Revista Medica Clinica Las Condes最新文献

Dermatomiositis clásica. Reporte de un caso Dermatomiositis经典。案例报告

IF 0.2

Revista Medica Clinica Las Condes Pub Date : 2025-03-01 DOI: 10.1016/j.rmclc.2025.03.006

Andry Devia-Pardo MD, Ayda Mongui-Fonseca MD, Lina Marroquín-Bravo MD, Teresita Pérez-Alonso MD

{"title":"Dermatomiositis clásica. Reporte de un caso","authors":"Andry Devia-Pardo MD, Ayda Mongui-Fonseca MD, Lina Marroquín-Bravo MD, Teresita Pérez-Alonso MD","doi":"10.1016/j.rmclc.2025.03.006","DOIUrl":"10.1016/j.rmclc.2025.03.006","url":null,"abstract":"<div><h3>Introduction</h3><div>Dermatomyositis is an inflammatory myopathy of variable course with different clinical manifestations, predominantly in the skin, which can present a chronic, progressive evolution with irreversible muscle damage and significant morbidity and mortality. The objective of this article is to describe the clinical case of a patient with classic dermatomyositis.</div></div><div><h3>Clinical Case Presentation</h3><div>A 59-year-old woman with a history of high blood pressure experienced muscle weakness in the shoulder and pelvic girdles in October 2022, with significant limitation of her daily activities. Various skin and muscle manifestations were found and motivated the execution of muscle and skin biopsies and electromyography. According to the findings on physical examination and the results of the other studies, the diagnosis of a classic adult dermatomyositis not associated with neoplastic processes was proposed. Treatment with hydroxychloroquine and immunosuppressants was initiated, with an adequate therapeutic response.</div></div><div><h3>Conclusion</h3><div>The accurate diagnosis of dermatomyositis requires the integration of the clinical picture, laboratory studies, histology and electromyography. This allows for the initiation of appropriate treatment in order to obtain, in most cases, a satisfactory clinical response.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"36 2","pages":"Pages 79-83"},"PeriodicalIF":0.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143878435","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}

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“¡Y LOS MÉDICOS... OTRA VEZ ASÍ!” 2021 “和医生……另一辆车在这里！2021”

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Revista Medica Clinica Las Condes Pub Date : 2025-03-01 DOI: 10.1016/j.rmclc.2025.04.007

引用次数: 0

Desafíos en hemorragia cerebral y cirrosis hepática. derivación ventricular bilateral como alternativa terapéutica 脑出血和肝硬化的挑战。双侧心室分流作为治疗替代

IF 0.2

Revista Medica Clinica Las Condes Pub Date : 2025-03-01 DOI: 10.1016/j.rmclc.2025.04.004

Antonio Arroyo MD , Andrés Ramos MD , Andrés Reccius MD

{"title":"Desafíos en hemorragia cerebral y cirrosis hepática. derivación ventricular bilateral como alternativa terapéutica","authors":"Antonio Arroyo MD , Andrés Ramos MD , Andrés Reccius MD","doi":"10.1016/j.rmclc.2025.04.004","DOIUrl":"10.1016/j.rmclc.2025.04.004","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the management of a patient with intraparenchymal hematoma, intraventricular hemorrhage (IVH) and coagulopathy secondary to liver cirrhosis; exploring bilateral ventricular shunt (bVSD) placement as a therapeutic option.</div></div><div><h3>Case report</h3><div>40-year-old man with liver cirrhosis and severe coagulopathy, found in coma and with multiple hemorrhagic brain lesions secondary to traumatic brain injury, as well as IVH and obstructive hydrocephalus. Despite the coagulopathy, an bVSD system was placed and used for ventricular lavage, achieving temporary control of intracranial pressure (ICP).</div></div><div><h3>Results</h3><div>Although temporary stabilization of ICP was achieved, the patient's evolution was unfavorable, basically influenced by the complex scenario of recurrent coagulopathy despite corrective measures, repeated obstruction of the DVEb, new hemorrhaging and the impossibility of performing other types of interventions. Finally, and as a consequence, limitation of therapeutic effort was performed.</div></div><div><h3>Conclusions</h3><div>DVEb placement may be a useful alternative to manage IVH in patients with severe coagulopathy, although long-term results still require further evaluation. This case illustrates the complexity of management in these patients and the need for further studies regarding this procedure.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"36 2","pages":"Pages 114-119"},"PeriodicalIF":0.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143878421","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}

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Terapia con inhibidores de la vía m-TOR en recién nacidos con hiperinsulinismo congénito resistente a diásóxido y octreotida 使用m-TOR途径抑制剂治疗患有先天性二氧耐药高胰岛素症和奥曲肽的新生儿

IF 0.2

Revista Medica Clinica Las Condes Pub Date : 2025-03-01 DOI: 10.1016/j.rmclc.2025.04.005

Patricio Astudillo MD, MSc

{"title":"Terapia con inhibidores de la vía m-TOR en recién nacidos con hiperinsulinismo congénito resistente a diásóxido y octreotida","authors":"Patricio Astudillo MD, MSc","doi":"10.1016/j.rmclc.2025.04.005","DOIUrl":"10.1016/j.rmclc.2025.04.005","url":null,"abstract":"<div><div>Congenital hyperinsulinism (CHI) is a challenging and severe disease in children due to diffuse involvement of the pancreas. Its treatment is based on chronic therapy with diazoxide or octreotide, followed by partial pancreatectomy, which is often not curative.</div><div>It has been previously described that sirolimus (rapamycin), an mTOR pathway inhibitor (mammalian target of rapamycin), is effective in the off-label treatment of CHI in infants who are refractory to conventional therapies.</div><div>This report presents the case of a premature 33-week-old infant with a severe form of CHI and a negative mutation in the ABCC8 gene, who responded to rapamycin treatment, showing significant improvement in blood glucose regulation and quality of life. No serious adverse events were observed after 24 months of follow-up. This is the first report of a successful intervention in a pediatric patient in Chile, providing a promising basis for future studies comparing rapamycin with other treatments for the management of congenital hyperinsulinism. The objective of this work is to present a clinical case involving the off-label use of rapamycin in a patient with congenital hyperinsulinism, along with a review of the current literature.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"36 2","pages":"Pages 120-125"},"PeriodicalIF":0.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143878520","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

Síndrome de hipotensión intracraneal en paciente neurocrítico: reporte de caso 神经临界患者的颅内低血压综合征：病例报告

IF 0.2

Revista Medica Clinica Las Condes Pub Date : 2025-03-01 DOI: 10.1016/j.rmclc.2025.04.002

Antonio Arroyo MD , Andrés Reccius MD

{"title":"Síndrome de hipotensión intracraneal en paciente neurocrítico: reporte de caso","authors":"Antonio Arroyo MD , Andrés Reccius MD","doi":"10.1016/j.rmclc.2025.04.002","DOIUrl":"10.1016/j.rmclc.2025.04.002","url":null,"abstract":"<div><h3>Objective</h3><div>to highlight the importance of recognizing intracranial hypotension syndrome (ICH), derived from the use of a spinal drainage (SD), in patients with aneurysmal subarachnoid hemorrhage (aSAH).</div></div><div><h3>Clinical Case</h3><div>a 42-year-old female patient with no prior medical history was admitted to the emergency department due to a generalized tonic-clonic seizure. An initial diagnosis of aSAH was made using brain CT angiography, and an aneurysm was treated through endovascular therapy with coils. SD was placed for management, but the patient subsequently developed SIH, characterized by negative intracranial pressure (ICP) and orthostatic headache as her cardinal symptoms.</div></div><div><h3>Discussion</h3><div>SIH presents with both clinical and radiological features, with orthostatic headache and cerebellar tonsillar descent being among the most common findings. Various treatment options for SIH have been described in the literature. However, the epidural blood patch is one of the most effective alternatives when performed using the appropriate technique.</div></div><div><h3>Conclusions</h3><div>SD is an effective alternative with a low rate of side effects in the management of aSAH. However, it is crucial to be aware of the associated risks. Proper knowledge of the different clinical presentations and diagnostic approaches is essential for managing SIH.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"36 2","pages":"Pages 109-113"},"PeriodicalIF":0.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143878432","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}

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Reporte de caso: mioclonias inducidas por quetiapina 病例报告：喹硫平引起的肌阵挛

IF 0.2

Revista Medica Clinica Las Condes Pub Date : 2025-03-01 DOI: 10.1016/j.rmclc.2025.03.005

Marcos Franchello MD , Ximena Sagues MD , Jerónimo Cossio MD , Griselda Alvarado MD

引用次数: 0

Drug-induced hypersensitivity syndrome associated with minocycline prescribed for acne treatment. Case report 药物致过敏综合征与米诺环素处方痤疮治疗相关。病例报告

IF 0.2

Revista Medica Clinica Las Condes Pub Date : 2025-03-01 DOI: 10.1016/j.rmclc.2025.03.003

Rodolfo Valenzuela MD , Paola Aravena MD , Katerine Garcia MD , Eduardo Cerda MD , Andrés Ferre MD, MSc

引用次数: 0

Cuando el fenómeno de Raynaud se acompaña de las temidas úlceras digitales: reporte de dos casos 当雷诺现象伴随着可怕的数字溃疡时：两例报告

IF 0.2

Revista Medica Clinica Las Condes Pub Date : 2025-03-01 DOI: 10.1016/j.rmclc.2025.03.002

Karen Vergara MD

{"title":"Cuando el fenómeno de Raynaud se acompaña de las temidas úlceras digitales: reporte de dos casos","authors":"Karen Vergara MD","doi":"10.1016/j.rmclc.2025.03.002","DOIUrl":"10.1016/j.rmclc.2025.03.002","url":null,"abstract":"<div><div>Raynaud's phenomenon (RP) is a vasospastic disorder, often triggered by cold or stress, that causes changes in the color of the fingers due to excessive vasoconstriction. A prevalence ranging from 5% to 14.5% has been described. Between 5% and 10% of patients with RP develop autoimmune diseases, such as systemic sclerosis, systemic lupus erythematosus, or rheumatoid arthritis. Of relevance, approximately 50% of patients with systemic sclerosis and RP experience digital ulcers, which can cause considerable pain and functional impairment.</div><div>The clinical cases described in this article correspond to a 33-year-old woman and an 18-year-old man with RP and digital ulcers. The woman showed no improvement despite medical treatment, while the man experienced healing of his lesions.</div><div>The pathophysiology of RF involves genetic and environmental factors, and the management of digital ulcers requires a multidisciplinary approach, combining medical care with wound care and the use of vasodilators. Although rare, digital ulcers represent a significant challenge that needs further research and better treatment options.</div><div>The aim of this paper is to describe the clinical features, laboratory, complementary studies, treatment and evolution of two patients with digital ulcers.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"36 2","pages":"Pages 88-92"},"PeriodicalIF":0.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143878522","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

Técnica de expansión tisular para reconstrucción de cuero cabelludo en nevus melanocítico congénito gigante verrugoso. Reporte de caso 一种组织扩张技术，用于重建先天性疣状黑素细胞痣的头皮。案例报告

IF 0.2

Revista Medica Clinica Las Condes Pub Date : 2025-03-01 DOI: 10.1016/j.rmclc.2025.04.001

Amauris Martínez Fernández MD , Stephany García Sánchez MD , Georgeana Chirino Rodríguez MD , Christian Mayorga Hernández MD

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BCGitis: Absceso pélvico por Mycobacterium bovis BCG posterior a inmunoterapia en cáncer de vejiga. Reporte de un caso 卡介苗：膀胱癌免疫治疗后由牛分枝杆菌引起的盆腔脓肿。案例报告

IF 0.2

Revista Medica Clinica Las Condes Pub Date : 2025-03-01 DOI: 10.1016/j.rmclc.2025.03.004

Eduardo Cerda MD , Katerine García de Urbina MD , Andrés Ferre MD, MSc , Jorge Dreyse MD , Andrés Giglio MD, MSc , Rodolfo Valenzuela MD

{"title":"BCGitis: Absceso pélvico por Mycobacterium bovis BCG posterior a inmunoterapia en cáncer de vejiga. Reporte de un caso","authors":"Eduardo Cerda MD , Katerine García de Urbina MD , Andrés Ferre MD, MSc , Jorge Dreyse MD , Andrés Giglio MD, MSc , Rodolfo Valenzuela MD","doi":"10.1016/j.rmclc.2025.03.004","DOIUrl":"10.1016/j.rmclc.2025.03.004","url":null,"abstract":"<div><div>Immunotherapy with BCG for non-invasive or superficial bladder cancer is the standard adjuvant treatment following transurethral resection. Despite its effectiveness and safety, approximately 1 to 5% of patients experience local or disseminated (BCGitis) infectious adverse effects. We present the case of an 80-year-old male patient with a history of bladder cancer undergoing intravesical immunotherapy during the induction phase, hospitalized due to a month long history of generalized weakness, acute kidney injury, and a positive urine culture for Escherichia coli ESBL (+). Prior to a new dose of immunotherapy, treatment with imipenem was initiated. Abdomen and pelvic computed tomography (CT) scan revealed a left periprostatic inflammatory collection involving the ipsilateral ureter with proximal hydronephrosis, a finding justified by the patient's medical history. After completing treatment, he experienced a fever peak and an increase in inflammatory parameters. A new CT scan showed growth of the collection. Abscess puncture was performed with an extended study, obtaining positive acid-fast bacillus microscopy and amplification of specific nucleic acids, confirming the diagnosis of urogenital abscess caused by BCG. Therapy with rifampicin, isoniazid and ethambutol was initiated, achieving clinical improvement.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"36 2","pages":"Pages 98-102"},"PeriodicalIF":0.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143878351","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