Luis Toro's research while affiliated with Hospital Clínico Universidad de Chile and other places
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Publications (26)
End-stage renal disease (ESRD) patients are a population with high rates of COVID-19 and mortality. These patients present a low response to anti-SARS-CoV-2 immunization, which is associated with immune dysfunction. ESRD patients also present high plasma titers of Fibroblast Growth Factor 23 (FGF23), a protein hormone that reduces immune response i...
Heart failure with preserved ejection fraction (HFpEF) is a growing public health problem in nearly 50% of patients with heart failure. Therefore, research on new strategies for its diagnosis and management has become imperative in recent years. Few drugs have successfully improved clinical outcomes in this population. Therefore, numerous attempts...
The CoronaVac vaccine is the most used anti-SARS-CoV-2 vaccine worldwide. Previous data indicate that this vaccine produces a lower immune response than RNA vaccines such as BNT162b2. End-stage renal disease (ESRD) patients have an increased rate of COVID-19 and a reduced immune response to vaccinations. Currently, there is little data on this popu...
RESUMEN
Objetivo
Evaluar la eficacia de un protocolo estandarizado y simplificado basado en los pilares técnicos de la Iniciativa HEARTS para el control de pacientes hipertensos del Programa de Salud Cardiovascular en el primer nivel de atención de salud en Chile.
Métodos
Estudio observacional longitudinal (cohorte histórica), en 2 centros de sal...
Introduction
The COVID-19 pandemic is a global public health problem. Patients with end-stage renal disease on hemodialysis are at a higher risk of infection and mortality than the general population. Worldwide, a vaccination campaign has been developed that has been shown to reduce severe infections and deaths in the general population. However, t...
The Covid-19 pandemic has been responsible for millions of deaths worldwide. Patients with comorbidities– such as those on peritoneal dialysis (PD)– present higher morbidity and mortality than the general population. We prospectively evaluated all Chilean patients on PD (48 centres) and followed those who had Covid-19 from the beginning of the Covi...
Background:
Anticoagulation in continuous renal replacement therapy (CRRT) is essential to counteract the coagulation cascade activation, induced by the dialysis circuit. Heparin is the most widely used anticoagulant, followed by regional citrate anticoagulation (RCA).
Aim:
To determine the effectiveness and safety of anticoagulant treatment with...
The COVID-19 pandemic has had a significant global impact, with more than 280,000,000 people infected and 5,400,000 deaths. The use of personal protective equipment and the anti-SARS-CoV-2 vaccination campaigns have reduced infection and death rates worldwide. However, a recent increase in infection rates has been observed associated with the appea...
The SARS-CoV-2 pandemic has mobilized many efforts worldwide to curb its impact on morbidity and mortality. Vaccination of the general population has resulted in the administration of more than 6,700,000,000 doses by the end of October 2021, which is the most effective method to prevent hospitalization and death. Among the adverse effects described...
Introducción: La enfermedad por coronavirus 2019 (COVID-19) en enfermos renales crónicos (ERC) en terapia de reemplazo renal (TRR), hemodiálisis (HD), diálisis peritoneal (DP) y trasplante (Tx) renal tiene elevada mortalidad, con datos clínicos y epidemiológicos en Latinoamérica aún limitados. Métodos: Estudio nacional observacional, multicéntrico,...
Background
Steroid use in renal transplant is related to multiple adverse effects. Long-term effects of early withdrawal steroids in pediatric renal transplant were assessed.
Methods
Renal transplant children with low immunological risk treated on basiliximab, tacrolimus, and mycophenolate with steroid withdrawal or steroid control were evaluated...
COVID-19 infection causes a systemic inflammatory response, which mainly presents as a febrile syndrome with respiratory involvement. We report a 37-year-old male who consulted for myalgia, nausea and epigastric pain lasting three days. On admission, he had crepitations at the lung bases. The initial laboratory showed a creatine kinase of 62,768 U/...
Objectives:
As part of the HEARTS in the Americas initiative, Chilean primary healthcare centers have implemented novel hypertension management strategies, including new diagnostic approaches. This study evaluated the concordance between attended automated office blood pressure (AOBP) measurements with an oscillometric device and ambulatory blood...
Hypophosphatemia is a relatively frequent and a potentially serious adverse drug effect. Clinically it is characterized by bone pain and muscle weakness. There are several mechanisms by which a drug can induce hypophosphatemia and they can be classified according to whether or not they are mediated by an excess of Fibroblast Growth Factor 23 (FGF23...
Renal transplantation (RTx) is an effective therapy to improve clinical outcomes in paediatric patients with terminal chronic kidney disease. However, chronic immunosuppression with glucocorticoids (GC) reduces bone growth and mineral density. The mechanisms causing GC‐induced growth impairment have not been fully clarified. Fibroblast growth facto...
It is accepted that osteoblasts/osteocytes are the major source for circulating fibroblast growth factor 23 (FGF23). However, erythropoietic cells of bone marrow also express FGF23. The modulation of FGF23 expression in bone marrow and potential contribution to circulating FGF23 has not been well studied. Moreover, recent studies show that plasma F...
Introduction:
Describe the experience of clinical presentation, diagnostic study, and treatment of patients with tumor-induced osteomalacia (TIO) in a South American academic center in comparison to literature.
Methods:
Analysis of the records of patients diagnosed with TIO. The clinical presentation, diagnostic studies, and treatment were analy...
Citations
... Consequently, further evidence is needed to thoroughly understand anti-SARS-CoV-2 vaccines' impacts on hemodialysis patients (HDPs). Nevertheless, most studies contemplating vaccine efficacy in dialysis patients utilize mRNA-based vaccines, and, interestingly, studies comparing different types of COVID-19 vaccines in dialysis patients have concluded that mRNAbased vaccines are superior to other vaccines available for COVID-19 in terms of infection prevention and safety [15][16][17]. ...
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... Consequently, further evidence is needed to thoroughly understand anti-SARS-CoV-2 vaccines' impacts on hemodialysis patients (HDPs). Nevertheless, most studies contemplating vaccine efficacy in dialysis patients utilize mRNA-based vaccines, and, interestingly, studies comparing different types of COVID-19 vaccines in dialysis patients have concluded that mRNAbased vaccines are superior to other vaccines available for COVID-19 in terms of infection prevention and safety [15][16][17]. ...
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... This phosphorylated analog structurally resembles the endogenous substrate cytidine or uridine triphosphate for RdRp ( Figure 1A). Thus, EIDD-1931 triphosphate competitively inhibits RdRp and further inhibits viral replication [60,61]. ...
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... According to this hypothesis, the mRNA molecules released in endosomes or cytosol from the vaccine, acting as a mimic of viral mRNA, might be recognised as PAMPs by TLRs (e.g., TLR7 and TLR8) prior to the translation, therefore, stimulating the production of type I interferons and proinflammatory cytokines, which, as mentioned above, may have a role in the development of myocardial inflammation [124,126]. Furthermore, increased levels of NK cells have been detected in a patient who developed myocarditis after COVID-19 mRNA vaccination, suggesting a role of these immune cells in mRNA vaccine-induced myocardial injury, even though is not clear if this increase is the cause of this cardiovascular complication or a response to limit such a pathological process [24,127,128]. ...
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... COVID-19 dışı viral enfeksiyonlara bağlı RML olguları önceki yıllarda literatürde tanımlanmıştır [4][5][6]. Ancak son zamanlarda COVID-19 RML olguları da bildirilmeye başlanmıştır [7][8][9][10]. COVID-19 ilişkili RML nadiren görülmekte ve Çin'de 1099 hasta üzerinde yapılan bir çalışmada hastaların sadece %0.2'sinde rapor edilmiştir [11]. ...
Reference: Rabdomiyoliz: COVID-19’un nadir bir sunumu
... Adolescence and young adulthood are considered critical periods with a high risk of graft loss due to bad adherence (van Arendonk et al., 2013). Furthermore, previous studies in our center demonstrated that non-adherence was the main predictor of graft loss and death, turning immunosuppression monitoring into a primary priority to promote adherence in these patients (Gajardo et al., 2021). ...
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... [196] Compared with using the mean of the second and third readings, my approach could have overestimated hypertension prevalence and underestimated levels of controlled hypertension. [195] [198] Unfortunately, the potential of any white coat effect or masked hypertension could not be estimated using ENS data. Finally, levels of response to the ENS decreased from 75% in 2010 to 67% in 2017. ...
... La transmisión de este virus se produce a través del contacto entre personas y tiene incidencia relevante en la mortalidad y morbilidad 3 . Debido a su rápido avance, las autoridades de salud implementaron medidas de control 4 , adicionalmente y con el propósito de reducir la propagación se iniciaron cuarentenas masivas en todos los continentes, situación que afectó a gran parte de la ciudadanía 5 , incluida la población chilena 6 . En la actualidad investigadores continúan estudios para el desarrollo y aplicación de vacunas masivas 7 y se ha autorizado el uso de emergencia de varias de ellas 8 , las que han tenido favorables resultados 9 . ...
... The review by Delucchi et al also found an association between prednisone therapy and reduced longitudinal growth, as did Franke et al [30,34]. A new finding in this study was that corticosteroid use was the association with a decrease in bone mineral density and an increase in body fat. ...
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... This resulted in an 1.6-fold increase in serum FGF23 concentration within four hours [33]. Likewise, a single injection of mice with erythropoietin can also lead to a 2-4 times increase in serum intact FGF23 within 4-6 hours after injection [34]. Nevertheless, the systemic changes observed in serum FGF23 by loading of a single tibia only at 6 hours could be arbitrary and not an outcome of loading. ...
