolution. Patients and Method: We calculate the asthma hospitalization rate in children based on data from the National Hospitalization Discharge Registry from the Statistics and Health Information Department of the Ministry of Health (DEIS) and the National Institute of Statistics (INE). We evaluate the evolution of these rates from 2001 to 2014. Results: We observed a significant increase in the asthma hospitalization rates in children from 3,8 for 10.000 inhabitants in 2001 to 7,8 for 10.000 inhabitants in 2014. The average age was 8,5 years ± 2,7. Male gender was predominant (57,58%) with a mean length of stay of 3 days (range 1-12). Conclusions: The actual asthma hospitalization rate in Chile is 7,8 for 10.000 inhabitants for children 5 to 15 years old, with a double increase in this rate during the 14 year period analyzed.
Revista médica de Chile, 2018
Variables psicológicas asociadas a adherencia, cronicidad y complicaciones en pacientes con diabe... more Variables psicológicas asociadas a adherencia, cronicidad y complicaciones en pacientes con diabetes mellitus tipo 2 álvaro quiñones 1,a , Carla ugarte 1,a , ClauDia Chávez 2,b , jaime mañaliCh 3,c Psychological variables associated with adherence to treatment and complications in patients with type 2 diabetes mellitus Background: Lack of adherence to treatment may hamper the management of type 2 Diabetes Mellitus. Aim: To identify if there is a profile of psychological variables associated with adherence to treatment and complications in patients with type 2 diabetes mellitus. Material and Methods: The psychometric instruments
Boletín Micológico, 1998
d.n•c: Hongos anemófilos. estacionalidad. Sanliago-Chile Kc~' wonls: Anemophilous scasonal iluclu... more d.n•c: Hongos anemófilos. estacionalidad. Sanliago-Chile Kc~' wonls: Anemophilous scasonal iluclualion. Santiago-Chile RESUM Por elll/élodo de cllltivo de e.~poras lIlonílOrelÍ la rica presellle el! la alllló,~fera de 5,'rm/iago enlre 1991 y /992. Duran/e 52 semanas se I'ecolectaroll 1.0./0 II/uestras en 10 lugares //Iediante la ill/pacfacián de 20 litros de aire en la superficie de 11/1 /IIedio de cul/il'o, u/irizando IIn equipo colee/or portátil RC,)'. La se cualilmi-Fa y cuanti/atÍl'alJlenle, CO/l lIna CO/lcelllración media de 1. 9./5 u{c/m', El contenidojiíngico aUlI/en/á enjhrllla nijica/i\YI en verano y p/'esell/lÍ correlociólI posi/ivo con la lemperatura y luz sO/al' y COII hllllledad rela-presiál1 barolllétrica, 39taxo. 7% hongos v 13,2% a lel'mluras. Los predolllinante.l• en orden decrecienle /i¡eroll C/ados-jJOrium, UIOe!lIIlillf71, Altemaria, Peuicillium, A.'11l!rgilllls, Aureobasidiul1I, Bofrytis y El'icoccul1I , los que en COI1j/lnto /'cpresel/lorOIl el 75,6% del /(l/al de los colonias. C/m/osporillm, Uloc/adium y oUlI/eIllan su cOl1celllraciól/ en verano y se correlacionan en posiliva con lo telllpero/llro y luz solar; Bolrytis y PCllicillium mllllen{rll/ ell inFierno y ofOiío y A,\pergillus solo en %í'ío. INTROOUCCION Los ulilizan dh'crstls eSlratcgi;¡s para colonizar 1lI1C\'OS sustratos. dispcrsando sus prop{¡gulos por el agua y el aire: la mayoría de los géncros fúngícos que prescntan eslructuras dc fructificación IlIcntahnente [)cuh•I'OIl1~'Cc(cs).
Revista médica de Chile, 2016
Validation of the short assessment of health literacy for spanish-speaking adults test in Chile B... more Validation of the short assessment of health literacy for spanish-speaking adults test in Chile Background: Health literacy is defined as the degree to which individuals obtain, process and understand basic health information and services. It is necessary to make appropriate decisions about their health. Evidence has shown that the level of health literacy is critical to the prognosis of chronic diseases. The Short Assessment of Health Literacy for Spanish-speaking Adults (SAHLSA-50) is a short and simple health literacy adult assessment. Aim: To determine the validity and reliability indicators of SAHLSA-50 in Chilean adults. Material and Methods: The survey was applied to 84 older adults living in high and low income neighborhoods. Results: The survey had an adequate construct validity and reliability, its Comparative Fit Index was 0.93, its Tucker-Lewis index was 0.927 and its Root Mean Square Error of Approximation was 0.044. "Close fit" was not statistically significant (p = 0.828). Reliability was estimated by K-Richardson, which reported a good outcome (0.9255). Despite the good global indicators obtained, it is necessary to pay attention to some items that would fail to explain the "Health literacy" construct or were beyond the parameters of difficulty and discrimination proposed by the authors of the test. Conclusions: We propose this test as a useful tool to assess health literacy in the adult population in Chile. Its use and incorporation into local research can be especially recommended in the areas of education and health promotion.
Nephrology Dialysis Transplantation, 1997
Revista médica de Chile, 2019
National action plan for the emergence of invasive meningococcal disease in Chile, 2012-2013 Inva... more National action plan for the emergence of invasive meningococcal disease in Chile, 2012-2013 Invasive meningococcal disease is challenging for public health, mainly when it manifests with sudden changes in incidence, serogroups and hypervirulent clones that spread in the population, causing great alarm due to its sequelae and often fatal course, a situation that occurred in Chile, starting at week 26 of the year 2012. To face this scenario, an organization of multidisciplinary teams was required, called W-135 Action Plan in Chile, which included sanitary alerts, education, reinforcement of the epidemiological surveillance of suspicious cases, immediate diagnosis through state-of-the-art techniques, blocking of contacts, communication plans, and, from the 42 nd week, ON the vaccination campaign was started for children aged from 9-months-old to less than 5 years of age. The vaccination strategy had a great impact on the decrease in incidence (1.3 to 0.1/100,000) and case fatality rate in the vaccinated population (23% to 0%), with a high safety profile, leading to its subsequent inclusion in the national immunization program. The ability to develop molecular, clinical and epidemiological studies allowed us to better understand the situation, supporting public health policy decisions for its control. The W-135 Action Plan implemented by the Ministry of Health in Chile, to manage the outbreak of meningococcal disease by Neisseria meningitidis serogroup W, demonstrated that the coordination of these efforts, through an organized Action Plan, allows the implementation of campaigns at the national level achieving high coverage of risk populations in short periods of time, generating a positive impact on the health of the population.
Revista médica de Chile, 2002
Background: Hypertension is a common and important cardiovascular risk factor in patients on chro... more Background: Hypertension is a common and important cardiovascular risk factor in patients on chronic hemodialysis. Aim: To report the prevalence and characteristics of hypertension among patients on chronic hemodialysis. Patients and methods: Cross sectional study of ...
Clinical Infectious Diseases, 2010
See the editorial commentary by Glezen, on pages 869-870.) Background. In Chile, the novel influe... more See the editorial commentary by Glezen, on pages 869-870.) Background. In Chile, the novel influenza A (H1N1) epidemic began in the middle-high income area of Santiago. Clinical and laboratory surveillance was intensified with the aim to characterize the epidemic and determine its impact in a large hospital setting. Methods. Demographic and clinical data were obtained from all patients whose symptoms met the clinical definition of influenza A (H1N1) infection during the epidemic period. Laboratory confirmation was obtained by use of a nasopharyngeal antigen detection test for influenza A and/or influenza A (H1N1) polymerase chain reaction (PCR). A case was considered confirmed if the antigen detection test result for influenza A and/or the PCR test result were positive. Results. The total number of emergency department (ED) visits increased by 88.5% from a mean of 14,489 ED visits in 2006-2008 to a mean of 27,308 ED visits in 2009, during the epidemic period. There were 10,048 patients who were clinically diagnosed with influenza A (H1N1), and they represented 78% of all visits, of which 4591 (45.6%) were laboratory confirmed. The median time from symptom onset to diagnosis was 1 day, and 99.7% of individuals received antiviral treatment. School-aged children represented 67% of ED visits at the beginning of the epidemic and 24% of ED visits at the end of the epidemic. Only 2% of cases were hospitalized; of these, 70% of cases occurred in patients 6-50 years of age, and 32% of cases occurred in patients who had an underlying medical condition. Eleven patients (age range, 1-53 years) required admission to the intensive care unit (ICU); 6 of these patients had pneumonia with or without hemodynamic shock. No influenza-associated deaths occurred. Conclusions. Many cases of influenza A (H1N1) occurred in school-aged and adult individuals who required an ED visit; these visits resulted in a low impact on the use of hospital beds. Aggressive ICU management and/ or experience in extracorporeal membrane oxygenation significantly improved outcomes. Early antiviral treatment may have played an important role in the low number of severe cases. Vaccines targeted for school-aged children and young adults may modify the first epidemic wave in the northern hemisphere.
Revista chilena de infectología, 2016
Los autores declaran no tener conflictos de interés.
Rev Med Clin Condes, Dec 1, 1996
Revista Chilena de Salud Pública, 2011
Revista medica de Chile
The aim of this work was to assess the quality of life of 87 patients older than 60 years, out of... more The aim of this work was to assess the quality of life of 87 patients older than 60 years, out of 200 undergoing chronic hemodialysis in 9 centers at Santiago. A visual analog scale, with scores ranging from 0 (bad) to 100 (optimal) and a specific questionnaire about the impact of hemodialysis in daily activities, with scores ranging from -10 (severe limitation) to +10 (no limitation) were applied to patients and their attending nurses. Using the visual analog scale, patients assessed their quality of life in 51.7%, and health personnel in 61.3%. Patients had a questionnaire score of 2.3. Quality of life scores were inversely correlated with the condition of being diabetic and the number of hospital admissions.
Revista medica de Chile
Hypertension is a common and important cardiovascular risk factor in patients on chronic hemodial... more Hypertension is a common and important cardiovascular risk factor in patients on chronic hemodialysis. To report the prevalence and characteristics of hypertension among patients on chronic hemodialysis. Cross sectional study of 313 patients (192 male, aged 57 +/- 18 years) dialyzed in 7 representative centers in Santiago, Chile. Patients were on hemodialysis for a mean of 68 +/- 53 months and 67 (21%) were diabetic. 230 (74%) were hypertensive and 223 of these (97%) had predialysis hypertension. A multivariate analysis showed that hypertension was associated with increased weight gain between dialysis, failure to achieve the postdialysis dry weight, increasing age and the presence of diabetes. Among hypertensive patients, 61% were receiving antihypertensive medications, compared with 27% of patients with normal blood pressure. High blood pressure is highly prevalent among patients on chronic hemodialysis and is associated to hypervolemia, age and the presence of diabetes.
Clinical and investigative medicine. Médecine clinique et experimentale
ABSTRACT
Therapeutic Drug Monitoring, 2003
C(2) Cyclosporine (CsA) level, as a surrogate of area under the time-concentration curve (AUC) 0-... more C(2) Cyclosporine (CsA) level, as a surrogate of area under the time-concentration curve (AUC) 0-4 hours, is a good predictor of drug absorption and clinical outcome after kidney transplantation. It has been difficult to define the optimal C(2) level in the individual case and given the broad range of C(2) due to interindividual absorption variability it has been troublesome to determine the drug dose needed to obtain an expected C(2)-CsA concentration. In this study data of 16 stable renal and renal/pancreas recipients treated with prednisone, azathioprine, and CsA (Neoral) managed by C(0) level was examined. CsA concentrations at time 0 (basal), 2, 6, and 12 hours post CsA (Neoral) intake were determined the day of the study. A significant linear regression level was established between C(2) (but not C(0), C(6) and C(12)) and the dosage expressed as mg/kg/d (P = 0.0113, correlation coefficient r = 0.573018). Subsequently, another 27 renal transplant recipients were studied retrospectively and divided into three groups according to posttransplant period: 1 to 6, 7 to 12, and beyond 12 months after transplant. Equations derived from the relationship between C(2) and dose (mg/kg/d) were similar between the three groups and when compared with the first study. A formula obtained from the 27 patients in the whole posttransplant period (mg/kg/d = C(2) x 0.0010208 + 1.86125) was applied to patients of the first study obtaining a regression coefficient between actual and calculated CsA dose of 0.6145 (P = 0.01). A more accurate equation (P = 0.0001, r = 0.5925) was obtained by analyzing 145 C(2) determinations covering a period from 1 month to 8 years following transplant which gave a linear regression line defined by the equation C(2) x 0.001473 + 1.6673. This equation would permit the calculation mg/kg/d of CsA (Neoral) dose to obtain an expected C(2) level. The derived equation shown in this paper has a predictive value of 50% to 60% only, but can help to find adequate dosage in the presence of an inappropriate C(2) level.
Revista Medica De Chile, 2002
Background: Hypertension is a common and important cardiovascular risk factor in patients on chro... more Background: Hypertension is a common and important cardiovascular risk factor in patients on chronic hemodialysis. Aim: To report the prevalence and characteristics of hypertension among patients on chronic hemodialysis. Patients and methods: Cross sectional study of ...
Clinical Infectious Diseases, 2010
In Chile, the novel influenza A (H1N1) epidemic began in the middle-high income area of Santiago.... more In Chile, the novel influenza A (H1N1) epidemic began in the middle-high income area of Santiago. Clinical and laboratory surveillance was intensified with the aim to characterize the epidemic and determine its impact in a large hospital setting.
PubMed, Dec 1, 1995
The cost of alternative dialysis modalities for the treatment of end-stage renal disease (ESRD) w... more The cost of alternative dialysis modalities for the treatment of end-stage renal disease (ESRD) was evaluated, using a societal viewpoint, in a regional nephrology program in south-western Ontario. The dialysis treatments compared were hospital hemodialysis, home hemodialysis, self-care hemodialysis, and continuous ambulatory peritoneal dialysis (CAPD). The participants were all patients treated by the same dialysis modality for the fiscal year April 1990 to March 1991. Fully allocated costs are expressed in 1993 Canadian dollars. The average costs per patient year were 88,585forhospitalhemodialysis,88,585 for hospital hemodialysis, 88,585forhospitalhemodialysis,55,593 for self-care hemodialysis, 44,790forCAPD,and44,790 for CAPD, and 44,790forCAPD,and32,570 for home hemodialysis. The dialysis treatment costs were 54,929forhospitalhemodialysis,54,929 for hospital hemodialysis, 54,929forhospitalhemodialysis,43,313 for self-care hemodialysis, 31,918forCAPD,and31,918 for CAPD, and 31,918forCAPD,and26,048 for home hemodialysis. These data quantify the magnitude of the differences between fully-allocated costs among the dialysis modalities in a regional nephrology program in Canada. The methodology used in this economic analysis can be applied to programs which differ in structure and scale. The breakdown of dialysis treatment costs into overhead, support department, personnel, supplies, and medication identifies potential areas for cost reduction strategies.
Revista Medica De Chile, 2020
Medición de la calidad del trato al usuario tras la introducción del asistente-alumno en centros ... more Medición de la calidad del trato al usuario tras la introducción del asistente-alumno en centros de salud familiar en Chile marceLo concha i. a , aLan hirschBerg g. a , nicoLás arraño r. a , marceLa cárcamo i. 1,b , Jaime mañaLich m. 1 Effect of the presence of student-assistants on the quality of care perception by ambulatory patients Background: The time dedicated to patients and how they are treated are crucial in the evaluation of health care quality. Medical students acting as medical assistants could improve the perception of a good quality of care among ambulatory patients. Aim: To evaluate if the presence of Student-Assistants improves the patients' perception of health care quality in ambulatory primary care. Patients and Methods: Quasi-experimental exploratory study. In two health care centers, patients answered a questionnaire about their perception of how they were treated at baseline and after an intervention period. In one center, prior to the appointment of the patient with the doctor, the student interviewed patients focusing on chief complaints and registered their vital signs, orally presenting this information to the clinician. In the other center, there was no student intervention. Patients answered the questionnaire at the end of appointments. Results: At baseline 103 patients answered the questionnaire (58 in the experimental and 45 in the control center). After the intervention, 121 patients answered it (56 in the experimental and 65 in the control center). Basal scores were 6,25 and 6,06 in experimental and control center, respectively (p = NS). After the intervention, the scores were 6,49 and 6,15, respectively (p = 0,01). Conclusions: These data support the hypothesis that the presence of a Student-Assistant could improve the perception of patients about how they are treated at primary health care centers.
Revista chilena de pediatría, 2017
Background: Bronchial asthma is the most prevalent chronic disease in children. Every year an imp... more Background: Bronchial asthma is the most prevalent chronic disease in children. Every year an important number of asthmatic children is hospitalized for asthma crisis. The magnitude of this problem in Chile is unknown. Objective: To evaluated the asthma hospitalization rate in 5-15 year-old children and evaluate their evolution. Patients and Method: We calculate the asthma hospitalization rate in children based on data from the National Hospitalization Discharge Registry from the Statistics and Health Information Department of the Ministry of Health (DEIS) and the National Institute of Statistics (INE). We evaluate the evolution of these rates from 2001 to 2014. Results: We observed a significant increase in the asthma hospitalization rates in children from 3,8 for 10.000 inhabitants in 2001 to 7,8 for 10.000 inhabitants in 2014. The average age was 8,5 years ± 2,7. Male gender was predominant (57,58%) with a mean length of stay of 3 days (range 1-12). Conclusions: The actual asthma hospitalization rate in Chile is 7,8 for 10.000 inhabitants for children 5 to 15 years old, with a double increase in this rate during the 14 year period analyzed.
Revista médica de Chile, 2018
Variables psicológicas asociadas a adherencia, cronicidad y complicaciones en pacientes con diabe... more Variables psicológicas asociadas a adherencia, cronicidad y complicaciones en pacientes con diabetes mellitus tipo 2 álvaro quiñones 1,a , Carla ugarte 1,a , ClauDia Chávez 2,b , jaime mañaliCh 3,c Psychological variables associated with adherence to treatment and complications in patients with type 2 diabetes mellitus Background: Lack of adherence to treatment may hamper the management of type 2 Diabetes Mellitus. Aim: To identify if there is a profile of psychological variables associated with adherence to treatment and complications in patients with type 2 diabetes mellitus. Material and Methods: The psychometric instruments
Boletín Micológico, 1998
d.n•c: Hongos anemófilos. estacionalidad. Sanliago-Chile Kc~' wonls: Anemophilous scasonal iluclu... more d.n•c: Hongos anemófilos. estacionalidad. Sanliago-Chile Kc~' wonls: Anemophilous scasonal iluclualion. Santiago-Chile RESUM Por elll/élodo de cllltivo de e.~poras lIlonílOrelÍ la rica presellle el! la alllló,~fera de 5,'rm/iago enlre 1991 y /992. Duran/e 52 semanas se I'ecolectaroll 1.0./0 II/uestras en 10 lugares //Iediante la ill/pacfacián de 20 litros de aire en la superficie de 11/1 /IIedio de cul/il'o, u/irizando IIn equipo colee/or portátil RC,)'. La se cualilmi-Fa y cuanti/atÍl'alJlenle, CO/l lIna CO/lcelllración media de 1. 9./5 u{c/m', El contenidojiíngico aUlI/en/á enjhrllla nijica/i\YI en verano y p/'esell/lÍ correlociólI posi/ivo con la lemperatura y luz sO/al' y COII hllllledad rela-presiál1 barolllétrica, 39taxo. 7% hongos v 13,2% a lel'mluras. Los predolllinante.l• en orden decrecienle /i¡eroll C/ados-jJOrium, UIOe!lIIlillf71, Altemaria, Peuicillium, A.'11l!rgilllls, Aureobasidiul1I, Bofrytis y El'icoccul1I , los que en COI1j/lnto /'cpresel/lorOIl el 75,6% del /(l/al de los colonias. C/m/osporillm, Uloc/adium y oUlI/eIllan su cOl1celllraciól/ en verano y se correlacionan en posiliva con lo telllpero/llro y luz solar; Bolrytis y PCllicillium mllllen{rll/ ell inFierno y ofOiío y A,\pergillus solo en %í'ío. INTROOUCCION Los ulilizan dh'crstls eSlratcgi;¡s para colonizar 1lI1C\'OS sustratos. dispcrsando sus prop{¡gulos por el agua y el aire: la mayoría de los géncros fúngícos que prescntan eslructuras dc fructificación IlIcntahnente [)cuh•I'OIl1~'Cc(cs).
Revista médica de Chile, 2016
Validation of the short assessment of health literacy for spanish-speaking adults test in Chile B... more Validation of the short assessment of health literacy for spanish-speaking adults test in Chile Background: Health literacy is defined as the degree to which individuals obtain, process and understand basic health information and services. It is necessary to make appropriate decisions about their health. Evidence has shown that the level of health literacy is critical to the prognosis of chronic diseases. The Short Assessment of Health Literacy for Spanish-speaking Adults (SAHLSA-50) is a short and simple health literacy adult assessment. Aim: To determine the validity and reliability indicators of SAHLSA-50 in Chilean adults. Material and Methods: The survey was applied to 84 older adults living in high and low income neighborhoods. Results: The survey had an adequate construct validity and reliability, its Comparative Fit Index was 0.93, its Tucker-Lewis index was 0.927 and its Root Mean Square Error of Approximation was 0.044. "Close fit" was not statistically significant (p = 0.828). Reliability was estimated by K-Richardson, which reported a good outcome (0.9255). Despite the good global indicators obtained, it is necessary to pay attention to some items that would fail to explain the "Health literacy" construct or were beyond the parameters of difficulty and discrimination proposed by the authors of the test. Conclusions: We propose this test as a useful tool to assess health literacy in the adult population in Chile. Its use and incorporation into local research can be especially recommended in the areas of education and health promotion.
Nephrology Dialysis Transplantation, 1997
Revista médica de Chile, 2019
National action plan for the emergence of invasive meningococcal disease in Chile, 2012-2013 Inva... more National action plan for the emergence of invasive meningococcal disease in Chile, 2012-2013 Invasive meningococcal disease is challenging for public health, mainly when it manifests with sudden changes in incidence, serogroups and hypervirulent clones that spread in the population, causing great alarm due to its sequelae and often fatal course, a situation that occurred in Chile, starting at week 26 of the year 2012. To face this scenario, an organization of multidisciplinary teams was required, called W-135 Action Plan in Chile, which included sanitary alerts, education, reinforcement of the epidemiological surveillance of suspicious cases, immediate diagnosis through state-of-the-art techniques, blocking of contacts, communication plans, and, from the 42 nd week, ON the vaccination campaign was started for children aged from 9-months-old to less than 5 years of age. The vaccination strategy had a great impact on the decrease in incidence (1.3 to 0.1/100,000) and case fatality rate in the vaccinated population (23% to 0%), with a high safety profile, leading to its subsequent inclusion in the national immunization program. The ability to develop molecular, clinical and epidemiological studies allowed us to better understand the situation, supporting public health policy decisions for its control. The W-135 Action Plan implemented by the Ministry of Health in Chile, to manage the outbreak of meningococcal disease by Neisseria meningitidis serogroup W, demonstrated that the coordination of these efforts, through an organized Action Plan, allows the implementation of campaigns at the national level achieving high coverage of risk populations in short periods of time, generating a positive impact on the health of the population.
Revista médica de Chile, 2002
Background: Hypertension is a common and important cardiovascular risk factor in patients on chro... more Background: Hypertension is a common and important cardiovascular risk factor in patients on chronic hemodialysis. Aim: To report the prevalence and characteristics of hypertension among patients on chronic hemodialysis. Patients and methods: Cross sectional study of ...
Clinical Infectious Diseases, 2010
See the editorial commentary by Glezen, on pages 869-870.) Background. In Chile, the novel influe... more See the editorial commentary by Glezen, on pages 869-870.) Background. In Chile, the novel influenza A (H1N1) epidemic began in the middle-high income area of Santiago. Clinical and laboratory surveillance was intensified with the aim to characterize the epidemic and determine its impact in a large hospital setting. Methods. Demographic and clinical data were obtained from all patients whose symptoms met the clinical definition of influenza A (H1N1) infection during the epidemic period. Laboratory confirmation was obtained by use of a nasopharyngeal antigen detection test for influenza A and/or influenza A (H1N1) polymerase chain reaction (PCR). A case was considered confirmed if the antigen detection test result for influenza A and/or the PCR test result were positive. Results. The total number of emergency department (ED) visits increased by 88.5% from a mean of 14,489 ED visits in 2006-2008 to a mean of 27,308 ED visits in 2009, during the epidemic period. There were 10,048 patients who were clinically diagnosed with influenza A (H1N1), and they represented 78% of all visits, of which 4591 (45.6%) were laboratory confirmed. The median time from symptom onset to diagnosis was 1 day, and 99.7% of individuals received antiviral treatment. School-aged children represented 67% of ED visits at the beginning of the epidemic and 24% of ED visits at the end of the epidemic. Only 2% of cases were hospitalized; of these, 70% of cases occurred in patients 6-50 years of age, and 32% of cases occurred in patients who had an underlying medical condition. Eleven patients (age range, 1-53 years) required admission to the intensive care unit (ICU); 6 of these patients had pneumonia with or without hemodynamic shock. No influenza-associated deaths occurred. Conclusions. Many cases of influenza A (H1N1) occurred in school-aged and adult individuals who required an ED visit; these visits resulted in a low impact on the use of hospital beds. Aggressive ICU management and/ or experience in extracorporeal membrane oxygenation significantly improved outcomes. Early antiviral treatment may have played an important role in the low number of severe cases. Vaccines targeted for school-aged children and young adults may modify the first epidemic wave in the northern hemisphere.
Revista chilena de infectología, 2016
Los autores declaran no tener conflictos de interés.
Rev Med Clin Condes, Dec 1, 1996
Revista Chilena de Salud Pública, 2011
Revista medica de Chile
The aim of this work was to assess the quality of life of 87 patients older than 60 years, out of... more The aim of this work was to assess the quality of life of 87 patients older than 60 years, out of 200 undergoing chronic hemodialysis in 9 centers at Santiago. A visual analog scale, with scores ranging from 0 (bad) to 100 (optimal) and a specific questionnaire about the impact of hemodialysis in daily activities, with scores ranging from -10 (severe limitation) to +10 (no limitation) were applied to patients and their attending nurses. Using the visual analog scale, patients assessed their quality of life in 51.7%, and health personnel in 61.3%. Patients had a questionnaire score of 2.3. Quality of life scores were inversely correlated with the condition of being diabetic and the number of hospital admissions.
Revista medica de Chile
Hypertension is a common and important cardiovascular risk factor in patients on chronic hemodial... more Hypertension is a common and important cardiovascular risk factor in patients on chronic hemodialysis. To report the prevalence and characteristics of hypertension among patients on chronic hemodialysis. Cross sectional study of 313 patients (192 male, aged 57 +/- 18 years) dialyzed in 7 representative centers in Santiago, Chile. Patients were on hemodialysis for a mean of 68 +/- 53 months and 67 (21%) were diabetic. 230 (74%) were hypertensive and 223 of these (97%) had predialysis hypertension. A multivariate analysis showed that hypertension was associated with increased weight gain between dialysis, failure to achieve the postdialysis dry weight, increasing age and the presence of diabetes. Among hypertensive patients, 61% were receiving antihypertensive medications, compared with 27% of patients with normal blood pressure. High blood pressure is highly prevalent among patients on chronic hemodialysis and is associated to hypervolemia, age and the presence of diabetes.
Clinical and investigative medicine. Médecine clinique et experimentale
ABSTRACT
Therapeutic Drug Monitoring, 2003
C(2) Cyclosporine (CsA) level, as a surrogate of area under the time-concentration curve (AUC) 0-... more C(2) Cyclosporine (CsA) level, as a surrogate of area under the time-concentration curve (AUC) 0-4 hours, is a good predictor of drug absorption and clinical outcome after kidney transplantation. It has been difficult to define the optimal C(2) level in the individual case and given the broad range of C(2) due to interindividual absorption variability it has been troublesome to determine the drug dose needed to obtain an expected C(2)-CsA concentration. In this study data of 16 stable renal and renal/pancreas recipients treated with prednisone, azathioprine, and CsA (Neoral) managed by C(0) level was examined. CsA concentrations at time 0 (basal), 2, 6, and 12 hours post CsA (Neoral) intake were determined the day of the study. A significant linear regression level was established between C(2) (but not C(0), C(6) and C(12)) and the dosage expressed as mg/kg/d (P = 0.0113, correlation coefficient r = 0.573018). Subsequently, another 27 renal transplant recipients were studied retrospectively and divided into three groups according to posttransplant period: 1 to 6, 7 to 12, and beyond 12 months after transplant. Equations derived from the relationship between C(2) and dose (mg/kg/d) were similar between the three groups and when compared with the first study. A formula obtained from the 27 patients in the whole posttransplant period (mg/kg/d = C(2) x 0.0010208 + 1.86125) was applied to patients of the first study obtaining a regression coefficient between actual and calculated CsA dose of 0.6145 (P = 0.01). A more accurate equation (P = 0.0001, r = 0.5925) was obtained by analyzing 145 C(2) determinations covering a period from 1 month to 8 years following transplant which gave a linear regression line defined by the equation C(2) x 0.001473 + 1.6673. This equation would permit the calculation mg/kg/d of CsA (Neoral) dose to obtain an expected C(2) level. The derived equation shown in this paper has a predictive value of 50% to 60% only, but can help to find adequate dosage in the presence of an inappropriate C(2) level.
Revista Medica De Chile, 2002
Background: Hypertension is a common and important cardiovascular risk factor in patients on chro... more Background: Hypertension is a common and important cardiovascular risk factor in patients on chronic hemodialysis. Aim: To report the prevalence and characteristics of hypertension among patients on chronic hemodialysis. Patients and methods: Cross sectional study of ...
Clinical Infectious Diseases, 2010
In Chile, the novel influenza A (H1N1) epidemic began in the middle-high income area of Santiago.... more In Chile, the novel influenza A (H1N1) epidemic began in the middle-high income area of Santiago. Clinical and laboratory surveillance was intensified with the aim to characterize the epidemic and determine its impact in a large hospital setting.