Browsing by Author "Irarrázaval Domínguez, Sebastián"

Now showing 1 - 9 of 9
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    Acetazolamide for the treatment of acute mountain sickness
    (2019) Tapia Chávez, Luciano Dante; Irarrázaval Domínguez, Sebastián
    Introduction: Acute mountain sickness is the most prevalent illness related to acute exposure to high altitude, secondary to the hypobaric hypoxia effects in our body. Acetazolamide has been traditionally used for its prevention and treatment, however, there is still controversy regarding the degree of usefulness of this medication as monotherapy. Methods: We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. Results and conclusions: We identified a systematic review that included two primary studies, both corresponding to randomized trials. We conclude that it is not possible to establish clearly whether treatment with acetazolamide reduces the symptoms of acute mountain disease or increases the risk of adverse effects, because the certainty of the existing evidence has been evaluated as very low.
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    An Isolated Transosseous Flexible Suture Frame in the Treatment of Patellar Tendon Rupture Provides Adequate Mechanical Resistance
    (2021) Besa Vial, Pablo José; Telias, Alberto; Orrego, Francisca; Guzmán-Venegas, Rodrigo; Cariola, Martín; Amenábar, Diego; Palma, Felipe H.; Irarrázaval Domínguez, Sebastián; Orrego Luzoro, Mario Santiago
    Introduction: Acute patellar tendon ruptures are frequently observed in patients with metabolic comorbidities, and the benchmark treatment is surgical repair. It is desirable not to harm an already fragile biologic environment with sutures and hardware. We aimed to compare the mechanical requirements of an isolated, flexible, high-strength nonabsorbable transosseous suture frame with that of the Krackow suture technique. Methods: A total of 12 cadaveric pieces were randomized into two groups: the isolated flexible frame group (n = 6) and the standard Krackow fixation group (n = 6). A traumatic rupture of the patellar tendon was performed, and a transosseous displacement sensor was installed on a validated biomechanical system. Gap formation was measured during 50 cycles of flexion and extension with traction on the quadriceps (250 N). Subsequently, specimens underwent progressive loading in a fixed flexion position until failure occurred. The data were analyzed using nonparametric statistical tools with a significance level of 5%. Results: The isolated frame group had a smaller gap formation (1.7 mm) than the Krackow group (3.4 mm; P = 0.01). No significant difference existed in the median failure end points of the two groups (676 and 530 N, respectively; P = 0.11). Discussion: Patellar tendon repair using an isolated, transosseous, flexible, suture frame outperformed using the traditional Krakow repair technique in gap formation. Further studies are needed to determine if this will result in better functional outcomes or fewer clinical failures. Level of evidence: Level IV, experimental case series.
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    Clinical Management of Ligament Injuries of the Knee and Postoperative Rehabilitation
    (2017) Irarrázaval Domínguez, Sebastián; Yaseen, Z.; Guenther, D.; Fu, Freddie H.
    Ligament injuries of the knee are common and occur via a variety of mechanisms. The medial collateral ligament is most commonly injured but injury to the anterior cruciate ligament is most often highlighted in the media due to its prevalence in sports. However, there are other less common but important ligamentous injuries that can also occur. The long term impact on overall function of the knee depends on the injury pattern and severity. Each ligament is distinct with respect to anatomy. Therefore, mechanism of injury, diagnosis and treatment are based on physical exam as well as imaging. Treatment and overall outcome depends on type of injury and time from the lesion. Surgical management involves restoring specific anatomy and biomechanical properties of these ligaments. Rehabilitation is tailored to the specific injury pattern and should be individualized for each patient with the hope to provide a stable functional knee.
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    Editorial: “Individualized Anatomical Anterior Cruciate Ligament Reconstruction”
    (2017) Irarrázaval Domínguez, Sebastián; Kuroda, Ryosuke
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    Medial opening wedge high tibial osteotomy: more than ten years of experience with Puddu plate technique supports its indication
    (2022) Orrego Luzoro, Mario Santiago; Besa Vial, Pablo José; Orrego, Francisca; Amenábar, Diego; Vega Mayer, Jorge Rafael; Irribarra Trivelli, Luis Alfonso; Espinosa, J.; Vial Irarrázabal, Raimundo; Phillips, V.; Irarrázaval Domínguez, Sebastián
    Purpose: To describe the short-term and long-term results of patients who underwent a medial opening wedge high tibial osteotomy (MOW-HTO) for unicompartmental medial knee joint osteoarthritis. Methods: A retrospective review was conducted of patients with MOW-HTO using a Puddu plate®, with more than ten year follow-up. The degree of correction, initial chondral damage, number of meniscal lesions, preoperative and 1-year postoperative functional scale scores (IKDC and Lysholm), and arthroplasty conversion rates at the ten year follow-up were registered. We assumed early indication when patients underwent the operation before they were 40 years old and delayed ≥ 40. Functional outcomes were analyzed by adjusting for pre-operative values. Fisher’s exact test was used to study the association between the arthroplasty conversion rates and the timing of indication. Results: Fifty-five patients were included, 37 of whom were male (67%). Twenty-nine patients had early indications for surgery (53%). All patients completed ten year follow-up. All patients improved IKDC (p < 0.01) and Lysholm (p < 0.01) scores compared to their presurgical scores at the one year post-operative evaluation. We had six minor complications, none requiring revision surgery. We had three conversions to arthroplasty, all in the late indication group, not statistically significant different. Linear regression showed that early indication was associated with a higher IKDC score when adjusting for the Outerbridge chondral damage score, the number of meniscal lesions, and sex (p < 0.01). Conclusion: All patients improved functional scores one year after surgery. Early indication (i.e., younger than 40 years of age) was independently associated with better functional outcomes than late indication at one year follow-up.
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    Offloader knee braces for knee osteoarthritis
    (2021) Moller Macherone, Francesca Andrea; Ortiz Muñoz, Luis Eugenio; Irarrázaval Domínguez, Sebastián
    INTRODUCTION Knee osteoarthritis is a relevant health problem given its high prevalence and associated disability. Within the non-pharmacological management alternatives, the use of offloader knee braces has been proposed, however, there is no consensus in the literature regarding its indication. METHODS We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS We identified 14 systematic reviews including nine studies overall, all of which were randomized trials. We conclude that the use of offloader knee braces in patients with knee osteoarthritis probably increases physical function through walking distance. However, its use may make little or no difference to physical function measured with the Hospital for Special Surgery Knee score, it may slightly worsen the quality of life and increase adverse events, but the certainty of the evidence is low. In addition, we are uncertain whether the use of offloader knee braces reduces pain as the certainty of the evidence has been assessed as very low.
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    Síndrome de Horner pediátrico: Análisis de 5 casos
    (2006) Pizarro Gamboa, María Ester; Campos Lepe, Verónica Andrea; Irarrázaval Domínguez, Sebastián; Mesa Latorre, Manuel Tomás; Escobar Henríquez, Raúl Guillermo; Hernández Chávez, Marta Isabel
    Introducción: El síndrome de Horner (SH) u oculosimpaticoparesia es causado por la interrupción de la vía simpática (VS) que va desde el cerebro hasta el ojo. Los signos clínicos son miosis, ptosis, enoftalmos, heterocromía del iris y hemianhidrosis facial ipsilateral, en su forma completa. Generalmente es benigno pero la proximidad arterias carotídeas, órganos torácicos y cerebro nos obliga a descartar patologías potencialmente riesgosas. Objetivo: Describir la utilidad de la historia clínica y el examen neurológico en la evaluación de la etiología y localización de la lesión en el SH. Pacientes y Método: 5 pacientes de sexo masculino entre 2-72 meses edad controlados en Neurología infantil de la Pontificia Universidad Católica de Chile entre los años 2003-2004. Resultados: Según tiempo de aparición, 4 casos fueron congénitos y 1 caso adquirido. Los signos neurológicos acompañantes clasificaban los casos como SH periférico (4) y SH central (1). La hemianhidrosis clasificaban 3 casos como preganglionares y dos postganglionares Conclusión: En niños con SH la anamnesis, el análisis de la signología propia y asociada del SH nos ayudan a localizar la lesión y reducen una extensa evaluación sistémica.
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    Tibial tubercle to trochlear groove and the roman arch method for tibial tubercle lateralisation are reliable and distinguish between subjects with and without major patellar instability
    (2024) Irarrázaval Domínguez, Sebastián; Besa Vial, Pablo José; Fernández, Tomás; Fernandez Schlein, Francisco Andrés; Aguirre Donoso, Rodrigo; Tuca De Diego, María Jesús; Lira Salas, María Jesús; Orrego Luzoro, Mario Santiago
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    Tratamiento de diacereína y artrosis
    (2018) Irarrázaval Domínguez, Sebastián; Alegría Mejias, Anselmo Ignacio; Bravo Soto, Gonzalo Antonio; Rada, Gabriel