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INTRODUCCIÓN: COVID-19 cobró millones de vidas especialmente en la era pre-vacunas. Estudios preliminares mostraban eficacia promisoria del plasma de personas convalecientes anti SARS-CoV-2 (PPC). Objetivo: evaluar la eficacia del PPC en hospitalizados por COVID-19 de moderada gravedad. MATERIAL Y MÉTODOS: Estudio retrospectivo, bicéntrico, en adultos hospitalizados por COVID-19 moderado (no crítico) que requirieron oxigenoterapia. Al plasma donado por sobrevivientes de cuadros leves (600 cc) se les realizó búsqueda de IgG anti SARS-CoV-2. Se evaluó su impacto en mortalidad, estadía hospitalaria (días) y necesidad de ventilación mecánica (VMI). RESULTADOS: De los 119 pacientes incluidos, 58% eran hombres (edad mediana 60 años), 88% poseía comorbilidad y 43% tenía "CALL score" de alto riesgo. 43 pacientes (36%) recibieron PPC, sólo 15 (12,6%) precozmente (< 7 días). 22 pacientes debieron trasladarse a unidad intensiva, 18 recibieron VMI y 15 fallecieron (12,6%). El uso de PPC no se asoció a cambios en la mortalidad (p = 0,16), necesidad de VMI (p = 0,79) ni en la estadía hospitalaria (p = 0,24). Su administración en forma precoz (< 7 días de síntomas) tampoco demostró asociación significativa. La presencia de cardiopatía y el requerir posteriormente VMI fueron factores independientes asociados a mortalidad. CONCLUSIONES: El uso de PPC en pacientes hospitalizados por COVID-19 de moderada gravedad no se asoció a menor mortalidad, estadía hospitalaria ni necesidad de VMI.

INTRODUCTION: COVID-19 claimed millions of lives, mainly in the pre-vaccine era. Preliminary studies showed promising efficacy of convalescent plasma against SARS-CoV-2 (CP). Objective: To evaluate the efficacy of CP in patients hospitalized for COVID-19 with moderate severity. METHODS: Retrospective, bicentric study including adults hospitalized for moderate (non-critical) COVID-19 who required oxygen therapy. CP donated by survivors of mild cases (600 cc) were searched for IgG anti-SARS-CoV-2. Its impact on mortality, hospital stay (days), and need for mechanical ventilation (IMV) was evaluated. RESULTS: Of the 119 patients included, 58% were men (median age 60 years), 88% had comorbidity, and 43% had a high-risk CALL score. Forty-three patients (36%) received CP, only 15 (12.6%) early (< 7 days). Twenty-two patients had to be transferred to the intensive care unit; 18 received IMV, and 15 died (12.6%). The use of CP was not associated with changes in mortality (p = 0.16), need for IMV (p = 0.79), or hospital stay (p = 0.24). Its early administration (< 7 days of symptoms) did not show a significant association either. The presence of heart disease and subsequently requiring IMV were independent factors of mortality. CONCLUSIONS: The use of CP in patients hospitalized for moderately severe COVID-19 was not associated with lower mortality, hospital stay, or the need for IMV.

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INTRODUCTION: COVID-19 claimed millions of lives, mainly in the pre-vaccine era. Preliminary studies showed promising efficacy of convalescent plasma against SARS-CoV-2 (CP). OBJECTIVE: To evaluate the efficacy of CP in patients hospitalized for COVID-19 with moderate severity. METHODS: Retrospective, bicentric study including adults hospitalized for moderate (non-critical) COVID-19 who required oxygen therapy. CP donated by survivors of mild cases (600 cc) were searched for IgG anti-SARS-CoV-2. Its impact on mortality, hospital stay (days), and need for mechanical ventilation (IMV) was evaluated. RESULTS: Of the 119 patients included, 58% were men (median age 60 years), 88% had comorbidity, and 43% had a high-risk CALL score. Forty-three patients (36%) received CP, only 15 (12.6%) early (< 7 days). Twenty-two patients had to be transferred to the intensive care unit; 18 received IMV, and 15 died (12.6%). The use of CP was not associated with changes in mortality (p = 0.16), need for IMV (p = 0.79), or hospital stay (p = 0.24). Its early administration (< 7 days of symptoms) did not show a significant association either. The presence of heart disease and subsequently requiring IMV were independent factors of mortality. CONCLUSIONS: The use of CP in patients hospitalized for moderately severe COVID-19 was not associated with lower mortality, hospital stay, or the need for IMV.

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BACKGROUND: Acute myeloid leukemia (AML) is the most common acute leukemia in adults, emphasizing its high recurrence rate despite hematopoietic cell transplantation (HCT). AIM: To report the results of AML treatment at the Catholic University of Chile Clinical Hospital. PATIENTS AND METHODS: Review of medical records of patients with AML. RESULTS: 63 patients, median age 55.4 years (range:16-89), treated between 2010 and 2014. Admission laboratory values showed (median values): leukocytes 45.989/mm³, hemoglobin 9.1 g/dl, platelets 75.548/mm³, peripheral blood blasts 38% and bone marrow blasts 74%. According to cytogenetic risk classification we observed the following groups: favorable 8% (n = 5), intermediate 51% (n = 32), unfavorable 13% (n = 8) and unknown 28% (n = 17). Seventy five percent of patients received induction chemotherapy and 25% palliative care. Median survival of treated and palliative care patients was 27.3 and 1 month respectively. Induction chemotherapy (IC) mortality (ICM) was 4.2%. Seventy percent (n = 33) of patients who received IC had complete response (CR) with a 3-year relapse free survival (RFS) of 25% and overall survival (OS) of 31%. Multivariate analysis demonstrated that achievement of CR, cytogenetic risk group and receiving consolidation chemotherapy were significantly associated with better RFS and OS. CONCLUSIONS: AML treatment with standard chemotherapy in our center achieves similar results to what has been described in international series regarding induction rates and ICM, however RFS and OS are still very low, especially in intermediate and high cytogenetic risk groups.

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Background: Acute myeloid leukemia (AML) is the most common acute leukemia in adults, emphasizing its high recurrence rate despite hematopoietic cell transplantation (HCT). Aim: To report the results of AML treatment at the Catholic University of Chile Clinical Hospital. Patients and Methods: Review of medical records of patients with AML. Results: 63 patients, median age 55.4 years (range:16-89), treated between 2010 and 2014. Admission laboratory values showed (median values): leukocytes 45.989/mm³, hemoglobin 9.1 g/dl, platelets 75.548/mm³, peripheral blood blasts 38% and bone marrow blasts 74%. According to cytogenetic risk classification we observed the following groups: favorable 8% (n = 5), intermediate 51% (n = 32), unfavorable 13% (n = 8) and unknown 28% (n = 17). Seventy five percent of patients received induction chemotherapy and 25% palliative care. Median survival of treated and palliative care patients was 27.3 and 1 month respectively. Induction chemotherapy (IC) mortality (ICM) was 4.2%. Seventy percent (n = 33) of patients who received IC had complete response (CR) with a 3-year relapse free survival (RFS) of 25% and overall survival (OS) of 31%. Multivariate analysis demonstrated that achievement of CR, cytogenetic risk group and receiving consolidation chemotherapy were significantly associated with better RFS and OS. Conclusions: AML treatment with standard chemotherapy in our center achieves similar results to what has been described in international series regarding induction rates and ICM, however RFS and OS are still very low, especially in intermediate and high cytogenetic risk groups.

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Introducción: La estructura organizacional de las Unidades de Cuidados Intensivos está basada en turnos, con cambios en los equipos durante la noche y los fines de semana-festivos (FdS-F). Se ha descrito una mayor mortalidad en los ingresos realizados durante estos períodos. Nuestro objetivo es evaluar si la mortalidad de los pacientes ingresados a nuestra unidad se ve influenciada porel horario nocturno o los FdS-F. Metodología: Estudio retrospectivo de la cohorte de pacientes ingresados desde el 1 de enero al 31 de diciembre de 2011 en el Hospital Clínico Regional Valdivia. Se consideró turno día (TD)el comprendido entre las 08:00 AM y las 20:59 PM, y el turno noche (TN) entre las 21:00 y las 07:59 horas. Se asignó como horario de fin de semana al comprendido entre el día viernes a las21:00 horas y el lunes a las 07:59. Dentro de esta misma categoría se incluyeron los festivos, con el mismo rango horario descrito. Base de datos en Excel MAC y análisis estadístico con Vassar Stats. Resultados: Durante el año 2011, se produjeron 425 ingresos, con una mortalidad global de 25 por ciento, variando según el tipo de patología que motivó el ingreso a la unidad (sepsis 45 por ciento, cardiovascular 17 por ciento, respiratorio 30 por ciento, neurológico 26 por ciento, trauma 24 por ciento, digestivo 32 por ciento, renal 14 por ciento, otras 18 por ciento). Los principales motivos de ingreso fueron las patologías cardiovasculares (32 por ciento), sepsis (18 por ciento) y enfermedades respiratorias (14 por ciento). El 51 por ciento requirió de Ventilación Mecánica Invasiva. El tiempo de estadía fue una mediana de 3 días (0-80). El 48 por ciento de los pacientes ingresó en el horario de TD, 38 por ciento en TN, sin contar con la hora de ingreso en el 14 por ciento de los casos. La mortalidad de los pacientes ingresados en TN fue 30 por ciento y los ingresados en TD 25 por ciento (OR 1,29 IC 95 por ciento 0,8126-2,0393; p= 0,29)...

Introduction: The job in most of Intensive Care Units (ICU) is organized in shift work, this system includes the activities performed during nights and weekends or holidays (W-HD). Higher mortality has been described in patients admitted at nights and W-HD. We decided to study if mortality in our unit was related to the admission during these periods. Methods: We reviewed the clinical records of patients admitted at the ICU of Valdivia Hospital since January 31, 2011 to December 31, 2011. Day shift (DS) was defined between 8:00 and 20:59 hours, night shift (NS) between 21:00 and 7:59 hours, weekend was considered as the period between Friday at 21:00hours and Monday at 7:59 and finally, holiday was considered as the period between the previous date at 21:00 and next day at 7:59 hours of a non-laboral day. Data were analyzed with Microsoft EXCEL for Mac and Vassar stats software. Results: four hundred twenty five patients were admitted at the ICU during this period, the mortality was 25 percent. It was different according with type of disease (sepsis 45 percent, cardiovascular disease 17 percent, respiratory disease 30 percent, neurologic disease 26 percent, trauma 24 percent, gastrointestinal disease 32 percent, renal disease 14 percent, others 18 percent). The most frequent causes of admission were cardiovascular diseases (32 percent), sepsis (19 percent) and respiratory diseases (14 percent). 51 percent of patients were submitted to mechanical ventilation. The median of staying in the unit was 3 days (0-80 days). 48 percent of patients were entered at the unit at DS, 38 percent at NS and in 14 percent of cases the time of admission was not registered. Mortality of patients admitted was 30 percent in NS and 25 percent in DS (OR 1,29 CI 95 percent 0,8126-2,0393; p=0,29)...

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Tradicionalmente se han descrito factores asociados a la Lactancia que varían en las diferentes culturas. En Colombia, los indicadores de prevalencia de la Lactancia materna exclusiva y duración de la Lactancia están lejos de las recomendaciones establecidas por la Organización Mundial de la Salud (OMS). El Departamento de Pediatría del Hospital Universitario Clínica San Rafael, teniendo en cuenta los beneficios que la leche materna tiene, ha venido trabajando en los últimos años en pro de rescatar la lactancia como una práctica cultural adecuada. En respuesta a esta necesidad creó en Agosto de 2004 el programa institucional de Lactancia "Primero los niños, niñas y adolescentes", a partir del cual surgieron varios interrogantes acerca del comportamiento de la lactancia en nuestro medio, que dieron origen al presente trabajo de investigación. Se diseñó un estudio de cohorte prospectivo realizado mediante la aplicación de una encuesta a 372 madres de recién nacidos sanos en postparto. La cohorte se reclutó entre julio de 2007 y junio de 2008 y se siguió hasta los 24 meses de edad del bebé con el fin de determinar la duración de la lactancia, sus factores condicionantes y las causas más frecuentes de su abandono. Se estableció la salida de los pacientes del estudio al cumplir 24 meses (recomendación de la OMS de la duración de lactancia) o al documentar su abandono antes de los 24 meses. Se encontró una lactancia materna exclusiva a los 6 meses de 14.7% y una duración acumulada de 14 meses para la población analizada...

Traditionally, factors associated with breastfeeding which vary according to the different cultures have been described. In Colombia, the indicators of exclusive breastfeeding prevalence and breastfeeding duration are very far from the recommendations settled by the World Health Organization (WHO). The Pediatrics Department of the Hospital Universitario Clínica San Rafael, taking into account the benefits provided by the breast milk, have been working for the last years in favor of rescuing the breastfeeding as a suitable cultural practice. In response to this need, in August 2004, it created the Breastfeeding institutional program "First boys, girls and adolescents", form which various questions emerged regarding the breastfeeding behavior in our environment, which gave rise to the present research work. A cohort, prospective study was designed, conducted by administering a survey to 372 mothers of healthy newborns in post partum. The cohort was recruited between July 2007 and June 2008 and was followed-up until the infants were 24 months of age with the aim of determining the breastfeeding duration, its conditioning factors and the most frequent causes for its drop-out. The infants were to be withdrawed from the study when they completed 24 months of age (Breastfeeding duration recommended by the WHO) or upon documenting their drop-out before 24 months of age. 14.7% of exclusive breastfeeding at 6 months and a cumulative duration of 14 months were found for the examined population...

Tradicionalmente foram descrito fatores associados à amamentação que variam nas diferentes culturas. Na Colômbia, os indicadores de prevalência da amamentação materna exclusiva e duração da amamentação estão longe das recomendações estabelecidas pela Organização Mundial da Saúde (OMS). O Departamento de Pediatria do Hospital Universitário Clínica San Rafael, tendo em conta os benefícios que o leite materno tem, vem trabalhando nos últimos anos em prol de resgatar a amamentação como uma prática cultural adequada. Em resposta a esta necessidade criou-se em agosto de 2004 o programa institucional de Amamentação "Primeiro as crianças e adolescentes", a partir do qual surgiram várias dúvidas sobre o comportamento da amamentação em nosso meio que deram origem a este trabalho de pesquisa. Foi desenhado um estudo de cooorte prospectivo realizado mediante a aplicação de um questionário a 372 mães de recém nascido sãos em pós-parto. A população foi recrutada entre julho de 2007 e junho de 2008 e foi seguida até os 24 meses de idade do bebê com o objetivo de determinar a duração da amamentação, seus fatores condicionantes e as causas mais frequentes de seu abandono. Foi estabelecida a saída dos pacientes do estudo ao completar 24 meses (recomendação da OMS da duração da lactação) ou ao documentar seu abandono antes dos 24 meses. Encontrou-se uma lactação materna exclusiva aos 6 meses de 14.7% e uma duração acumulada de 14 meses para a população analisada...

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Diversos estudios indican que el apego en el adulto, a pesar de ser un aspecto de la persona que se forja en la temprana infancia, es factible de modificaciones a lo largo de la vida, sobre todo en situaciones de cambio, como lo es la experiencia de padecer una enfermedad crónica. El presente estudio pretende describir los patrones de apego de un grupo de pacientes con insuficiencia renal crónica terminal (IRCT). Se estudió a un grupo de 22 pacientes con IRCT que requieren diálisis, comparándolo con un grupo de 22 adultos, correspondientes a muestra no-clínica (sin la enfermedad), igualando a los participantes en relación a sexo y edad. Los resultados mostraron diferencias significativas en los patrones de apego de ambos grupos. Las personas clínicamente sanas tienden a mostrar, predominantemente, un patrón de apego seguro, mientras que los pacientes dializados tienden a presentar un patrón de apego preocupado.

Several studies indicate that attachment in adults is feasible with modifications throughout life, especially in situations of change, as is the experience of chronic disease. This study aims to describe the attachment patterns of a group of patients with end-stage renal disease. We studied a group of 22 patients with this disease requiring dialysis, compared with a group of 22 adults for non-clinical sample (without disease), matching the participants according to sex and age. The results showed differences significant patterns of attachment in both groups. Clinically healthy individuals tend to have predominantly a secure attachment pattern, while those patients on dialysis tend to have a preoccupied attachment pattern.

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Objetivo: Conocer la situación psicosocial de los pacientes amputados traumáticos de extremidad inferior de la ACHS. Material y método: Se aplicó a 98 pacientes consecutivos amputados traumáticos de extremidad inferior una encuesta estructurada, el Cuestionario de Salud de Goldberg-30 y el Inventario de Beck, entre noviembre 2000 y septiembre 2002. Resultados: El 75,5% tiene pareja o está casado. Tiene vida sexual el 75,5%. El 80,6% tiene a quien manifestar sus problemas. El apoyo social proviene de la familia en el 71,4%. Participa en actividades sociales el 41,8%. Presenta un cuadro depresivo moderado a severo un 28,4% y un 29,2% síntomas ansioso-depresivos significativos. El 71,7%niega mayor consumo de alcohol, tabaco y/o drogas postamputación. Presenta dolor el 69,4%, ya sea local, fantasma o combinado. De 62 casos que consignan intensidad, es severo en el 22,2%. El 52,5¨% refiere verse limitado por éste en sus actividades. Pacientes que no tienen a quien contar sus problemas presentan más síntomas depresivos y ansiosos (Beck p = 0,003 y Goldberg p = 0,000). Tener pareja se asocia significativamente con menos síntomas ansiosos y depresivos. Trabajan más pacientes casados (p = 0,008). Los individuos con buena satisfacción de la rehabilitación tienen menos síntomas depresivos (p = 0,005) y ansioso-depresivos (p = 0,000). Conclusiones: Los con pareja trabajan significativamente en mayor proporción y presentan menos síntomas ansioso-depresivos. Destaca el casi 30% con síntomas ansioso-depresivos importantes. Es frecuente el dolor local, fantasma o combinado, no asociándose a síntomas ansioso-depresivos.

Objective: To know the psychosocial situation of traumatic lower extremity amputees patients of the ACHS. Material and method: A structured survey, the Goldberg-30 questionnaire and Beck inventory were applied to 98 traumatic lower extremity amputees consecutive patients between November 2000 and September 2002. Results: A 75,5% has a partner or is married. A 75,5% are sexually active. An 80,6% have someone to tell their problems. Social support comes from the family in a 71,4%. A 41,85 participate in social activities. A 28,4% present moderate to severe depression symptoms and a 29,2% present significant anxious-depressive symptoms. A 71,7% deny a higher consumption of alcohol, tobacco and/or drugs post amputation. A 69,4%, present local, ghost or combined pain. Out of the 62 cases mentioning intensity, a 22,2% report it as severe. A 52,5% mention being limited in their activities because of it. Patients who do not have someone to tell their problems present more depressive and anxious-symptoms (Beck p = 0,003 and Goldberg p = 0,000). Having a partner is significantly associated with less anxious and depressive symptoms. Married patients work more (p = 0,008). Individuals well satisfied with rehabilitation have less depressive symptoms (p = 0,005) and anxious-depressive symptoms (p = 0,000). Conclusions: Those with a partner work in a significantly larger proportion and present less anxious-depressive symptoms. It is noteworthy the almost 30% with important anxious-depressive symptoms. Local, ghost or combined pain is frequent and is not associated with anxious or depressive symptoms.

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Objetivo: Conocer capacidad funcional y situación laboral de amputados traumáticos de extremidad inferior. Material y método: a 98 pacientes consecutivos con niveles de amputación traumática de calcáneo útil a proximal, derivada de accidente laboral, controlados en el Hospital del Trabajador Santiago, se les aplicó una encuesta estructurada entre noviembre 2000 y septiembre 2002. Resultados 95 por ciento son varones, con edad promedio 44 años, escolaridad promedio 8,9 años y seguimiento promedio 9 años. Mayoritariamente son amputados unilaterales, transtibial (45,5 por ciento) y transfemoral (35,4 por ciento). 85 por ciento son obreros, el 55,6 por ciento sin calificación. Esta situación varía poco en el seguimiento. Un 67 por ciento está activo laboralmente. El 62,1 por ciento requiere un cambio de actividad laboral. El ingreso económico es considerado peor por el 43,1 por ciento (25).El 75 por ciento de transfemorales y el 60 por ciento de transtibiales refieren caminar una hora o más sin descanso. El 82 por ciento de los transfemorales y el 91 por ciento de los transtibiales suben de un piso a otro. Logra estar de pie 2 o más horas el 72 por ciento de los transfemorales y el 62 por ciento de los transtibiales. Existe asociación entre la capacidad de estar de pie por 2 horas o más y trabajar (p< 0,024). El 83,7 por ciento refiere un buen grado de satisfacción con la rehabilitación. Conclusiones: los amputados traumáticos mayores de extremidad inferior relativamente jóvenes logran buenos niveles de funcionalidad. El reintegro laboral se relaciona específicamente con la capacidad de estar de pie por 2 horas o más.

Objective: To know the functional capacity and laboral situation of traumatic low extremity amputees. Material and method: A structured survey was applied to 98 consecutive patients with traumatic amputation levels of useful calcaneous at proximal, resulting from work accident, controlled at the Hospital del Trabajador in Santiago between November 2000 and September 2002. Results: A 95 percent are male, averaging 44 years of age, average education of 8.9 years and average follow-up of 9 years. Most of them are unilateral amputees, transtibial (45.5 percent) and transfemoral (35.4 percent). 85 percent are workers, a 55.6 percent are non-qualified. This situation varies little in the follow-up. A 67 percent is laborally active. A 62.1 percent require a change of work activity. The economic income is considered worst by the 43.1 percent (25). A 75 percent of transfemorals and the 60 percent of transtibials mention walking one hour or more without resting. A 82 percent of transfemorals and, a 91 percent of transtibials, go up from one floor to the other. A 72 percent of transfemorals and a 62 percent of transtibials manage to stand 2 or more hours. There is an association between the capacity to be standing for 2 or more hours and work (p< 0,024). A 83,7 percent mention a good degree of satisfaction with rehabilitation. Conclusions: Relatively young adult traumatic low extremity amputees attain good levels of functionality. Return to work relates specifically to the capacity for standing for 2 or more hours.

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Mediante medios selectivos se aislaron 105 cepas bacterianas desde quesos de cabra, adquiridos en mercados locales de la ciudad de Valparaiso (Chile). Todas las cepas bacterianas junto a 4 de referencia, fueron examinadas para para 54 características fenotípicas, incluyendo pruebas morfológicas, fisiológicas y bioquímicas. Los resultados obtenidos fueron sometidos a un análisis numérico, utilizando el coeficiente de apareamiento simple Ssm. y la técnica de agrupación UPGMA. A nivel de semejanza de un 80 por ciento las cepas se agruparon en 8 fenómenos, representando a miembros de la familia enterobacteriaceae (7) y uno al género streptococcus

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