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Echeverria L. S.,University of Chile | Herrera G. O.,Hospital Dr. Luis Calvo Mackenna | Henriquez D'A. E.,University of Chile | Sepulveda R. R.,University of Chile
Revista Chilena de Pediatria | Year: 2012

Prevalence of early childhood caries in children with chronic respiratory diseases introduction: children with chronic health conditions may have an increased risk for developing caries. although the literature on early childhood cavities (ecc) is extensive, little is known about its prevalence in children with these conditions. objective: to determine the prevalence of ecc in children with chronic respiratory disease (cRD) at Luis calvo Mackenna hospital in santiago, chile, and to determine their association. Patients and Methods: a cross-sectional study was performed on 120 children aged 2 to 5 years 11 months, a study group of 60 children with cRD and a control group of 60 healthy children were analyzed. ecc was diagnosed meeting the aapD criteria, an oral exam conducted by an operator under standardized conditions. the stata 11 program was used for statistical analysis. results: the prevalence of ecc was 53% in children with cRD and 25% in healthy children (p < 0.0001). the value of odds ratio for children with cRD was 7.046 showing an increased risk of ecc compared with healthy children. (95% cI: 2.372 to 20.929). conclusion: In this population, children with CRD have a high prevalence of ECC. In this sample, a statistically significant association between ecc and cRD was found.

Cofre F.,University of Chile | Villarroe M.,Hospital Dr. Luis Calvo Mackenna | Castellon L.,Servicio de Cirugia | Santolaya M.E.,University of Chile
Revista Chilena de Infectologia | Year: 2015

The fungi of the order Mucorales cause mucormycosis, which usually presents as an invasive fungal disease with rapid angioinvasion in immunocompromised patients. Rhinocerebral is the most common presentation. The lipid formulations of amphotericin B are used as primary treatment in invasive mucormycosis; the combined use of posaconazole could allow a reduction in the dose of amphotericin B improving tolerance and adherence to treatment. Caspofungin and amphotericin B association has been shown to be synergistic in vitro and effective in murine models. We present the case of a preschool patient that during the debut of acute lymphoblastic leukemia developed a rhinocerebral mucormycosis successfully responding to antifungal treatment with the combination of liposomal amphotericin and caspofungin. © 2015, Sociedad Chilena de Infectologia. All rights reserved.

Parot C.,Hospital Dr. Luis Calvo Mackenna | Leclercq C.,Institute Of La Main
Surgical and Radiologic Anatomy | Year: 2016

Purpose: The median nerve is responsible for the motor innervation of most of the muscles usually involved in upper limb spasticity. Selective neurectomy is one of the treatments utilized to reduce spasticity. The purpose of this study was to describe the variations of the motor branches of the median nerve in the forearm and draw recommendations for an appropriate planning of selective neurectomy. Materials and methods: The median nerve was dissected in the forearm of 20 fresh cadaver upper limbs. Measurements included number, origin, division, and entry point of each motor branch into the muscles. Results: One branch for the pronator teres was the most common pattern. In 9/20 cases, it arose as a common trunk with other branches. A single trunk innervated the flexor carpi radialis with a common origin with other branches in 17/20 cases. Two, three or four branches innervated the flexor digitorum superficialis, the first one frequently through a common trunk with other branches. They were very difficult to identify unless insertions of pronator teres and flexor digitorum superficialis were detached. The flexor digitorum profundus received one to five branches and flexor pollicis longus one to two branches from the anterior interosseous nerve. Conclusions: There is no regular pattern of the motor branches of the median nerve in the forearm. Our findings differ in many points from the classical literature. Because of the frequency of common trunks for different muscles, we recommend the use of peroperative electrical stimulation. Selective neurotomy of flexor digitorum superficialis is technically difficult, because the entry point of some of their terminal branches occurs just below the arch and deep to the muscle belly. © 2015, Springer-Verlag France.

Repetto G.M.,University for Development | Guzman M.L.,University for Development | Delgado I.,University for Development | Loyola H.,University for Development | And 6 more authors.
BMJ Open | Year: 2014

Objective: Chromosome 22q11.2 deletion is the most commonly occurring known microdeletion syndrome. Deaths related to the syndrome have been reported, but the magnitude of death has not been quantified. This study evaluated the deletion's impact on survival and its clinical manifestations in a large cohort of Chilean patients.Design: Demographic and clinical data of individuals with 22q11 deletions diagnosed between 1998 and 2013 were collected from medical records and death certificates. Case fatality rate was calculated and compared with national vital statistics. OR with 95% CI analysis was used to assess the association between clinical manifestations and death.Setting: Genetic services in tertiary care centres in Chile, following patients with 22q11.2 deletion.Outcomes: Fatality rate and associated factors.Results: 59 of 419 patients (14.1%) died during the study period at a median of 3.4 months (range 0 to 32 years of age). Factors associated with death included congenital heart disease (OR 5.27; 95% CI 2.06 to 13.99; p<0.0001), hypocalcaemia (OR 4.27; 95% CI 1.67 to 11.15; p<0.002) and airway malacia (OR 13.37; 95% CI 1.19 to 110.51; p<0.002). Patients with deletions and defects such as tetralogy of Fallot with or without pulmonary atraesia, truncus arteriosus or ventricular septal defect, had a 2.6-fold to 4.6-fold higher death rate compared with nationwide reports for the same types of defects.Conclusions: In this cohort, we observed a death rate of 14.1%, implying that one in seven patients with 22q11 deletion died during the study period. Significant associations with cardiac defects, hypocalcaemia and airway malacia were observed. Furthermore, the death risk in patients with 22q11 deletion and cardiac defects exceeded the global figures observed in Chile for infants with structurally similar but apparently isolated anomalies. These observations indicate a need to identify patients who may require specific perioperative management to improve survival.

Sierralta M.C.,Hospital Dr. Luis Calvo Mackenna | Gonzalez G.,Section of Pediatric Renal Transplantation | Nome C.,Hospital Dr. Luis Calvo Mackenna | Pinilla C.,Section of Pediatric Renal Transplantation | And 5 more authors.
Pediatric Transplantation | Year: 2015

The aim of the current study was to compare results in pediatric renal transplantation of patients with and without SBP. Between 2001 and 2013, a total of 168 kidney transplants were performed at our center. A retrospective analysis was performed and recipients were divided into two groups: NB and SBP. Incidence of surgical complications after procedure, and graft and patient survival were evaluated. A total of 155 recipients (92%) with complete data were analyzed, and 13 recipients that had had previous bladder surgeries were excluded (11 with VUR surgery and two with previous kidney transplants), of the 155 recipients: 123 (79%) patients had NB, and 32 (21%) patients had SBP, with a median follow-up of 60 (1–137) and 52 (1–144) months, respectively. Among post-transplant complications, UTI (68.8% vs. 23%, p < 0.0001) and symptomatic VUR to the graft (40.6% vs. 7.3%, p < 0.0001) were significantly higher in the SBP group. There was no significant difference in overall graft and patient survival between groups. Renal transplantation is safe in pediatric recipients with SBP; however, urologic complications such as UTI and VUR were significantly higher in this group. Graft and patient survival was similar in SBP and NB groups. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

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