Revista Medica Clinica Las Condes最新文献

Rehabilitación temprana en cáncer: propuesta de un modelo interdisciplinario basado en vigilancia prospectiva y navegación clínica 癌症早期康复：基于前瞻性监测和临床导航的跨学科模式的建议

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Revista Medica Clinica Las Condes Pub Date : 2026-03-01 Epub Date: 2026-05-02 DOI: 10.1016/j.rmclc.2026.03.004

Francisca Madrid PT, Inés Fuentealba SLP, Patricia Simian OT, Olga Rincón PT

{"title":"Rehabilitación temprana en cáncer: propuesta de un modelo interdisciplinario basado en vigilancia prospectiva y navegación clínica","authors":"Francisca Madrid PT, Inés Fuentealba SLP, Patricia Simian OT, Olga Rincón PT","doi":"10.1016/j.rmclc.2026.03.004","DOIUrl":"10.1016/j.rmclc.2026.03.004","url":null,"abstract":"<div><div>Individuals diagnosed with cancer experience limitations in activities of daily living and usual roles due to the side effects of the disease and its treatments, which may emerge early and persist long term. Despite this, referrals to rehabilitation remain delayed and predominantly reactive. Key barriers include both individual and health system factors, such as age, geographic distance, poor coordination between services, limited awareness of rehabilitation benefits, and the lack of structured referral pathways. This context underscores the need to integrate rehabilitation early into oncologic care.</div><div>In this setting, an interdisciplinary model of early cancer rehabilitation based on prospective surveillance is proposed, aimed at facilitating timely referral and optimizing functional outcomes. International evidence supports the integration of rehabilitation professionals throughout the continuum of cancer care, including oncology physical therapy, pelvic floor rehabilitation, speech-language pathology, and occupational therapy. The prospective surveillance model, widely used in breast cancer, has demonstrated effectiveness in the early detection of functional impairments, supporting its potential extension to other cancer types. Additionally, a rehabilitation navigation role is incorporated, led by a professional with oncology training, responsible for conducting functional screening, providing education, and coordinating referrals based on functional risk in collaboration with the treating team.</div><div>The implementation of this interdisciplinary model, grounded in prospective surveillance and clinical navigation, represents a strategy for early detection of functional limitations, optimization of function, and improvement in quality of life. Future studies are needed to evaluate its implementation and impact across diverse clinical settings.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"37 2","pages":"Pages 204-212"},"PeriodicalIF":0.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147801633","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

Editorial. Tema central. Oncología centrada en el paciente: de la teoría a la práctica real 出版商。中心问题。以患者为中心的肿瘤学：从理论到实际实践

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Revista Medica Clinica Las Condes Pub Date : 2026-03-01 Epub Date: 2026-05-02 DOI: 10.1016/j.rmclc.2026.04.013

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Detección precoz del cáncer de mama: impacto clínico, sanitario y desafíos en Chile 乳腺癌的早期发现：智利的临床影响、健康和挑战

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Revista Medica Clinica Las Condes Pub Date : 2026-03-01 Epub Date: 2026-05-02 DOI: 10.1016/j.rmclc.2026.04.005

Paola Andrea Ruiz de Viñaspre Alvear MD, José Luis Soto Noriega MD, Hernando Paredes Farto MD, Nuvia Aliaga Molina MD

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Guía práctica de tratamiento con SBRT para el carcinoma de células renales 肾细胞癌SBRT治疗实用指南

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Revista Medica Clinica Las Condes Pub Date : 2026-03-01 Epub Date: 2026-05-02 DOI: 10.1016/j.rmclc.2026.04.012

Mariana Alberdi MD, Lorena Vargas MD, Francisca Barahona MD, Pelayo Besa MD, Rodrigo Barrientos MD

引用次数: 0

Ki67 como factor pronóstico dependiente de la edad en cáncer de mama rh positivo/HER2 negativo en etapa temprana Ki67作为早期rh阳性/HER2阴性乳腺癌的年龄依赖性预后因素

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Revista Medica Clinica Las Condes Pub Date : 2026-03-01 Epub Date: 2026-05-02 DOI: 10.1016/j.rmclc.2026.04.001

B. Christine Constabel MD , Francisco Acevedo MD , Alejandro Cataldo , Pablo A. Rey , César Sánchez MD , Antoine Sauré , Benjamín Walbaum MD

{"title":"Ki67 como factor pronóstico dependiente de la edad en cáncer de mama rh positivo/HER2 negativo en etapa temprana","authors":"B. Christine Constabel MD , Francisco Acevedo MD , Alejandro Cataldo , Pablo A. Rey , César Sánchez MD , Antoine Sauré , Benjamín Walbaum MD","doi":"10.1016/j.rmclc.2026.04.001","DOIUrl":"10.1016/j.rmclc.2026.04.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Breast cancer (BC) incidence in young women has increased. However, a few studies have examined prognostic factors specific to this population.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study of stage I–III HR+/HER2– BC patients diagnosed between 2012 and 2021. We compared clinicopathological features and invasive disease-free survival (IDFS) between women aged<50 and =50 years.</div></div><div><h3>Results</h3><div>Among 2,826 patients, 819 (29%) were under 50. Younger patients had higher Ki67 and lower IDFS compared to older women. Stage III disease was associated with worse IDFS in both age groups. Ki67 significantly predicted recurrence in patients =50 years (p=0.016), but not in those<50 (p=0.454).</div></div><div><h3>Discussion and Conclusion</h3><div>Clinical stage was a strong prognostic factor regardless of age. Women<50 with HR+/HER2– BC had poorer outcomes and higher tumor proliferation. These findings highlight the need for age-specific prognostic biomarkers in young women with luminal breast cancer.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"37 2","pages":"Pages 253-262"},"PeriodicalIF":0.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147801639","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

Más allá del antígeno prostático específico: actualización sobre la detección precoz del cáncer de próstata 超越前列腺特异性抗原：前列腺癌早期检测的最新情况

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Revista Medica Clinica Las Condes Pub Date : 2026-03-01 Epub Date: 2026-05-02 DOI: 10.1016/j.rmclc.2026.04.002

Pablo Rojas-Ruz MD , Norman Zambrano-Aravena MD

{"title":"Más allá del antígeno prostático específico: actualización sobre la detección precoz del cáncer de próstata","authors":"Pablo Rojas-Ruz MD , Norman Zambrano-Aravena MD","doi":"10.1016/j.rmclc.2026.04.002","DOIUrl":"10.1016/j.rmclc.2026.04.002","url":null,"abstract":"<div><div>Prostate cancer (PCa) is one of the most common malignancies and a significant cause of male mortality. The routine use of prostate-specific antigen (PSA) has contributed to a reduction in disease-specific mortality; however, its low specificity has led to overdiagnosis and overtreatment. The aim of this review is to summarize recent evidence on early detection strategies within the context of personalized medicine.</div><div>PCa risk is primarily determined by age, family history, modifiable factors (e.g., obesity and high-fat diets), and genetic alterations such as BRCA2 and HOXB13, which are associated with more aggressive disease. Current screening strategies focus on detecting clinically significant cancer. PSA-based screening reduces disease-specific mortality but does not impact overall mortality, and digital rectal examination has limited value as a screening tool.</div><div>International guidelines recommend a risk-adapted, individualized approach, typically starting between 45–50 years of age or earlier in high-risk populations. Multiparametric magnetic resonance imaging (mpMRI) has become a key tool, reducing unnecessary biopsies and the detection of clinically insignificant tumors.</div><div>Blood- and urine-based biomarkers may improve risk stratification, although their use remains limited. Emerging strategies such as liquid biopsy and artificial intelligence show promise in optimizing early detection. Current screening strategies are based on a multimodal model that prioritizes the detection of clinically significant disease while reducing unnecessary interventions.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"37 2","pages":"Pages 170-177"},"PeriodicalIF":0.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147801598","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

Importancia de los estudios genéticos germinales en la terapia oncológica: más allá del cáncer hereditario 生殖系遗传学研究在癌症治疗中的重要性：超越遗传性癌症

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Revista Medica Clinica Las Condes Pub Date : 2026-03-01 Epub Date: 2026-05-02 DOI: 10.1016/j.rmclc.2026.04.006

Elsa Cabrera Acosta MD

引用次数: 0

Cáncer de pulmón: el sueño de detectar en etapas precoces 肺癌：早期发现的梦想

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Revista Medica Clinica Las Condes Pub Date : 2026-03-01 Epub Date: 2026-05-02 DOI: 10.1016/j.rmclc.2026.04.010

Patricia Bitar MD , María Paz Saavedra Md

引用次数: 0

Evolución en el tratamiento de la leucemia mieloide aguda no promielocítica, de la investigación a la práctica clínica 急性非粒细胞性骨髓性白血病从研究到临床实践的治疗进展

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Revista Medica Clinica Las Condes Pub Date : 2026-03-01 Epub Date: 2026-05-02 DOI: 10.1016/j.rmclc.2026.04.003

Paola Aravena MD

{"title":"Evolución en el tratamiento de la leucemia mieloide aguda no promielocítica, de la investigación a la práctica clínica","authors":"Paola Aravena MD","doi":"10.1016/j.rmclc.2026.04.003","DOIUrl":"10.1016/j.rmclc.2026.04.003","url":null,"abstract":"<div><div>Acute myeloid leukemia is a heterogeneous clonal hematologic malignancy and the most common leukemia in adults, with an incidence of approximately 4 cases per 100 000 inhabitants per year, increasing with age. In Chile, overall survival remains limited, particularly among patients over 60 years old, due to restricted access to molecular diagnostics, targeted therapies, and transplantation.</div><div>In recent decades, advances in molecular biology have reshaped the understanding and management of acute myeloid leukemia. Recurrent mutations have led to the development of targeted therapies that significantly improve outcomes. The introduction of Fms-like tyrosine kinase 3 inhibitors like midostaurina or gilteritinib, B cell lymphoma 2 inhibitors like venetoclax and hypomethylating agents like azacytidine or decitabine (has expanded treatment options and increased survival in patients unfit for intensive chemotherapy.</div><div>In Chile, challenges remain regarding the implementation of next-generation sequencing delayed cytogenetic results, and inequitable access to new therapies. Strengthening diagnostic infrastructure and national collaborative groups is crucial to ensure equitable, biology-driven AML care.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"37 2","pages":"Pages 178-185"},"PeriodicalIF":0.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147801599","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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Mejorando la formación médica mediante evaluaciones de 360 grados: Una revisión y propuesta para la formación en la UCI 通过360度评估加强医疗培训：统一医疗中心培训的审查和建议

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Revista Medica Clinica Las Condes Pub Date : 2026-03-01 Epub Date: 2026-05-02 DOI: 10.1016/j.rmclc.2026.03.005

Andrés Giglio MD, MSc, MHA, MPH , Andrés Ferre MD, MSc , César Pedreros MD , Valentina Vuletin RN , Soledad Armijo-Rivera MD, MSc

{"title":"Mejorando la formación médica mediante evaluaciones de 360 grados: Una revisión y propuesta para la formación en la UCI","authors":"Andrés Giglio MD, MSc, MHA, MPH , Andrés Ferre MD, MSc , César Pedreros MD , Valentina Vuletin RN , Soledad Armijo-Rivera MD, MSc","doi":"10.1016/j.rmclc.2026.03.005","DOIUrl":"10.1016/j.rmclc.2026.03.005","url":null,"abstract":"<div><div>The training of medical residents requires educational strategies that foster the comprehensive development of clinical, communication, and professional competencies. In this context, 360-degree evaluations have emerged as an alternative to traditional assessment methods, enabling a more comprehensive appraisal of performance. This narrative review aimed to analyze their implementation, effectiveness, challenges, and long-term outcomes in medical education. A comprehensive literature search was conducted using terms related to “360-degree evaluation,” “multisource feedback,” and “health education,” identifying 34 studies across diverse training settings.</div><div>Findings indicate that 360-degree evaluations provide a holistic perspective by integrating feedback from multiple sources, including peers, supervisors, patients, and self-assessment. Their use is associated with improvements in clinical competencies, communication skills, professionalism, and overall performance. Additionally, continuous feedback promotes reflective practice and sustained professional development, contributing to improved quality of care and patient satisfaction.</div><div>However, several challenges were identified, including evaluator bias, logistical complexities, and difficulties in effectively integrating feedback into training programs. Successful implementation strategies include structured evaluator training, the use of standardized tools, regular feedback sessions, and strong institutional support supported by appropriate technological platforms.</div><div>In conclusion, 360-degree evaluations represent a valuable complement to traditional assessment methods by providing a multidimensional view of resident performance. Careful implementation can maximize their benefits and contribute to both professional development and the quality of healthcare delivery.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"37 2","pages":"Pages 263-274"},"PeriodicalIF":0.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147801640","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