Browsing by Author "D'Apremont, Ivonne"
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- ItemBenefits of home-based administration of palivizumab in high-risk groups(2024) Ortiz, Carolina; Vasquez, Ignacia; Zamorano, Alejandra; D'Apremont, Ivonne; Pittaluga, Enrica; Diaz, Marcela; Campos, CatalinaPalivizumab, a humanized monoclonal antibody against the respiratory syncytial virus (RSV), rrently is indicated in groups at higher risk of developing severe RSV disease, such as extreme premature infants and patients with hemodynamically significant heart disease. In Chile, this strategy guaranteed by Law 20850 (Ricarte Soto Law). Nevertheless, barriers to its administration included the need to transfer these labile patients and exposure to other users, with the risk of contagion waiting rooms. Objective: to describe the impact of the palivizumab administration strategy in home care program for high-risk patients. Patients and Method: retrospective, descriptive, observational cohort study of patients born before 32 weeks of gestation or weighing less than 1500 grams, who received palivizumab between January 2019 and December 2021 at the Hospital Dr. S & oacute;tero Rio. . Results: 272 patients were included (median gestational age: 30 weeks). The percentage of doses administered at home was 35.9% (2019) and 37.2% (2021). Each dose of 2020 following the administration in Neonatology, was administered at home during the COVID-19 pandemic. The median interval between doses was as recommended. Adherence was over 90%. The unadjusted incidence RSV infection was 5.7% (2019), 0% (2020), and 0.9% (2021). Conclusions: palivizumab administration was adequate and timely; home indication was associated with high adherence rates and administration interval between doses in line with current recommendations.
- ItemExtremely and very preterm children who were born appropriate for gestational age show no differences in cortisol concentrations or diurnal rhythms compared to full-term children(2023) Dominguez-Menendez, Gonzalo; Poggi, Helena; Ochoa-Molina, Fernanda; D'Apremont, Ivonne; Moore, Rosario; Allende, Fidel; Solari, Sandra; Martinez-Aguayo, AlejandroObjectives: The objective of this study was to compare the diurnal variations in cortisol and cortisone concentrations in serum and saliva among extremely preterm (EPT), very preterm (VPT), and full-term (FT) children, all born appropriate for gestational age (AGA).Methods: EPT, VPT, and FT children, all born AGA, were recruited from two healthcare centers. Cortisol and cortisone concentrations in serum and saliva were measured by liquid chromatography-mass spectrometry (LC-MS). Statistical analysis was performed using nonparametric tests.Results: A total of 101 children (5.0-8.9 years old) were included in this study: EPT=18, VPT=43 and FT=40. All groups had similar distributions in terms of age, birth weight standard deviation score (SDS) and BMI (SDS), showing no differences in serum ACTH, cortisol, or cortisone levels. Additionally, salivary cortisol and cortisone concentrations decreased significantly throughout the day (p values<0.0001). Salivary cortisol concentrations were below the limit of detection (0.55 nmol/L) before dinner and before bedtime in approximately one-third and two-thirds of all children, respectively. Salivary cortisone was detectable in all but one sample.Conclusions: The diurnal cortisol rhythm was preserved in all preterm children, regardless of their gestational age, and no differences in cortisol concentrations among the groups were found. This may have significant implications for the clinical management and follow-up of preterm individuals.
- ItemHigher Dehydroepiandrosterone Levels in Prepubertal Children Born Very Preterm(KARGER, 2018) Mericq, Veronica; Martinez Aguayo, Alejandro; Iniguez, German; Poggi, Helena; D'Apremont, Ivonne; Moore, Rosario; Arancibia, Monica; Garcia, Hernan; Peredo, Soledad; Trincado, Claudia; Sifaqui, Sofia; Tomas Ossa, Jose; Fardella, Carlos; Carvajal, Cristian; Campino, Carmen; Baudrand, Rene; Solari, Sandra; Allende, Fidel
- ItemInsulin resistance parameters in children born very preterm and adequate for gestational age(WILEY, 2022) Garcia, Hernan; Loureiro, Carolina; Poggi, Helena; D'Apremont, Ivonne; Moore, Rosario; Ossa, Jose Tomas; Bruera, Maria Jose; Peredo, Soledad; Carvajal, Jacqueline; Trincado, Claudia; Martinez Aguayo, AlejandroBackground Preterm neonates are at risk for metabolic syndrome later in life. Whether prematurity constitutes an independent risk factor for the development of cardiovascular disease and metabolic syndrome remains controversial. Objective To compare anthropometric measures, cardiometabolic risk factors and insulin resistance variables between children who were born very preterm (VPT, <32 gestational weeks) and at term (Term, >37 gestational weeks) and adequate for gestational age (AGA). Methods We designed a cross-sectional cohort study, recruiting 120 children (5.0-8.5 years old) from the preterm clinic at Red de Salud UC-Christus and Complejo Asistencial Dr. Sotero del Rio, and term children from the community. We excluded children born small for gestational age, based on INTERGROWTH21. Anthropometrics data were classified using WHO reference standards. The homeostasis model assessment insulin resistance (HOMA-IR) index, quantitative insulin sensitivity check index (QUICKI), triglyceride-to-HDL-C ratio (TG/HDL-C) and Pediatric Score Index for Metabolic Syndrome (PsiMS) were calculated. Results VPT children born AGA had lower HDL cholesterol levels (p = .019) and a higher PsiMS score than those born at term (p = .043). We observed a higher percentage of children with HDL cholesterol <= 40 mg/dl (13.0% vs. 2.3%, p = .026) and BP >= 90th percentile among the VPT children than among the Term children (26.0% vs. 11.6%, p = .031). Conclusions At school age, blood pressure was higher, and HDL-C was lower among VPT children born AGA, suggesting a potential metabolic risk; therefore, it is essential to follow this group throughout their lives.
- ItemInsulin Resistance Parameters in Children Who Were Born Very Preterm and Adequate for Gestational Age(KARGER, 2018) Garcia, Hernan; Poggi, Helena; Arancibia, Monica; Peredo, Soledad; Trincado, Claudia; Moore, Rosario; D'Apremont, Ivonne; Andrade, Daniela; Sifaqui, Sofia; Ossa, J. T.; Campino, Carmen; Carvajal, Cristian; Fardella, Carlos; Baudrand, Rene; Solari, Sandra; Allende, Fidel; Martinez Aguayo, Alejandro
- ItemMode of delivery and antenatal steroids and their association with survival and severe intraventricular hemorrhage in very low birth weight infants(2016) Hubner, M. E.; Ramirez, R.; Burgos, J.; Dominguez, A.; Tapia, J. L.; Colantonio, Guillermo; Zapata, Jorge; Perez, Gaston; Ana Pedraza, Susana Garcia; Kurlat, Isabel; Di Siervi, Oscar; Escarate, Adriana; Mariani, Gonzalo; Maria Ceriani, Jose; Fernandez, Silvia; Fustinana, Carlos; Brener, Pablo; Edwards, Eleonora; Tavosnaska, Jorge; Roldan, Liliana; Sexer, Hector; Saa, Gladys; Sabatelli, Debora; Laura Gendra, Maria; Fernanda Buraschi, Maria; Molina, Paula; Daniel, Agost; Morganti, Federico; Fontana, Adriana; Chandias, Daniela; Rinaldi, Monica; Grandi, Carlos; Rojas, Elio; Solana, Claudio; Nieto, Ricardo; Meritano, Javier; Larguia, Miguel; Kasten, Laura; Cuneo, Lucrecia; Decaro, Marcelo; Cracco, Lionel; Bassi, Gustavo; Jacobi, Noemi; Brum, Andrea; Vain, Nestor; Aguilar, Adriana; Guerrero, Miriam; Szyld, Edgardo; Escandar, Alcira; Abdala, Daniel; Guida, Martin; Ferrin, Lucila; Roge, Horacio; Musante, Gabriel; Capelli, Maria C.; Pablo Berazategui, Juan; de Elizalde, Magdalena; Ignacio Fraga, Juan; Keller, Rodolfo; Ahumada, Luis; Ferreyra, Mirta; Ferreira, Vanda; Borges, Roberta; Do Vale, Marynea; Cavalcante, Silvia; Gusmao, Joama; Franco, Patricia; Jose Silva, Maria; Fabres, Jorge; Estay, Alberto; Gonzalez, Alvaro; Kattan, Javier; Quezada, Mariela; Urzua, Soledad; Campos, Lilia; Cifuentes, Lilian; Leon, Jorge; Aguilar, Roxana; Treuer, Sergio; Giaconi, Jimena; Bancalari, Aldo; Standen, Jane; Escobar, Marisol; Veas, Viviana; Sandino, Daniela; Gonzalez, Agustina; Avila, Claudia; Guzman, Carla; Toro, Claudia; Mena, Patricia; Milet, Beatriz; Pittaluga, Enrica; Pena, Veronica; Mendizabal, Rafael; Pizarro, Dagoberto; D'Apremont, Ivonne; Tapia, Jose L.; Marshall, Guillermo; Villarroel, Luis; Quezada, Mariela; Dominguez, Angelica; Lacarruba, Jose; Cespedes, Elizabeth; Mir, Ramon; Mendieta, Elvira; Genes, Larissa; Caballero, Carlos; Webb, Veronica; Rivera, Fabiola; Llontop, Margarita; Bellomo, Sicilia; Zegarra, Jaime; Chumbes, Oscar; Castaneda, Anne; Cabrera, Walter; Llanos, Raul; Mucha, Jorge; Garcia, Gustavo; Ceruti, Beatriz; Borbonet, Daniel; Gugliucci, Sandra; Lain, Ana; Martinez, Mariza; Bazan, Gabriela; Piffaretti, Susana; Cuna, Isabel; Bermudez, PatriciaOBJECTIVE: To determine whether CS delivery and receipt of antenatal steroids (ANS) in vertex-presenting singletons with a gestational age (GA) between 24 and 30 weeks is associated with improved survival and improved severe intraventricular hemorrhage (sIVH)-free survival.
- ItemMortality in very low birth weight (VLBW) infants in South American NEOCOSUR Neonatal Network: timing and causes(2022) Toso, Alberto; Vaz Ferreira, C.; Herrera, T.; Villarroel del Pino, Luis A.; Brusadin, M.; Escalante Rivas, María José; Masoli, Daniela; D'Apremont, Ivonne; Tapia Illanes, José Luis; Mariani, G.Sociedad Argentina de Pediatría.INTRODUCTION: Mortality in very low birth weight infants (VLBWIs) has remained at ~26% in the past 16 years in the NEOCOSUR Neonatal Network. OBJECTIVE: Mortality in very low birth weight infants (VLBWIs) has remained at ~26% in the past 16 years in the NEOCOSUR Neonatal Network. POPULATION AND METHODS: Observational, multicenter cohort study; retrospective analysis of data collected prospectively. Newborn infants born between 24 and 31+6 weeks of gestation age with a birth weight between 500 and 1500 g in the 26 sites of the NEOCOSUR Neonatal Network were included. The causes of death were analyzed depending on whether they occurred in the delivery room (DR) or in the neonatal intensive care unit (NICU). The postnatal age at time of death was determined using the KaplanMeier test. RESULTS: Observational, multicenter cohort study; retrospective analysis of data collected prospectively. Newborn infants born between 24 and 31+6 weeks of gestation age with a birth weight between 500 and 1500 g in the 26 sites of the NEOCOSUR Neonatal Network were included. The causes of death were analyzed depending on whether they occurred in the delivery room (DR) or in the neonatal intensive care unit (NICU). The postnatal age at time of death was determined using the KaplanMeier test. CONCLUSIONS: Important differences were observed in the causes of death of VLBWIs depending on their occurrence in the DR or the NICU. Infectious and respiratory conditions were the most relevant factors following admission to the NICU.Introducción. La mortalidad de los recién nacidos de muy bajo peso de nacimiento (RNMBPN) se ha mantenido en ~26 % en los últimos 16 años en la Red Neonatal NEOCOSUR. Objetivo. Determinar la causa de muerte de los RNMBPN y su temporalidad en el período 20072016 en la Red Neonatal NEOCOSUR. Población y métodos. Estudio observacional de cohorte multicéntrica; análisis retrospectivo de datos obtenidos prospectivamente. Se incluyeron recién nacidos entre 24 y 31+6 semanas de edad gestacional y peso de nacimiento de 500-1500 g, en 26 centros de la Red Neonatal NEOCOSUR. Las causas de muerte se analizaron según ocurriera en sala de partos (SP) o durante la estadía en la unidad de cuidados intensivos neonatales (UCIN). La edad posnatal de muerte se determinó a través de análisis de Kaplan-Meier. Resultados. Se incluyeron un total de 11753 RNMBPN con una mortalidad global del 25,6 %. Las causas de muerte predominantes en SP fueron malformaciones congénitas (43,3 %), enfermedades respiratorias (14,3 %) y prematuridad (11,4 %). Las causas de muerte predominantes en UCIN fueron las respiratorias (24,2 %) e infecciosas (24,1 %). La edad promedio de muerte fue de 10,2 días y mediana de 4 días. El 10,2 % de las muertes ocurrieron en SP; el 21,5 %, durante el primer día; el 52 % ocurrió en los primeros 4 días y el 63,8 %, durante la primera semana de vida. , A través de los años, la mortalidad de los recién nacidos de muy bajo peso de nacimiento (RNMBPN) se ha mantenido estable, en torno al 26 % en la Red Neonatal NEOCOSUR.1 Esta mortalidad es mayor que la reportada por otras redes neonatales de países desarrollados. Así, los datos de la Red Suiza dan cuenta de una mortalidad de solo un 11 % entre los años 2012 a 2014 para el mismo grupo de recién nacidos.2 La red internacional iNEO, que agrupa 10 redes a lo largo del mundo, describe una mortalidad global del 9,1 % en RNMBPN de entre 24 a 32 semanas de edad gestacional entre los años 2007 y 2015.3 Por otra parte, la Red Neonatal Brasilera informa una mortalidad de 30 % en RNMBPN.4 f. Red Neonatal del Cono Sur (www. neocosur.org). Correspondencia: Alberto Toso: aatoso@ uc.cl Financiamiento: Ninguno. Conflicto de intereses: Ninguno que declarar. Recibido: 12-8-2021 Aceptado: 12-1-2022 Conclusiones. Se encuentran importantes diferencias en las causas de muerte de RNMBPN según ocurra en SP o en UCIN. Las infecciosas y respiratorias son las más relevantes luego del ingreso a la unidad de cuidados intensivos.
- ItemSeasonal 25-hydroxy Vitamin D3 variations in school-aged children from Santiago de Chile(KARGER, 2019) Poggi, Helena; Dominguez, Gonzalo; Monica, Arancibia; Moore, Rosario; D'Apremont, Ivonne; Solari, Sandra; Allende, Fidel; Sifaqui, Sofia; Garcia, Hernan; Martinez Aguayo, Alejandro
- ItemSituación socioeconómica familiar y neurodesarrollo de prematuros de muy bajo peso al nacer a los dos años de edad(2018) Salinas Ulloa, Viviana Monzerratt; D'Apremont, Ivonne; Mena Nannig, Patricia Isabel; Pittaluga, Enrica
- ItemSurvival and morbidity of very low birth weight infants in a South American Neonatal Network [Supervivencia y morbilidad en recién nacidos de muy bajo peso al nacer en una Red Neonatal sudamericana](2014) Fernández, Rocio; D'Apremont, Ivonne; Domínguez de Landa, María Angélica; Tapia Ibáñez, José Luis; Colantonio, G.; Zapata, J.; Pérez, G.; Rochinotti, L.; Galíndez, I.; Prudent, L.; Mariani, G.; Ceriani Cernadas, J. M.; Fernández, S.; Brener, P.; Fustiñana, C.; Roldán, L.; Sexer, H.; Sáa, G.; Sabatelli, D.
- ItemSurvival and Survival without Major Morbidity Seem to Be Consistently Better throughout Gestational Age in 24-to 30-Week Gestational Age Very-Low-Birth-Weight Female Infants Compared to Males(2022) Garcia-Munoz Rodrigo, Fermin; Fabres, Jorge G.; Zozaya Nieto, Carlos; San Feliciano, Laura; Figueras-Aloy, Josep; Saenz de Pipaon, Miguel; D'Apremont, Ivonne; Genes de Lovera, Larissa E.; Bancalari, Aldo; Tapia, Jose L.; Vento, MaximoIntroduction: Several studies showed advantages in outcomes for very-low-birth-weight (VLBW) female infants. It has been suggested that recent advances in perinatal care might have benefited boys relatively more than girls, making differences disappear. Objectives: The aims of the study were (1) to determine if sex differences in survival and survival without morbidity in VLBW infants are still present in the context of more advanced perinatal care and (2) to know whether these differences are consistent throughout gestational age (GA). Methods: Retrospective cohort study in seven countries participating in the Spanish SEN1500 and the South American NEOCOSUR neonatal networks. We included VLBW infants 24-30 weeks' GA, born alive without major congenital anomalies (2013-2016). Major morbidity, survival, and survival without morbidity were compared between male and female infants overall and stratified by GA. Results: 10,565 patients were included: 5,620 (53.2%) males and 4,945 (46.8%) females. Female infants exhibited a lower incidence rate ratio (95% CI) of respiratory distress syndrome: 0.91 (0.88, 0.94), necrotizing enterocolitis: 0.83 (0.74, 0.93), major brain damage: 0.79 (0.72, 0.86), moderate-severe bronchopulmonary dysplasia (BPD): 0.77 (0.72, 0.83), higher survival: 1.03 (1.01, 1.05), survival without BPD: 1.11 (1.07, 1.16), survival without major brain damage: 1.05 (1.02, 1.08), and survival without major morbidity: 1.14 (1.07, 1.21). Survival and survival without morbidity were almost consistently favourable to females throughout GA. Conclusions: Our findings suggest that perinatal results continue to be favourable for VLBW female infants in the context of current perinatology, and that they are almost consistent throughout GA.
- ItemThe unfinished work of neonatal very low birthweight infants quality improvement: Improving outcomes at a continental level in South America(2021) Tapia Illanes, José Luis; Toso, Alberto; Vaz Ferreira, C.; Fabres Biggs, Jorge Guillermo Eduardo; Musante, G.; Mariani, G.; Herrera, T., I; D'Apremont, IvonneNeonatal mortality rate varies between 4.2 and 18.6 per thousand by country in South America. There is little information regarding the outcomes of very low birth weight infants in the region and mortality rates are extremely variable ranging from 6% to over 50%. This group may represent up to 50-70% of the neonatal mortality and approximately 25-30% of infant mortality. Some initiatives, like the NEOCOSUR Network, have systematically collected and analyzed epidemiological information on VLBW infants' outcomes in the region. Over a 16-year period, survival without major morbidity improved from 37 to 44%. However, mortality has remained almost unchanged at approximately 27%, despite an increase in the implementation of the best available evidence in perinatal practices over time. Implementing quality improvement initiatives in the continent is particularly challenging but represents a great opportunity considering that there is a wide margin for progress in both care and outcomes.