Revista medica de Chile最新文献_第10页

[Encrusted Pyelitis Secondary to Corynebacterium urealyticum Infection: A Rare and Serious Complication]. [继发于尿囊炎棒状杆菌感染的结石性肾盂炎：罕见而严重的并发症]。

Revista medica de Chile Pub Date : 2024-04-01 DOI: 10.4067/s0034-98872024000400518

Tatiana Yáñez F, Enrique Elsaca M, Patricia García

{"title":"[Encrusted Pyelitis Secondary to Corynebacterium urealyticum Infection: A Rare and Serious Complication].","authors":"Tatiana Yáñez F, Enrique Elsaca M, Patricia García","doi":"10.4067/s0034-98872024000400518","DOIUrl":"https://doi.org/10.4067/s0034-98872024000400518","url":null,"abstract":"Corynebacterium urealitycum is a gram-positive bacillus, usually found as a colonizer on the skin. However, a pathogenic role has been described in susceptible patients, where it can cause urinary tract infection, nephrolithiasis, pyelitis, and encrusted cystitis.Methods: Retrospective cohort study of patients older than 18 years with positive urine cultures for C. urealyticumin the Laboratory of the Microbiology of the UC Health Network - CHRISTUS, between 2017 and 2020.Results: 6 positive urine cultures were obtained, corresponding to 5 patients. One case presented as encrusted pyelitis, with an associated reinfection, one case as lower urinary tract infection, and three as asymptomatic bacteriuria. All patients had some relevant risk factor. All patients presented urine tests with triple phosphate crystals and alkaline pH between 7.5 and 9.0.Conclusions: Patients with positive urine cultures for C. urelyticum represent a low percentage of all agents isolated from urine cultures. Although it may be asymptomatic, the development of encrusted pyelitis is a possible manifestation associated with an extended hospital stay. Urinalysis with alkaline pH and the presence of triple phosphate crystals is characteristic. More extensive clinical series and antibiotic susceptibility studies are necessary for a more standardized management of these patients. Finally, the authors' key lesson is remembering how unusual bacteria, such as C. urealyticum, can cause serious complications secondary to their phytopathogenic mechanism of urine alkalinization.","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"152 4","pages":"518-523"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Obstructive Sleep Apnea and Nocturnal Hypoxemia Increase the Cardiovascular Risk in Chilean]. [阻塞性睡眠呼吸暂停和夜间低氧血症增加智利人的心血管风险]。

Revista medica de Chile Pub Date : 2024-04-01 DOI: 10.4067/s0034-98872024000400424

Gonzalo Labarca, Mario Henríquez-Beltrán, Jorge Jorquera-Díaz, Jorge Dreyse, Jorge Jorquera

{"title":"[Obstructive Sleep Apnea and Nocturnal Hypoxemia Increase the Cardiovascular Risk in Chilean].","authors":"Gonzalo Labarca, Mario Henríquez-Beltrán, Jorge Jorquera-Díaz, Jorge Dreyse, Jorge Jorquera","doi":"10.4067/s0034-98872024000400424","DOIUrl":"https://doi.org/10.4067/s0034-98872024000400424","url":null,"abstract":"Obstructive sleep apnea (OSA) and cardiovascular (CV) risk co-existence is frequent. However, the implications of novel metrics used in the diagnosis of OSA in patients with CV risk are scarce in the Hispanic/Latino population.Aim: To determine the association between the respiratory disturbance index (RDI) and the Time under 90% of SpO2 (CT90%) with CV risk using the predictive model of Framingham 2008. In addition, we analyzed the diagnostic performance of the baseline CV risk model, adjusted for RDI, CT90%, and their combination to predict CV mortality. in patients with clinical suspicion of AOS.Methods: Single-center prospective cohort study, including 1560 subjects. All patients underwent a clinical evaluation for OSA, blood pressure, and anthropometric variables. To determine the association of the indices of interest with CV risk, a linear multivariate regression was performed between the RDI or CT90% score. All analyses were performed using R software (R-project), and a p-value < 0.05 was considered statistically significant.Results: RDI and CT90% showed significant differences for CV (p-value= <0.001). In addition, a percentage increase was demonstrated in each quartile of the RDI and CT90% (p-value= <0.001).Conclusions: The RDI and CT90% showed a significant and incremental association with the CV risk of the cohort. However, predictive analyses of CV mortality using the RDI and CT90% were not significant.","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"152 4","pages":"424-434"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Transcatheter Aortic Valve Implantation in a Large Aortic Annulus: A Case Report]. [大主动脉瓣环的经导管主动脉瓣植入术：病例报告]。

Revista medica de Chile Pub Date : 2024-04-01 DOI: 10.4067/s0034-98872024000400524

Pabla Cataldo, Christian Dauvergne, José Luis Winter, Manuel Duarte, Jorge Sandoval

引用次数: 0

[Acquired Epidermodysplasia Verruciformis in a Renal Transplant Patient: Case Report and Literature Review]. [肾移植患者获得性表皮增生症：病例报告和文献综述]。

Revista medica de Chile Pub Date : 2024-04-01 DOI: 10.4067/s0034-98872024000400514

Vicente Orellana-Westermeyer, Claudia Quiroz Palominos, Laura Carreño Toro

引用次数: 0

[Implications of cyberbullying in major depressive symptoms development in young people between 15 and 29 years of age in Chile]. [网络欺凌对智利 15 至 29 岁青少年重度抑郁症状发展的影响]。

Revista medica de Chile Pub Date : 2024-04-01 DOI: 10.4067/s0034-98872024000400435

Fernanda Rojas, Constanza Bravo, Rafael Miranda, Jorge Varela, Emanuel Pacheco

{"title":"[Implications of cyberbullying in major depressive symptoms development in young people between 15 and 29 years of age in Chile].","authors":"Fernanda Rojas, Constanza Bravo, Rafael Miranda, Jorge Varela, Emanuel Pacheco","doi":"10.4067/s0034-98872024000400435","DOIUrl":"https://doi.org/10.4067/s0034-98872024000400435","url":null,"abstract":"The use of digital means of communication and socialization among young people brings with it new stressors, risks, and forms of ag- gression, such as cyberbullying.Aim: To evaluate the relationship between cyberbullying and major depressive symptoms in young Chileans between 15 and 29 years.Methods: Survey through the StatKnows platform. Sampling was probabilistic and stratified with allocation proportional to the size of biphasic selection. The sample and the data were accessed virtually, respecting the bioethical standards of research with humans.Results: At all ages studied, the probability of experiencing depressive symptoms increases as levels of cyber aggression do, especially in the group between 19 and 24 years.Conclusions: The results reflect various factors of emerging adulthood that make this group more vulnerable, emphasizing the importance of studying the phenomenon at non-school ages since this form of aggression is not exclusive to adolescence, and neither are its effects on mental health.","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"152 4","pages":"435-443"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Characteristics of Depressed Individuals with Hypertension and/ or Diabetes Mellitus in Primary Health Care in Santiago de Chile]. [智利圣地亚哥基层医疗机构中患有高血压和/或糖尿病的抑郁症患者的特征]。

Revista medica de Chile Pub Date : 2024-04-01 DOI: 10.4067/s0034-98872024000400476

Graciela Rojas, Viviana Guajardo, Solange Campos, Pablo Herrera, Paul Vöhringer, Pablo Martínez

{"title":"[Characteristics of Depressed Individuals with Hypertension and/ or Diabetes Mellitus in Primary Health Care in Santiago de Chile].","authors":"Graciela Rojas, Viviana Guajardo, Solange Campos, Pablo Herrera, Paul Vöhringer, Pablo Martínez","doi":"10.4067/s0034-98872024000400476","DOIUrl":"https://doi.org/10.4067/s0034-98872024000400476","url":null,"abstract":"Eighty percent of depressed patients in Primary Health Care (PHC) have a comorbidity. It is essential to contribute local evidence on the characteristics of patients with physical and psychiatric comorbidities to better address clinical practice.Aim: To characterize depressed patients from the cardiovascular program (PCV) of eight family health centers (CESFAM) in two communes of the Metropolitan Region.Material and methods: Secondary analysis of data from a cluster-randomized clinical trial recruiting 359 program enrollees aged 18 years or older with a Patient Health Questionnaire 9-item (PHQ-9) score greater than or equal to 15. The inclusion criteria for participants were to be 18 years of age or older, to have a score on the Patient Health Questionnaire 9-item (PHQ-9) greater than or equal to 15, and to be enrolled in the cardiovascular program of the respective health center.Results: These are mainly women users of the cardiovascular program with depressive symptoms of moderate to severe intensity with a previous depressive history (60.39%), previously treated in a (75.69%). Only 17.7% were using antidepressant drugs at the time of the interview.97.1% of the interviewees were using drugs for hypertension and/or diabetes.Conclusions: These are people with depressive episode, hypertension and/or diabetes who, having a personal and family history of depression, are not receiving pharmacological treatment for depression, which probably affects their quality of life. Better adherence to clinical guidelines for the treatment of depression is required.","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"152 4","pages":"476-482"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Decision-Making by Hospital Teams Regarding Access and Use of Life-Support Technology and End-of-Life Processes in Critically Ill Adult Patients: A Narrative Review]. [医院团队对重症成人患者获取和使用生命支持技术及生命终结程序的决策：叙述性综述]。

Revista medica de Chile Pub Date : 2024-04-01 DOI: 10.4067/s0034-98872024000400483

María Cristina Paredes Escobar, Karen A Domínguez-Cancino

{"title":"[Decision-Making by Hospital Teams Regarding Access and Use of Life-Support Technology and End-of-Life Processes in Critically Ill Adult Patients: A Narrative Review].","authors":"María Cristina Paredes Escobar, Karen A Domínguez-Cancino","doi":"10.4067/s0034-98872024000400483","DOIUrl":"10.4067/s0034-98872024000400483","url":null,"abstract":"Death processes have been progressively transferred to hospital spaces due to biomedicalization and the use of technologies, generating important challenges for healthcare systems. The COVID-19 pandemic exposed the lack of unified criteria and principles for a dignified death in the hospital. This study corresponds to a narrative review using Higgins & Green's methodological framework as a reference. A systematized search was carried out with the question: What are the elements considered in the decision-making of hospital teams regarding access and use of life support technology and dying processes in adult critically ill patients? The searches conducted during October 2022 in MEDLINE/PubMed, Scopus, Science Direct, CINAHL, Biblioteca Virtual en Salud (BVS), Cochrane Library, and Scielo identified 1499 records for screening, and 148 were retrieved for full-text review. Eighty-four articles were included in the review, identifying seven categories. The evidence shows variability in decision-making associated with the clinical status of the patient, the criteria of the medical professional, added to structural elements of the health system and political-legal aspects. The literature recommends reflexive, dynamic, flexible, and individualized decision-making processes that consider the patient's preferences, clinical judgment, prognosis, and available resources. Communication, advance care planning, interdisciplinary discussions, external consultations, and the involvement of ethical committees are crucial throughout the process.","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"152 4","pages":"483-497"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Smallpox, a memory of the devastating epidemic in the XIX century in the provinces of central-southern Chile. The case of Parral]. [天花，十九世纪智利中南部各省毁灭性流行病的记忆。Parral 案例]。

Revista medica de Chile Pub Date : 2024-04-01 DOI: 10.4067/s0034-98872024000400529

Martín Lara, Jaime Zañartu, Manuel E Cortés

引用次数: 0

[Assessment of diagnostic utility of cerebrospinal fluid flow cytometry immunophenotyping and cytology in B cell non- Hodgkin lymphoma in a public chilean hospital]. [智利一家公立医院脑脊液流式细胞术免疫分型和细胞学对 B 细胞非霍奇金淋巴瘤诊断效用的评估]。

Revista medica de Chile Pub Date : 2024-04-01 DOI: 10.4067/s0034-98872024000400454

Casandra Jara, Carlos Veas, Carolina Delgado, Claudia Cabezas, Mauricio Chandía

{"title":"[Assessment of diagnostic utility of cerebrospinal fluid flow cytometry immunophenotyping and cytology in B cell non- Hodgkin lymphoma in a public chilean hospital].","authors":"Casandra Jara, Carlos Veas, Carolina Delgado, Claudia Cabezas, Mauricio Chandía","doi":"10.4067/s0034-98872024000400454","DOIUrl":"https://doi.org/10.4067/s0034-98872024000400454","url":null,"abstract":"Cerebrospinal fluid (CSF) involvement in B cell non-Hodgkin lymphomas is a poor prognostic sign and diagnosis is made using techniques such as flow cytometry (FCM) and conventional cytology (CC).Aim: To evaluate the frequency of CSF involvement in B-NHL by both techniques in a public hospital.Material and methods: 97 CSF samples were analyzed in tubes with cell preservative belonging to 70 patients, 71% male, median age 56 years (18-85 years), with a diagnosis of B-NHL and risk of infiltration according to medical criteria. Most were patients from new diagnosis (89%), diffuse large B cell lymphoma (60%), and Ann-Arbor stage III-IV (77%). In 67 samples (69%), CC and CMF were performed simultaneously.Results: Of the samples analyzed by CMF, 99% were valuable, while by CC, only 67% (p<0,05). Globally, 25% of the samples showed infiltration by CMF, while 18% by CC (p<0,0001). Forty-four valuable samples were evaluable and analyzed by CC and CMF, finding a similar frequency of positive cases (27%), with two-thirds positive only by CC or CMF. Positive samples in diffuse large B cell lymphoma were 28% by CC and/or CMF.Conclusions: A higher proportion of infiltration cases were detected by CMF than by CC. In valuable cases, CC complements CMF.","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"152 4","pages":"454-459"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Decline in Renal Function with Age in Chile: Gender Differences and the Impact of Comorbidities]. [智利肾功能随年龄下降：性别差异与合并症的影响]。

Revista medica de Chile Pub Date : 2024-04-01 DOI: 10.4067/s0034-98872024000400460

Sebastián Cabrera, Magdalena Walbaum, Leticia Elgueta, Erico Segovia, Lorena Flores, Alejandra Hernández, Melanie Paccot, Miriam Alvo

{"title":"[Decline in Renal Function with Age in Chile: Gender Differences and the Impact of Comorbidities].","authors":"Sebastián Cabrera, Magdalena Walbaum, Leticia Elgueta, Erico Segovia, Lorena Flores, Alejandra Hernández, Melanie Paccot, Miriam Alvo","doi":"10.4067/s0034-98872024000400460","DOIUrl":"https://doi.org/10.4067/s0034-98872024000400460","url":null,"abstract":"The estimated glomerular filtration rate (eGFR) using serum creatinine is widely utilized for assessing renal function. Its decrease with age and in the presence of chronic diseases such as diabetes, hypertension, and obesity is well-known. However, there are no representative data for the Chilean population.Aim: To estimate the decline in eGFR with age according to gender and the presence of chronic diseases in the adult Chilean population.Methods: This cross-sectional study involved 5,638 participants aged ≥18 years from the National Health Survey 2009 and 2017. The eGFR was estimated using the CKD-EPI formula based on serum creatinine. The decline in eGFR was compared by gender and the presence of chronic diseases (diabetes, hypertension, dyslipidemia, and/or obesity).Results: eGFR declined with age in both genders, with a steeper decrease in women (-0.88 vs. -0.78 mL/min/1.73 m2/year, p<0.01). The decline in eGFR started early and uniformly from the age of 18. In the presence of chronic diseases, the slope was significantly steeper (-0.94 vs. -0.83 mL/min/1.73 m2/ year, p<0.001), with women with chronic diseases experiencing the greatest decline (-1.00 mL/min/1.73 m2/year).Conclusion: eGFR progressively decreased with age in the Chilean population, showing an early decline starting from 18 years, more pronounced in women, and in the presence of chronic diseases. Our findings provide relevant population-based information for interpreting eGFR across different age groups and risk categories.","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"152 4","pages":"460-466"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0