Revista medica de Chile最新文献_第3页

Encephalitis by Epstein Barr Virus in a Transplant Immunosuppressed Patient. 移植免疫抑制患者的eb病毒引起的脑炎

Revista medica de Chile Pub Date : 2024-11-01 DOI: 10.4067/s0034-98872024000800931

Esteban Teneb, Fernando Uherek, Ricardo Wenger, Alberto Fica, Belén Inostroza, Maritza Navarrete

{"title":"Encephalitis by Epstein Barr Virus in a Transplant Immunosuppressed Patient.","authors":"Esteban Teneb, Fernando Uherek, Ricardo Wenger, Alberto Fica, Belén Inostroza, Maritza Navarrete","doi":"10.4067/s0034-98872024000800931","DOIUrl":"https://doi.org/10.4067/s0034-98872024000800931","url":null,"abstract":"Encephalitis due to Epstein-Barr Virus (EBV) is a rare condition that primarily affects children and immunosuppressed patients. Diagnosing EBV encephalitis can be challenging due to its nonspecific clinical presentation and the lack of confirmatory tests. We present the case of a 66-year-old woman with a history of kidney transplantation who was admitted due to progressive subacute mental deterioration, preceded by vertigo and without fever. Physical examination revealed no cranial nerve abnormalities, focal neurological deficits, or meningeal signs. Cerebrospinal fluid (CSF) analysis showed a mild increase in protein and pleocytosis (13/µL) without hypoglycorrhachia. Brain magnetic resonance imaging (MRI) revealed multiple bi-hemispheric supratentorial hyperintensities associated with mild vasogenic edema, most prominent at the cortico-subcortical interface, hippocampal regions, and basal ganglia. An extensive search for microorganisms identified EBV by RT-PCR in the CSF (1,650 copies/mL). The patient initially received acyclovir without improvement but achieved rapid recovery after switching to ganciclovir. The patient was discharged, and outpatient follow-up visits demonstrated full recovery. This case supports the effectiveness of ganciclovir, as observed in previous reports. Overall, patients with EBV encephalitis generally have a benign course with complete recovery or mild sequelae.","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"152 8","pages":"927-931"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034947","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

[Data Quality in the Chilean Health System: An Outstanding Debt with the Indigenous and Migrant Populations in Chile]. [智利卫生系统的数据质量：智利土著和移民人口的未偿债务]。

Revista medica de Chile Pub Date : 2024-11-01 Epub Date: 2025-02-03 DOI: 10.4067/s0034-98872024001101130

Carolina Acevedo De La Harpe, Nathalie Jaramillo-Brun

{"title":"[Data Quality in the Chilean Health System: An Outstanding Debt with the Indigenous and Migrant Populations in Chile].","authors":"Carolina Acevedo De La Harpe, Nathalie Jaramillo-Brun","doi":"10.4067/s0034-98872024001101130","DOIUrl":"https://doi.org/10.4067/s0034-98872024001101130","url":null,"abstract":"Health equity is an objective that is strongly linked to the strength of health systems. In this regard, the data and evidence that the health structure has on the population is of vital importance.Aim: was to evaluate the quality of data on sexual and reproductive health of migrant and indigenous women in Chile. We approach this issue from a perspective that emphasizes the importance of the State and its institutions relying on their populations to implement more effective and efficient social policies.Methods: The Monthly Statistical Summaries (REM) prepared by the Department of Health Statistics and Information (DEIS) for the years 2012 to 2024 were reviewed.Results: Regarding coherence, the origin of the data is the same, however, the codes have changed over time, this is where not all the dimensions observed have the indigenous or migrant category. Regarding availability, there is no clear differentiation between cells with zeros or empty cases, which makes the interpretation and completeness of the data difficult.Conclusions: The findings show a phenomenon that we have called \"negative interdependence\" which generates bias with respect to the information collected by the health information system (DEIS-Chile) that perpetuates the health inequities of the observed populations and, above all, omits the subnational territorial context as a basis for the continuous improvement of health systems.","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"152 11","pages":"1130-1137"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575088","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

[A Case of Recurrent Variceal Hemorrhage Secondary to Portosinusoidal Vascular Disease]. [门窦血管病继发静脉曲张出血1例]。

Revista medica de Chile Pub Date : 2024-11-01 Epub Date: 2025-02-03 DOI: 10.4067/s0034-98872024001101176

Nicolás Ortiz-López, Juan Pablo Roblero, Jaime Poniachik, Álvaro Urzúa, Laura Carreño

{"title":"[A Case of Recurrent Variceal Hemorrhage Secondary to Portosinusoidal Vascular Disease].","authors":"Nicolás Ortiz-López, Juan Pablo Roblero, Jaime Poniachik, Álvaro Urzúa, Laura Carreño","doi":"10.4067/s0034-98872024001101176","DOIUrl":"https://doi.org/10.4067/s0034-98872024001101176","url":null,"abstract":"Portal hypertension is a syndrome characterized by an elevation in pressure within the portal venous system, with severe consequences. Hepatic cirrhosis is its most common cause, but there are less frequent causes, including the recently described hepatic vascular disease, portosinusoidal vascular disease (PSVD), which affects portal venules and hepatic sinusoids. We present the case of a 68-year-old man with a history of portal hypertension and recurrent variceal bleeding. Despite medical treatment and endoscopic procedures, the hemorrhages persisted. A transjugular intrahepatic portosystemic shunt (TIPS) was performed to manage the condition. Hepatic elastography revealed unusually low liver stiffness for cirrhosis, prompting a liver biopsy. Histological findings supported the diagnosis of PSVD. Regarding treatment, there are no specific therapies for PSVD, and the focus is on managing complications associated with portal hypertension. PSVD is a rare entity that can be an underlying cause of non-cirrhotic portal hypertension. This case underscores the importance of awareness for early diagnosis and appropriate management. Ongoing research is crucial to gain a better understanding of this rare condition and enhance the quality of life for affected patients.","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"152 11","pages":"1176-1180"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575086","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

[Social Determinants of Combined Use of Alcohol and Non-prescription Drugs in Older Adults: A Population-based Study in Chile]. [老年人酒精和非处方药联合使用的社会决定因素：智利的一项基于人群的研究]。

Revista medica de Chile Pub Date : 2024-11-01 DOI: 10.4067/s0034-98872024000800867

Yamil Tala, Camila Skewes, Miguel Ángel Fernández

{"title":"[Social Determinants of Combined Use of Alcohol and Non-prescription Drugs in Older Adults: A Population-based Study in Chile].","authors":"Yamil Tala, Camila Skewes, Miguel Ángel Fernández","doi":"10.4067/s0034-98872024000800867","DOIUrl":"https://doi.org/10.4067/s0034-98872024000800867","url":null,"abstract":"Alcohol consumption by older adults has been called the \"silent epidemic.\" An aging population and high levels of alcohol consumption increase the future challenge for epidemiology and public health. In addition, the misuse of prescription drugs is a growing public health problem associated with increased hospitalizations and health complications in older adults.Aim: To analyze the social determinants associated with problematic alcohol and prescription drug use in the older adult population in the country.Methods: Analysis of SENDA's population-based survey of drug and alcohol use in older adults from 2021. A multivariate statistical model was used to identify the factors that increase or decrease the probability of occurrence of the phenomenon.Results: The prevalence of alcohol and prescription drug use in older adults in Chile reached 12.8%. At the multivariate level, it is men, with less social support and without sentimental cohabitation, who have a higher probability of combining alcohol consumption with prescription drugs.Conclusions: The combination of alcohol and medicine without medical prescription is a potential public health problem, especially among older adults. This study represents a national effort to understand this phenomenon, identifying the most vulnerable groups with the highest prevalence of consumption to which public prevention policies should give special attention.","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"152 8","pages":"867-874"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034944","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

[Eradication of Ageism in Elderly Care Facilities: Is it Possible?] [消除安老机构的年龄歧视：有可能吗？]］

Revista medica de Chile Pub Date : 2024-11-01 Epub Date: 2025-02-03 DOI: 10.4067/s0034-98872024001101181

Rodrigo Yáñez-Yáñez, Nelson McArdle

引用次数: 0

[Risk Profile for Preventable Hospitalizations in Older Adults: Challenges for the Interoperability of Health Networks]. [老年人可预防住院的风险概况：健康网络互操作性的挑战]。

Revista medica de Chile Pub Date : 2024-11-01 Epub Date: 2025-02-03 DOI: 10.4067/s0034-98872024001101111

Melisa A Münzenmayer, Claudio A Méndez, Antonio Tejeda Altamirano, Victoria Espinosa F

{"title":"[Risk Profile for Preventable Hospitalizations in Older Adults: Challenges for the Interoperability of Health Networks].","authors":"Melisa A Münzenmayer, Claudio A Méndez, Antonio Tejeda Altamirano, Victoria Espinosa F","doi":"10.4067/s0034-98872024001101111","DOIUrl":"https://doi.org/10.4067/s0034-98872024001101111","url":null,"abstract":"Health research teams routinely face difficulties processing clinical data to determine risk profiles in susceptible populations.Aim: Generate a risk profile of avoidable hospitalizations in older adult patients using integrated healthcare networks of the Southern Metropolitan Health Service (SSMS) of the Metropolitan Region of Chile from 2019-2021.Methods: The present research has a retrospective longitudinal descriptive design of anonymized clinical database records from four Family Health Centers and a high-complexity South Metropolitan Health Service (SMHS) hospital. The information available in TRACKCARE and RAYEN records for 2019-2021 was cleaned and filtered, considering only the ICD-10 diagnoses of interest. Demographic and clinical data analysis was performed with descriptive and inferential statistics using GraphPad Prism v5.0.Results: 57.2% of older adults are women with an average age of 74.2 ± 7.2 (P= 0.0352). There is a different distribution profile of the FONASA section between men and women (P= 0.0002) even when 74% of the total sample is affiliated with FONASA-B. 62.7% have a single ICD-10 diagnosis, the majority being high blood pressure and heart failure (I10-I11), reaching 34% of diagnoses.Conclusions: Despite the evident lack of interoperability between the available clinical registry bases, it was possible to identify a sociodemographic and clinical profile of people aged 65 years and more prone to avoidable hospitalizations. This is through a process of collection and cleansing from different sources of information available in the South Metropolitan Health Service and involved communities.","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"152 11","pages":"1111-1119"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574317","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

[Use of Artificial Intelligence in Diabetic Retinopathy Screening: Experience in a Health Service in Santiago, Chile]. [人工智能在糖尿病视网膜病变筛查中的应用：智利圣地亚哥卫生服务的经验]。

Revista medica de Chile Pub Date : 2024-11-01 Epub Date: 2025-02-03 DOI: 10.4067/s0034-98872024001101148

María C Ibañez-Bruron, Andrea Cruzat, Gonzalo Ordenes-Caviere, Marcelo Coria

{"title":"[Use of Artificial Intelligence in Diabetic Retinopathy Screening: Experience in a Health Service in Santiago, Chile].","authors":"María C Ibañez-Bruron, Andrea Cruzat, Gonzalo Ordenes-Caviere, Marcelo Coria","doi":"10.4067/s0034-98872024001101148","DOIUrl":"https://doi.org/10.4067/s0034-98872024001101148","url":null,"abstract":"Early detection of diabetic retinopathy is critical for preventing vision loss.Aim: To evaluate the use of artificial intelligence (AI) for screening sight threatening diabetic retinopathy (DR) in a public Hospital in Chile.Material and methods: The mydriatic retinal photographs of 366 participants were uploaded for analysis by EyeArt, a cloud-based AI software developed by Eyenuk (Los Ángeles, USA). Diagnostic accuracy was calculated by comparing its results with the clinical evaluation of the fundus by an ophthalmologist. Participants with severe non-proliferative DR or worse were considered as positive cases.Results: Twenty four percent of participants had DR, including 33 (9%) who had sight threatening DR in at least one eye. The sensitivity and specificity of EyeArt were 100% (95% confidence intervals (CI): 89-100%) and 84% (95% CI: 80-88%), respectively.Conclusions: EyeArt was highly sensitive for sight threatening DR and it may be a cost-effective method to improve DR screening in the Chilean public health system.","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"152 11","pages":"1148-1153"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574757","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

[Functional Assessment Tool Based on Hand Grasp in the Chilean Adult Population]. [基于智利成人握手功能的评估工具]。

Revista medica de Chile Pub Date : 2024-11-01 Epub Date: 2025-02-03 DOI: 10.4067/s0034-98872024001101183

Daniel Patiño-García, Margarita Ibáñez González

引用次数: 0

[Duties of the Physician in Relation to the Use of Alternative and Complementary Medicines by Their Patients]. [医生在患者使用替代和补充药物方面的职责]。

Revista medica de Chile Pub Date : 2024-11-01 DOI: 10.4067/s0034-98872024000800901

Rodrigo Salinas R, Carlos Echeverría B, Alberto Rojas O, Paulina Taboada R, Hernán Borja R, Anamaría Arriagada U, María A Rodríguez S, Gonzalo Ruiz-Esquide S, María Alejandra Florenzano V

{"title":"[Duties of the Physician in Relation to the Use of Alternative and Complementary Medicines by Their Patients].","authors":"Rodrigo Salinas R, Carlos Echeverría B, Alberto Rojas O, Paulina Taboada R, Hernán Borja R, Anamaría Arriagada U, María A Rodríguez S, Gonzalo Ruiz-Esquide S, María Alejandra Florenzano V","doi":"10.4067/s0034-98872024000800901","DOIUrl":"https://doi.org/10.4067/s0034-98872024000800901","url":null,"abstract":"In the prevailing medical pluralism of contemporary society, alternative and complementary medicine occupy a relevant place, comprising a heterogeneous group of practices with different values depending on tradition and social acceptance. Their scarce regulation and growing use, facilitated by promotion through social networks and distrust of the dominant biomedical model, have generated interest among medical organizations and health authorities in their use and consequences. Appreciations vary from outright rejection to interest in its adoption by public health systems as part of their services. Its growing use, however, contrasts with an incipient development of the scientific evidence supporting its use and, consequently, a scarce representation of its curricular teaching in our medical schools. The use of CAM by patients cannot be ignored in the therapeutic encounter. Physicians must be prepared to discuss their possible benefits and risks with their patients and to make recommendations in accordance with the principles of medical professionalism: the good of the patient must take precedence over other interests, taking into account the scarce scientific evidence of their efficacy and safety, the imperfect regulation to which they are subject and the lack of pharmacovigilance on their effects. The patient's autonomy over his or her health care, considerations regarding the use of scarce health care resources, and the due compassion and empathy owed to the patient as a suffering being cannot be ignored.","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"152 8","pages":"901-908"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034941","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

[Neurocognitive Performance in Patients with End-Stage Chronic Kidney Disease: Differences Between Conservative Medical Management and Hemodialysis]. [终末期慢性肾病患者的神经认知表现：保守治疗与血液透析的差异]。

Revista medica de Chile Pub Date : 2024-11-01 DOI: 10.4067/s0034-98872024000800856

Luna Sánchez, Bárbara Lanis, Nicolás Meza, Gustav Rohde

{"title":"[Neurocognitive Performance in Patients with End-Stage Chronic Kidney Disease: Differences Between Conservative Medical Management and Hemodialysis].","authors":"Luna Sánchez, Bárbara Lanis, Nicolás Meza, Gustav Rohde","doi":"10.4067/s0034-98872024000800856","DOIUrl":"https://doi.org/10.4067/s0034-98872024000800856","url":null,"abstract":"No consensus has been reached about how cognitive performance evolves in patients receiving hemodialysis (HD).Aim: to analyze the cognitive performance of patients with end-stage chronic kidney disease (CKD) undergoing conservative medical management or HD.Methods: We conducted a cross-sectional study. The cognitive performance of both groups was assessed through the INECO Frontal Screening (IFS) instrument.Results: 6 patients were analyzed in each group (n= 12). A significant difference was observed for the total IFS score, with 14.4±6.29 points in the HD group and 21.5±3.96 points in the conservative management group (p<0.05). Regarding the specific domains of the IFS, a significant difference was found in the domain of verbal inhibitory control, with an average of 1.83±1.17 points in the HD group and 4±0.89 points in the conservative management group (p<0.05). No associations were elucidated on the abbreviated MMSE, ACE-III, TMT-A and B, Grober and Buschke Test, Stroop Test and Boston Test Nomination Test.Conclusion: Patients with terminal CKD on HD (even those with a normal MMSE result) show an impairment in their executive functions compared to those who underwent conservative management.","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"152 8","pages":"856-866"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034943","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