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Un acercamiento teórico-metodológico al estudio del crecimiento urbano: la periodización de la ciudad de La Plata
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Rojas Chediac, Juan Ignacio

Estudios Socioterritoriales

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jun 2024, Volume 35 N. 1 Pages 59 - 80

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract The objective of this work is the development of a theoretical-methodological tool for understanding the expansion of cities based on periods of growth. From the perspective of critical geography, we seek to generate a conceptual instrument that provides a general framework for understanding urban studies. With the developed tool, the case of the city of La Plata is analyzed. The research is developed in four parts: i) the theoretical framework is built, highlighting the main categories that contribute to the study of urban periodization; ii) the analysis variables that determine periods of growth in Latin American cities are developed; iii) the process of urban growth of the district of La Plata since its foundation is investigated and; iv) final words are made as a reflection.

Resumen El presente trabajo tiene por objetivo el desarrollo de una herramienta teórico-metodológica para la comprensión de la expansión de las ciudades a partir de periodos de crecimiento. Desde la perspectiva de la geografía crítica, se busca generar un instrumento conceptual que aporte un marco general para el entendimiento de los estudios urbanos. Con la herramienta elaborada, se analiza el caso de la ciudad de La Plata. La investigación se desarrolla en cuatro partes: i) se construye el marco teórico, destacando las principales categorías que aportan al estudio de la periodización urbana; ii) se elaboran las variables de análisis que determinen periodos de crecimiento en las ciudades latinoamericanas; iii) se indaga en el proceso del crecimiento urbano del partido de La Plata desde su fundación y; iv) se confeccionan palabras finales a modo de reflexión.

https://doi.org/10.37838/unicen/est.35-1-103

Effect of three training programs on surgical performance in single-port laparoscopic surgery
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Pérez-Escamirosa, Fernando

; Nuñez-Rojas, Adriana N.

; Dorantes-Nava, Claudia L.

; Montoya-Alvarez, Salvador

; Sánchez-Margallo, Juan A.

; Oropesa, Ignacio

; Tapia-Jurado, Jesús

Cirugía y cirujanos

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apr 2024, Volume 92 N. 2 Pages 194 - 204

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract Objective: The aim of this study was to evaluate the effect of three training methodologies on the acquisition of psychomotor skills for laparoendoscopic single-site surgery (LESS), using straight and articulating instruments. Methods: A prospective study was conducted with subjects randomly divided into three groups, who performed a specific training for 12 days using three laparoscopic tasks in a laparoscopic simulator. Group-A trained in conventional laparoscopy setting using straight instruments and in LESS setting using both straight and articulating instruments. Group-B trained in LESS setting using straight and articulating instruments, whereas Group-C trained in LESS setting using articulating instruments. Participants´ performance was recorded with a video-tracking system and evaluated with 12 motion analysis parameters (MAPs). Results: All groups obtained significant differences in their performance in most of the MAPs. Group-C showed an improvement in nine MAPs, with a high level of technical competence. Group-A presented a marked improvement in bimanual dexterity skills. Conclusions: Training in LESS surgery using articulating laparoscopic instruments improves the quality of skills and allows smoother learning curves.

Resumen Objetivo: Evaluar el efecto de tres métodos de entrenamiento en la adquisición de habilidades psicomotrices para la cirugía laparoendoscópica por puerto único (LESS, laparoendoscopic single-site surgery) utilizando instrumental recto y articulado. Método: Se realizó un estudio prospectivo con sujetos divididos aleatoriamente en tres grupos, quienes realizaron un entrenamiento específico durante 12 días utilizando tres tareas laparoscópicas en un simulador laparoscópico. El grupo A entrenó en el entorno laparoscópico convencional con instrumentos rectos, y en el entorno LESS con instrumentos rectos y articulados. El grupo B entrenó en el entorno LESS con instrumentos rectos y articulados. El Grupo C entrenó en el entorno LESS con instrumentos articulados. El desempeño de los participantes se registró con un sistema de seguimiento en video y fue evaluado con 12 parámetros de análisis de movimiento (MAP, motion analysis parameters). Resultados: Todos los grupos obtuvieron diferencias significativas en su desempeño para la mayoría de los MAP. El grupo C mostró una mejora en nueve MAP, con un alto nivel de competencia técnica. El grupo A mostró una marcada mejora en la habilidad de destreza bimanual. Conclusiones: El entrenamiento en cirugía LESS con instrumentos articulados mejora la calidad de las habilidades adquiridas y permite curvas de aprendizaje más suaves.

https://doi.org/10.24875/ciru.22000536

Nefrectomía radical con trombectomía de vena cava: 20 años de cirugías por tumor renal
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Rojas, Pablo A.

; Bravo, Juan Cristóbal

; Navarro, Renato

; Villagran, Sofía

; Zúñiga, Álvaro

; Troncoso, Pablo

; Becker, Pedro

; Briceño, Eduardo

; Francisco, Ignacio F. San

Revista médica de Chile

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aug 2022, Volume 150 N. 8 Pages 994 - 999

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Background: Vena cava (VC) involvement in kidney tumors occurs in 4 to 10% of cases, and is associated with a higher mortality. Nephrectomy with thrombectomy of the VC, performed by a multidisciplinary team, improves survival. Aim: To report a series of consecutive nephrectomies with caval thrombectomy performed in an academic center. Patients and Methods: We report 32 patients with cT3b and 3c renal tumors, who underwent radical nephrectomy with VC thrombectomy between 2001 and 2021. A descriptive analysis of clinical, surgical and pathological variables was performed. Overall survival (OS) and cancer-specific survival (CSS) was calculated using Kaplan-Meier curves. Results: The mean tumor size was 9.7 cm. According to Mayo classification 3/32 (9%) patients had a type I thrombus, 10/32 (31%) had a type II thrombus, 8/32 (25%) had a type III thrombus, and 5/32 (16%) had a type IV thrombus. The mean bleeding was 2000 cc. There was one intraoperative death. Nineteen percent of patients had complications >= 3 according to Clavien-Dindo classification. Reoperations occurred in 9%. Pre and postoperative creatinine levels were 1.17 and 1.91 mg/dl respectively (p < 0.01). Pre and postoperative Hematocrit levels were 47.9 and 31% respectively (p = 0.02). Sixty six percent of tumors were clear cell renal cancer, 9% were papillary and 3% were chromophobic. Mean OS was 10 months. Two-year SCE was 40%. Conclusions: Our results are similar to those reported elsewhere. Despite being an unusual pathology, the surgical technique has been improving, thanks to the multidisciplinary work of urologists and surgeons.

Brain volume loss and physical and cognitive impairment in naïve multiple sclerosis patients treated with fingolimod: prospective cohort study in Buenos Aires, Argentina fingolimod Aires
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Rojas, Juan Ignacio

; Patrucco, Liliana

; Pappolla, Agustín

; Sánchez, Francisco

; Cristiano, Edgardo

Arquivos de Neuro-Psiquiatria

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jul 2022, Volume 80 N. 7 Pages 699 - 705

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Antecedentes A porcentagem de perda de volume cerebral (PPVC) é um biomarcador na esclerose múltipla (EM). Objetivo Analisar se a PPVC durante o 1° ano após o início da doença prediz deterioração física (DF) e cognitiva (DC) em pacientes com EM. Métodos Estudo de coorte prospectivo que incluiu pacientes recém-diagnosticados sem comprometimento cognitivo que iniciaram tratamento com fingolimode. Os pacientes foram acompanhados por 3 anos, sendo avaliados a presença de recidivas, progressão da Escala Expandida do Estado de Incapacidade (EDSS, na sigla em inglês) (definida como agravamento de 1 ponto na EDSS), o PPVC anual (avaliado pela avaliação de imagem estrutural de atrofia normalizada [SIENA, na sigla em inglês) e a presença de DC (avaliada no início do estudo e nos 2° e 3° anos). O PPVC no 1° ano de tratamento com fingolimode foi utilizado como variável independente. Resultados foram incluídos 71 pacientes com idade média de 35,4 ± 3 anos. No 3° ano, 14% dos pacientes tiveram DC e 6,2% tiveram progressão de EDSS. No grupo DC, o PPVC durante o 1o ano foi - 0,52 (± 0,07) versus - 0,42 (± 0,04) no grupo sem DC (p<0,01; razão de probabilidades [OR, na sigla em inglês] =2,24; intervalo de confiança [IC] de 95%: 1,72-2,44). No grupo que apresentou progressão da EDSS, o PPVC durante o 1° ano foi de - 0,59 (± 0,05) versus - 0,42 (± 0,03) (p < 0,01; OR = 2,33; IC95%: 1,60-2,55). Conclusões Um maior PPVC durante o 1° ano foi associado a um risco significativo de progressão de DC e EDSS durante o seguimento. (PPVC EM . (EM) DF (DF (DC recémdiagnosticados recém diagnosticados anos recidivas (EDSS inglês definida , EDSS) avaliado SIENA, SIENA [SIENA avaliada 2 anos) independente 7 354 35 4 35, 14 62 6 6,2 052 0 52 0,5 ( 0,07 007 07 042 42 0,4 0,04 004 04 p<0,01 p001 p 01 (p<0,01 OR, [OR =2,24 224 24 IC [IC 95% 95 1,722,44. 172244 1,72 2,44 72 44 1,72-2,44) 059 59 0,05 005 05 0,03 003 03 0,01 001 2,33 233 33 IC95% IC95 1,602,55. 160255 1,60 2,55 60 55 1,60-2,55) seguimento (EM 6, 5 0, 0,0 00 p<0,0 p00 (p<0,0 =2,2 22 9 722 1,722,44 17224 172 1,7 244 2,4 1,72-2,44 2,3 23 IC9 602 1,602,55 16025 160 1,6 255 2,5 1,60-2,55 p<0, p0 (p<0, =2, 1,722,4 1722 17 1, 2, 1,72-2,4 1,602,5 1602 16 25 1,60-2,5 p<0 (p<0 =2 1,722, 1,72-2, 1,602, 1,60-2, p< (p< 1,722 1,72-2 1,602 1,60-2 1,72- 1,60-

Abstract Background The percentage of brain volume loss (PBVL) has been classically considered as a biomarker in multiple sclerosis (MS). Objective The objective of the present study was to analyze if the PBVL during the 1st year after the onset of the disease predicts physical and cognitive impairment (CI). Methods Prospective study that included naïve patients without cognitive impairment who initiated MS treatment with fingolimod. Patients were followed for 3 years and relapses, expanded disability status scale (EDSS) progression (defined as worsening of 1 point on the EDSS), the annual PBVL (evaluated by structural image evaluation using normalization of atrophy [SIENA]), and the presence of CI were evaluated. Cognitive impairment was defined in patients who scored at least 2 standard deviations (SDs) below controls on at least 2 domains. The PBVL after 1 year of treatment with fingolimod was used as an independent variable, while CI and EDSS progression at the 3rd year of follow-up as dependent variables. Results A total of 71 patients were included, with a mean age of 35.4 ± 3 years old. At the 3rd year, 14% of the patients were classified as CI and 6.2% had EDSS progression. In the CI group, the PBVL during the 1st year was-0.52 (± 0.07) versus-0.42 (± 0.04) in the no CI group (p < 0.01; odds ratio [OR] = 2.24; 95% confidence interval [CI]: 1.72–2.44). In the group that showed EDSS progression, the PBVL during the 1st year was - 0.59 (± 0.05) versus - 0.42 (± 0.03) (p < 0.01; OR = 2.33; 95%CI: 1.60-2.55). Conclusions A higher PBVL during the 1st year in naïve MS patients was independently associated with a significant risk of CI and EDSS progression. (PBVL MS. . (MS) st CI. (CI) relapses (EDSS EDSS, , EDSS) evaluated SIENA, SIENA [SIENA]) SDs (SDs domains variable rd followup follow up variables 7 354 35 4 35. old 14 62 6 6.2 was0.52 was052 0.52 0 52 was-0.5 ( 0.07 007 07 versus0.42 versus042 42 versus-0.4 0.04 004 04 p 0.01 001 01 [OR 2.24 224 24 95 [CI] 1.72–2.44. 172244 1.72–2.44 72 44 1.72–2.44) 059 59 0.5 0.05 005 05 042 0.4 0.03 003 03 2.33 233 33 95%CI 95CI 1.602.55. 160255 1.60 2.55 60 55 1.60-2.55) (MS (CI [SIENA] 6. was0 was0.5 was05 052 5 was-0. 0.0 00 versus0 versus0.4 versus04 versus-0. 2.2 22 9 [CI 17224 1.72–2.4 0. 2.3 23 602 1.602.55 16025 160 1.6 255 2.5 1.60-2.55 [SIENA was0. was-0 versus0. versus-0 2. 1722 1.72–2. 1.602.5 1602 16 1. 25 1.60-2.5 was- versus- 172 1.72–2 1.602. 1.60-2. 17 1.72– 1.602 1.60-2 1.72 1.60- 1.7

https://doi.org/10.1055/s-0042-1755277

Tabaquismo y tumores mayores de 2 centímetros son predictores de mortalidad en pacientes sometidos a nefro-ureterectomías por carcinoma de urotelio alto
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Rojas, Pablo A.

; Bravo, Juan Cristóbal

; Gallegos, Héctor

; Zúñiga, Álvaro

; Francisco, Ignacio San

Revista médica de Chile

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feb 2022, Volume 150 N. 2 Pages 172 - 177

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Background: Upper urinary tract urothelial carcinoma (UTUC) represents 5-10% of urothelial carcinomas. It is managed with nephroureterectomy (NUR); however, kidney-sparing techniques are growingly used. Aim: To report the results of a 20-year series of NUR conducted in an academic center. Patients and Methods: Review of clinical and pathological characteristics of patients undergoing NUR between 1999 and 2020. Patients were followed for 63 months. Global survival curves (OS) and mortality predictors were established through Cox regression. Results: We included 90 patients with a median age of 68 years undergoing NUR, of whom 68 (75%) had a pelvic tumor and 22 (25%) had a proximal ureteral tumor. A laparoscopic NUR was performed in 60 patients (66%). Thirty-three patients (37%) had tumors confined to the urothelium (pTa), penetrating the lamina propria (pT1) or carcinoma in situ (CIS), 10 patients (11%) had a tumor spreading to the muscle layer (pT2) and 47 (52%) had a tumor spreading to nearby organs (pT3 / T4). Average tumor size was 3.69 cm, nodal disease (pN) was present 12 patients (13%). Twelve patients (13%) received adjuvant chemotherapy. A higher mortality was observed among smokers (Hazard ratio (HR) 8.79, 95% confidence intervals (CI) 1.5-49.0, p = 0.01), patients with tumors classfied as pT≥ 2 (HR 1.09, 95% CI 0.01-1.0, p = 0.04) and those with tumors larger than 2 cm (HR 14.79, CI 95% 1.5-272, p = 0.01). Conclusions: Smoking patients, those with invasive tumors (T2-T4) and greater than 2 cm have higher mortality. Therefore, they should not be candidates for conservative management.

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Vivienda informal y las organizaciones territoriales en América Latina
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Vergara-Perucich, Francisco

; Fuster-Farfán, Xenia

; Rojas Rubio, Ignacio

; Hidalgo Dattwyller, Rodrigo

; Rincón Quiroz, Sasha

; Álvarez, Juan Camilo

; Alvarado Peterson, Voltaire

; Meseguer Ruiz, Oliver

; Lizana Vásquez, Fabián

Revista de geografía Norte Grande

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2022, N. 81 Pages 5 - 14

Abstract: Es | Text: Es | PDF: Es

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Consenso chileno de diagnóstico y manejo de neoplasias quísticas pancreáticas. Club de páncreas Chile-SCHGE
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Espino, Alberto

; Vargas, José Ignacio

; Mancilla, Carla

; Muñoz, Pablo

; Martínez, Waldo

; Menéndez, Alejandra

; Jara, Daniela

; Mansilla, Rodrigo

; Schiappacasse, Giancarlo

; Santamarina, Mario

; Huete, Álvaro

; Candia, Roberto

; Silva, Felipe

; Castillo, Cecilia

; Richter, Hugo

; Mejía, Ricardo

; Vial, Paula

; Robles, Ignacio

; Martínez, Jorge

; Jarufe, Nicolás

; Briceño, Eduardo

; Lembach, Hanns

; Zoroquiain, Pablo

; Roa, Juan Carlos

; Walker, Kenneth

; Torres, Javiera

; Carreño, Laura

; Castiblanco, Adriana

; Fernández, Wanda

; Ríos, Álvaro

; Chandia, Javiera

; Ayala, María José

; Rojas, Tamara

; Verdugo, Jorge

; Berger, Zoltán

Revista médica de Chile

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dec 2021, Volume 149 N. 12 Pages 1773 - 1786

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Pancreatic cystic neoplasms (PCN) are frequently detected on abdominal images performed for non-pancreatic indications. Their prevalence in asymptomatic population ranges from 2.7 to 24.8%, and increases with age. There are several types of pancreatic cysts. Some may contain cancer or have malignant potential, such as mucinous cystic neoplasms, including mucinous cystadenoma (MCN) and intraductal papillary mucinous neoplasms (IPMN). In contrast, others are benign, such as serous cystadenoma (SCA). However, even those cysts with malignant potential rarely progress to cancer. Currently, the only treatment for pancreatic cysts is surgery, which is associated with high morbidity and occasional mortality. The Board of the Chilean Pancreas Club of the Chilean Gastroenterology Society developed the first Chilean multidisciplinary consensus for diagnosis, management, and surveillance of PCN. Thirty experts were invited and answered 21 statements with five possible alternatives: 1) fully agree; 2) partially agree; 3) undecided; 4) disagree and 5) strongly disagree. A consensus was adopted when at least 80% of the sum of the answers “fully agree” and “partially agree” was reached. The consensus was approved by the Board of Directors of the Chilean Pancreas Club for publication.

https://doi.org/10.4067/s0034-98872021001201773 73 downloads

Reconocimiento póstumo al profesor Joan Pagés Blanch
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Rojas Rubio, Ignacio

; Hidalgo Dattwyler, Rodrigo

; Rincón Quiroz, Sasha

; Alvarado Peterson, Voltaire

; Álvarez Naranjo, Juan Camilo

; Meseguer Ruiz, Oliver

; Fuster Farfán, Xenia

; Lizana Vásquez, Fabián

Revista de geografía Norte Grande

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sep 2021, N. 79 Pages 5 - 8

Abstract: Es | Text: Es | PDF: Es

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Estudio unicéntrico del tratamiento con trombolíticos dirigidos por catéter en el tromboembolismo pulmonar agudo
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Seropian, Ignacio M.

; Rojas Matas, Carlos A.

; Damonte, Juan I.

; Chiabrando, Juan G.

; Bluro, Ignacio M.

; Berrocal, Daniel H.

Medicina (Buenos Aires)

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jun 2021, Volume 81 N. 3 Pages 382 - 388

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract We performed a single center retrospective study in patients with pulmonary embolism (PE) undergoing catheter directed thrombolysis (CDT) from 2014 to 2020. Efficacy was defined by mean pulmonary pressure drop, and safety was assessed by intracranial and severe bleeding (defined by GUSTO). Forty-three patients were included, aged 64 (56-79) years old, 5 (12%) with shock, most with right ventricle dilation (95%) and bilateral PE (95%) or unilateral (5%) in patients with only one functional lung. CDT was used as first treatment (53%), upscale after anticoagulation alone (42%), or after failed systemic thrombolytics (5%). Median recombinant tissue plasminogen activator (rtPA) dose was 30 (25-35) mg over 20 (20-20) hours, and rtPA bolus was used after catheter placement in 38 cases (89%), consisting of 5 mg (95%) or 1 mg (5%). Only one lung was treated for technical reasons, and 4 (9%) were repositioned in the same lung for continuation of infusion. A significant reduction in mean pulmonary pressure was observed (pre 35 [29-41] mmHg vs. post 24 [20-34] mmHg, p<0.001) with no intracranial bleeding. One patient (2%) experienced severe bleeding, while 5 (12%) presented access site bleeding, and 3 (7%) required blood transfusions. In-hospital mortality was 12% but only one case (2%) due to PE. Our results are similar to previously reported studies.

Resumen Se realizó un estudio unicéntrico retrospectivo para evaluar la eficacia y seguridad de trombolisis dirigida por catéter (TDC) en pacientes con tromboembolismo pulmonar agudo (TEP) de 2014 a 2020. Se analizó la efectividad (mejoría de presión pulmonar), y seguridad (sangrado intracraneal y grave definido por compromiso hemodinámico). Se incluyeron 43 pacientes, de 67(56-79) años, 5 (12%) con shock, 41 (95%) con dilatación del ventrículo derecho y TEP bilateral. La decis ión de TDC fue: tratamiento inicial (53%), escalada de anticoagulación (42%) y rescate de trombolisis sistémica (5%). Se utilizó TDC facilitada por ultrasonido en 40 casos (93%), utilizándose 30 (25-35) mg de activador tisular del plasminógeno recombinante (rtPA) durante 20 h. Se administró un bolo de rtPA en 38 (89%) casos, que fue 5 mg (95%) o 1 mg (5%). Se utilizó un solo catéter por paciente. En 4 (9%) se decidió recolocación (mismo pulmón) para continuar infusión en otro sector. Se observó una disminución significativa de la presión media pulmonar (pre 35 [29-41] mmHg vs. post 24 [20-34] mmHg, p<0.001). No se observó ningún caso de hemorragia intracraneal, y un caso (2%) de sangrado grave. Se observó hematoma del sitio de punción en 5 (12%) (incluyendo el sangrado grave), y requirió transfusiones en 3 (7%). La mortalidad intrahospitalaria fue 12%, siendo un solo c aso (2%) atribuido al TEP. El tratamiento con TDC fue efectivo asociándose a una reducción significativa de la presión pulmonar, sin observarse ningún sangrado intracraneal y con un sangrado grave. Nuestros resultados se asemejan a lo publicado en otros estudios.

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Real-world experience of ocrelizumab in multiple sclerosis patients in Latin America
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ROJAS, Juan Ignacio

; PATRUCCO, Liliana

; FRUNS, Manuel

; HORNUNG, Giesela

; FLORES, José

; CARNERO CONTENTTI, Edgar

; LOPEZ, Pablo Adrian

; PETTINICCHI, Juan Pablo

; CARIDE, Alejandro

; GALLEGUILLOS, Lorna

; BARAHONA, Jorge

; DIAZ, Violeta

; HERNÁNDEZ, Marianella

; ALONSO, Ricardo

; CRISTIANO, Edgardo

Arquivos de Neuro-Psiquiatria

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apr 2021, Volume 79 N. 4 Pages 305 - 309

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

ABSTRACT Background: Despite the abundance of information concerning ocrelizumab in phase III clinical trials, there is scarce evidence regarding real-world patient profiles. Objective: The aim of this study was to investigate patient profiles, effectiveness and persistence with treatment among patients who used ocrelizumab for treatment of multiple sclerosis in Latin America. Methods: This was a retrospective multicenter study in Argentina, Chile and Mexico. Medical record databases on patients who received ocrelizumab were analyzed. Demographic and clinical variables were described, along with effectiveness outcomes, which included the proportions of patients free from clinical relapses, from disability progression and from new or enlarging T2 or T1 gadolinium-enhancing lesions, on annual magnetic resonance imaging. Results: A total of 81 patients were included. The most frequent phenotype was relapsing-remitting MS, in 64.2% of the patients. The mean age at study entry was 41.3 ± 12.0 years and 51.8% were women. A total of 38% had had relapse activity during the 12 months before starting on ocrelizumab, with a mean relapse rate of 1.3 ± 0.6 during that period. 75% were free from clinical relapses and 91% were free from gadolinium-enhancing lesions in the relapsing-remitting course. Ocrelizumab discontinuation during the first 12 months was observed in three patients (3.7%). The mean persistence observed during the first-year follow-up was 338 ± 24 days. Conclusions: Our study is in line with previous randomized clinical trials and recent real-world studies describing patient profiles, effectiveness and persistence regarding ocrelizumab treatment in multiple sclerosis patients in Latin America.

RESUMEN Introducción: A pesar de la abundante información sobre ocrelizumab proveniente de los ensayos clínicos de fase III, todavía se tiene poca evidencia sobre la efectividad y el perfil de pacientes provenientes de la vida real. Objetivo: Evaluar el perfil clínico y demográfico, la efectividad y la persistencia al tratamiento en pacientes que usaron el ocrelizumab para el tratamiento de esclerosis múltiple (EM) en Latinoamérica. Métodos: Estudio retrospectivo multicéntrico en Argentina, Chile y México. Se analizaron los datos de los pacientes que recibieron ocrelizumab. Se describieron las variables demográficas y clínicas, así como los resultados de efectividad que incluyeron la proporción de pacientes libres de recaídas clínicas, libres de progresión de la discapacidad, libres de nuevas lesiones en la secuencia T2 o T1 con gadolinio durante el seguimiento. Resultados: Se incluyeron 81 pacientes. El fenotipo más frecuente fue EM remitente recurrente (EMRR) en el 64,2% de los pacientes. La edad media fue de 41.3±12 años, y el 51,8% eran mujeres. Un total de 38% tuvo recaídas durante los 12 meses previos al inicio de ocrelizumab, con una tasa anualizada de recaídas media de 1.3±0.6 durante ese período. En el seguimiento a 12 meses, el 75% estuvo libre de recaídas clínicas y el 91%, libre de nuevas lesiones en RM. Tres pacientes interrumpieron el tratamiento durante el seguimiento (3,7%). La persistencia al tratamiento observada durante el primer año de seguimiento fue de 338±24 días. Conclusión: Nuestro estudio está en línea con los datos provenientes de ensayos clínicos aleatorizados previos y estudios recientes del mundo real que describen la efectividad de los perfiles de pacientes y la persistencia al tratamiento con ocrelizumab en pacientes con EM en Latinoamérica.

https://doi.org/10.1590/0004-282x-anp-2020-0339 265 downloads

11.

Recomendaciones para el primer nivel de atención de salud frente a la emergencia por Covid-19
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Quimí López, Dennis Ignacio

; Giraldo Barbery, Enrique José

; Rojas Riera, Janeth Mabel

; Avilés Quinto, Juan Manuel

; Pazos Galeas, Shurguen Gustavo

Revista Eugenio Espejo

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apr 2021, Volume 15 N. 1 Pages 73 - 88

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract 80% of SARS-Cov-2 cases receive treatment at the first level of care, health policies must reinforce this issue in their systems. The authors carried out a bibliographic review in order to increase the resolution capacity of their units, reduce infections and possible complications in the health status of the patients. These recommendations are not absolute, but require a permanent update based on new scientific evidence and epidemiological trends of the disease.

Resumen El 80% de los casos de SARS-Cov-2 recibe tratamiento en el primer nivel de atención, las políticas sanitarias deben reforzar este eslabón en sus sistemas. Los autores realizaron una revisión de la bibliográfica con el propósito de incrementar la capacidad resolutiva de sus unidades, disminuir los contagios y las posibles complicaciones en el estado de salud de los pacientes. Sin que esas recomendaciones tengan un carácter absoluto, sino que se precisa una actualización permanente según las nuevas evidencias científicas y las tendencias epidemiológicas de la enfermedad.

https://doi.org/10.37135/ee.04.10.08 64 downloads

12.

¿Hacia un nuevo ciclo extractivista? Revisitando la relación entre comunidades, conflictos e industrias extractivas
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Irarrázaval, Felipe

; Rojas Rubio, Ignacio

; Hidalgo Dattwyller, Rodrigo

; Rincón Quiroz, Sasha

; Álvarez, Juan Camilo

; Alvarado Peterson, Voltaire

; Fuster-Farfán, Xenia

; Meseguer Ruiz, Oliver

; Lizana Vásquez, Fabian

Revista de geografía Norte Grande

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2021, N. 80 Pages 5 - 11

Abstract: Es | Text: Es | PDF: Es

46 downloads

13.

Espacio público y acción colectiva: análisis de los procesos de disputa por la mejora del hábitat en dos barrios periféricos de la Ciudad de la Plata
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Ursino, Sandra Valeria

; Rojas Chediac, Juan Ignacio

; Muiños Cirone, Maira

Revista de urbanismo

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dec 2020, N. 43 Pages 96 - 115

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract: This article presents the relevance that urban public space acquired in relation to two collective actions, in the dispute over habitat improvement in peripheral sectors of the city of La Plata. One in San Carlos, after the flood of April 2, 2013; and the other, in Los Hornos, due to the drop in energy supply in 2016. Both events acted as triggers that modified the uses and appropriations of public space by the inhabitants of each neighborhood. Due to the critical conditions of the popular habitat, due to the deterioration of infrastructure, such as social and housing equipment, urban public space was used by neighbors and social organizations to hold assemblies. In both cases, the demands made generated processes of organization and active participation in decision making, which led us to ask ourselves how symbolic and material links are established with a given urban space, and what importance they acquire in neighborhood organization. We also investigated their impact on citizen participation, as well as whether these practices persist over time or whether they disappear once the conflict has passed.

Resumen: En este artículo, se presenta la relevancia que adquirió el espacio público urbano en relación con dos acciones colectivas, en la disputa por la mejora del hábitat en sectores periféricos de la ciudad de La Plata. Uno en San Carlos, posterior a la inundación del 2 de Abril de 2013; y el otro, en Los Hornos, por la baja en el suministro de energía en el año 2016. Ambos acontecimientos actuaron como disparadores que modificaron los usos y apropiaciones que realizaron del espacio público los/as habitantes de cada barrio. A partir de las condiciones críticas del hábitat popular, por el deterioro de infraestructura, como equipamiento social y habitacional, el espacio público urbano fue utilizado por vecinos, vecinas y organizaciones sociales para realizar asambleas. En ambos casos, las demandas planteadas generaron procesos de organización y participación activa en la toma de decisiones, que llevó a preguntarnos cómo se establecen vínculos simbólicos y materiales con un espacio urbano determinado, y qué importancia adquieren en la organización barrial. Asimismo se indagó en su incidencia en la participación ciudadana de los/as habitantes, como también en sí son prácticas que persisten en el tiempo o si pasado el momento conflictivo, desaparecen.

https://doi.org/10.5354/0717-5051.2020.55482 231 downloads

14.

Mielitis longitudinal extensa de presentación muy tardía: Una entidad del espectro de la neuromielitis óptica
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Varela, Lucía

; Serra, Marcelo

; Rojas, Juan Ignacio

; Patrucco, Liliana

; Pappolla, Agustín

Medicina (Buenos Aires)

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jun 2020, Volume 80 N. 3 Pages 275 - 279

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Optic neuromyelitis spectrum diseases are inflammatory disorders of the central nervous system characterized by severe demyelination and immunomediated axonal damage that mainly affects the optic nerves and spinal cord. They usually appear at an early age, although there are some reports in the literature of patients with late presentations. We present the case of a 78-year-old woman who consulted for severe paraparesis, sensory disorders, and urinary retention. An MRI of the cervicodorsal spine was performed, showing extensive longitudinal spinal injury. Secondary causes based on clinical observations and laboratory studies were ruled out. The dosage of anti-aquaporin 4 antibodies was positive. Acute treatment with high-dose glucocorticoids and plasmapheresis was indicated, and maintenance with rituximab, obtaining little clinical response. In patients with extensive spinal injuries, multiple differential diagnoses should be considered according to the clinical presentation, findings through imaging studies and epidemiology. Likewise, it should include the search for anti-aquaporin 4 antibodies and against the oligodendrocyte myelin glycoprotein, since the functional prognosis of these patients is usually unfavourable due to the large destructive component of the lesions. Consequently, early treatment is essential in order to limit acute damage and prevent future relapses, which is especially important in late presentations of this entity due to the low functional reserve and low remyelination capacity.

Las enfermedades del espectro neuromielitis óptica son trastornos inflamatorios del sistema nervioso central caracterizados por una grave desmielinización y daño axonal inmunomediado que afecta principalmente a los nervios ópticos y médula espinal. Suelen presentars e en edades tempranas, aunque existen algunas comunicaciones en la literatura de pacientes con presentaciones tardías. Presentamos el caso de una mujer de 78 años que consultó por un cuadro de paraparesia grave, trastornos sensitivos y retención urinaria. Se realizó una resonancia magnética de columna cervicodorsal que evidenció una lesión medular longitudinal extensa. Se descartaron otras causas secundarias, basadas en la clínica y en resultados de laboratorio. El dosaje de anticuerpos anti-acuaporina 4 resultó positivo. Se indicó tratamiento con glucocorticoides a altas dosis y plasmaféresis, y mantenimiento con rituximab, obteniendo escasa respuesta clínica. En pacientes con lesiones medulares extensas se deben contemplar múltiples diagnósticos diferenciales según la presentación clínica, hallazgos mediante estudios por imágenes y epidemiología. Asimismo, debe incluir la búsqueda de anticuerpos anti-acuaporina 4 y contra la glicoproteína de la mielina del oligodendrocito, ya que el pronóstico funcional de estos pacientes suele ser desfavorable debido al gran componente destructivo de las lesiones. En consecuencia, el tratamiento temprano es fundamental a fin de limitar el daño agudo y prevenir futuras recaídas, lo cual es especialmente importante en presentaciones tardías de esta entidad debido a la escasa reserva funcional y baja capacidad de remielinización.

249 downloads

15.

Colonización nasal por Staphylococcus aureus resistente a la meticilina en pacientes sometidos a cirugía cardiovascular en un hospital universitario de Bogotá, Colombia
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Martínez-Díaz, Heidy C.

; Valderrama-Beltrán, Sandra L.

; Hernández, Ana C.

; Pinedo, Silvia K.

; Correa, Juan R.

; Ríos, Édgar G.

; Rojas, Julie J.

; Hernández, Yessica Y.

; Hidalgo, Marylin

Biomédica

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may 2020, Volume 40 Suppl. 1 Pages 37 - 44

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen Introducción. Staphylococcus aureus resistente a la meticilina (SARM) es un microorganismo que coloniza las fosas nasales y diferentes partes del cuerpo, lo cual se considera un factor de riesgo para adquirir infecciones invasivas, especialmente en pacientes sometidos a cirugía cardiovascular. Objetivo. Determinar la colonización nasal por SARM y establecer las características clínicas en pacientes programados para cirugía cardiovascular. Materiales y métodos. Se hizo un estudio descriptivo entre febrero y diciembre de 2015. Se incluyeron pacientes adultos programados para cirugía cardiovascular en el Hospital Universitario San Ignacio de Bogotá. La colonización se identificó mediante reacción en cadena de la polimerasa (Polymerase Chain Reaction, PCR) en tiempo real en muestras obtenidas mediante hisopados nasales. Los pacientes fueron descolonizados con mupirocina al 2,0 % intranasal dos veces al día y baños con gluconato de clorhexidina al 4 % del cuello hacía abajo durante cinco días, al cabo de lo cual se hizo una PCR de control. Resultados. Se incluyeron 141 pacientes, 52 hospitalizados y 89 ambulatorios. Del total, 19 (13,4 %) tenían colonización nasal por SARM, correspondientes a 9 (17,3 %) de los 52 hospitalizados y 10 (11,2 %) de los 89 ambulatorios. Todos los pacientes sometidos a descolonización tuvieron resultado negativo en la PCR al final del proceso y ninguno presentó infección del sitio operatorio por S. aureus. Conclusiones. Se demostró colonización nasal por SARM tanto en los pacientes hospitalizados como en los ambulatorios. La descolonización con mupirocina fue efectiva para erradicar el estado de portador a corto plazo, lo que podría tener efecto en las tasas de infección del sitio operatorio en las cirugías cardiovasculares.

Abstract Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) is a microorganism that colonizes nostrils and different parts of the body, which is considered a risk factor to acquire invasive infections, especially in cardiovascular surgery patients. Objective: To determine the frequency of nasal colonization by MRSA and to establish the clinical characteristics in patients scheduled for cardiovascular surgery. Materials and methods: This was a descriptive study conducted between February and December, 2015. We included adult patients scheduled for cardiovascular surgery at the Hospital Universitario San Ignacio in Bogotá, Colombia. Colonization was identified by real-time PCR from nasal swabs. Colonized patients were treated with mupirocin 2.0% intranasally twice a day and bathed with chlorhexidine 4% from the neck downwards for five days. At the end of this treatment, PCR control was carried out. Results: We included 141 patients with a percentage of nasal colonization of 13.4% (19/141). There were 52 hospitalized patients and 89 outpatients with a percentage of nasal colonization of 17.3% (9/52), and 11.2% (10/89), respectively. All colonized patients who received treatment had a negative PCR at the end of the regime and none of the participating patients had a surgical site infection by S. aureus at the end of the study. Conclusions: Nasal colonization was observed both in hospitalized patients and outpatients. Decolonization treatment with mupirocin was effective to eradicate the carrier state in the short term, which could impact the rates of surgical wound infection associated with cardiovascular surgery.

https://doi.org/10.7705/biomedica.4791 471 downloads

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