Revista Medica Clinica Las Condes最新文献

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Osteoporosis secundaria
IF 0.4
Revista Medica Clinica Las Condes Pub Date : 2025-07-01 DOI: 10.1016/j.rmclc.2025.07.002
Pamela Trejo MD , Carolina Martínez MD
{"title":"Osteoporosis secundaria","authors":"Pamela Trejo MD ,&nbsp;Carolina Martínez MD","doi":"10.1016/j.rmclc.2025.07.002","DOIUrl":"10.1016/j.rmclc.2025.07.002","url":null,"abstract":"<div><div>Secondary osteoporosis is a condition that arises as a consequence of underlying diseases or medical treatments that affect bone metabolism, in contrast to primary osteoporosis, which is associated with age-related bone loss and the hormonal changes of menopause. Its clinical presentation differs, as it can occur in younger patients and, in some cases, be associated with more severe bone loss, increasing the prevalence of fragility fractures.</div><div>Identifying secondary causes is crucial, as it directly impacts treatment strategies and fracture risk assessment. Early recognition is essential to ensure an adequate evaluation, individualize treatment based on the underlying etiology and patient needs, and ultimately prevent fragility fractures.</div><div>This review aims to highlight when to suspect secondary osteoporosis, how to properly assess it, as well as provide tools for its clinical management.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"36 4","pages":"Pages 306-314"},"PeriodicalIF":0.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912555","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
Insuficiencia adrenal inducida por glucocorticoides: tratamiento y seguimiento clínico 糖皮质激素引起的肾上腺素缺乏:治疗和临床随访
IF 0.4
Revista Medica Clinica Las Condes Pub Date : 2025-07-01 DOI: 10.1016/j.rmclc.2025.08.008
Enrique Ramos Maurell MD
{"title":"Insuficiencia adrenal inducida por glucocorticoides: tratamiento y seguimiento clínico","authors":"Enrique Ramos Maurell MD","doi":"10.1016/j.rmclc.2025.08.008","DOIUrl":"10.1016/j.rmclc.2025.08.008","url":null,"abstract":"<div><div>Glucocorticoid-induced adrenal insufficiency is a common complication of prolonged exogenous corticosteroid use, caused by suppression of the hypothalamic-pituitary-adrenal (HPA) axis and resulting in insufficient endogenous cortisol production. Given the widespread use of glucocorticoids across multiple medical fields, a substantial proportion of the population is at risk. Although adrenal crises are rare, they can be severe or life-threatening if not promptly recognized and treated, particularly during acute physiological stress. This underscores the need for close and long-term monitoring. Recent guidelines and clinical studies recommend periodic assessment of the HPA axis using basal cortisol measurements and ACTH stimulation tests, especially in patients with persistent symptoms or without documented hormonal recovery. A significant proportion of patients may regain adrenal function even 12–24 months after discontinuing corticosteroids. Management should include patient education, crisis prevention strategies, recognition of withdrawal symptoms, and individualized adjustment of replacement therapy, including stress-dose steroids if required. In 2024, the European Society of Endocrinology and the Endocrine Society published the most up-to-date guideline, which serves as the basis for this work. This review synthesizes current recommendations and proposes a practical, evidence-based approach for the follow-up of adults with glucocorticoid-induced adrenal insufficiency.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"36 4","pages":"Pages 357-363"},"PeriodicalIF":0.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912558","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
Hacia un sistema de salud sustentable en Chile: el papel de los hospitales verdes 智利的可持续卫生系统:绿色医院的作用
IF 0.4
Revista Medica Clinica Las Condes Pub Date : 2025-07-01 DOI: 10.1016/j.rmclc.2025.08.005
Fernanda Olivé C RN , María Bernardita Sanhueza RN
{"title":"Hacia un sistema de salud sustentable en Chile: el papel de los hospitales verdes","authors":"Fernanda Olivé C RN ,&nbsp;María Bernardita Sanhueza RN","doi":"10.1016/j.rmclc.2025.08.005","DOIUrl":"10.1016/j.rmclc.2025.08.005","url":null,"abstract":"<div><div>The healthcar<strong>e</strong> sector play<strong>s a</strong> crucial <strong>r</strong>ole in protecting the population, but its environmental impact is undeniable. Globall<strong>y,</strong> healthcar<strong>e</strong> is <strong>r</strong>esponsible <strong>f</strong>or 4.4% of greenhouse gas emissions. In Chile, sustainable hospital wast<strong>e</strong> management is inadequate, with onl<strong>y</strong> 2% of wast<strong>e</strong> being <strong>r</strong>ecycled. Intensive C<strong>are</strong> Units (ICUs) have <strong>a p</strong>articularl<strong>y</strong> high environmental <strong>f</strong>ootprint, generating three times mor<strong>e CO</strong><sub><strong>2</strong></sub> per bed than other hospital areas.</div><div>The objective of this article is to analyze the environmental impact of the healthcare system in Chile and to highlight the strategic role of hospitals—particularly their clinical teams—in the transition toward more sustainable models of care.</div><div>In this context, it is essential for the Chilean healthcare system to shift toward a greener approach, addressing challenges such as waste generation, overuse of plastic materials, and CO<sub><strong>2</strong></sub> emissions. Healthcare teams play a key role in leading sustainability initiatives, providing training, and promoting best practices. Several successful cases demonstrate the feasibility and associated benefits of such efforts. However, regulatory changes and institutional commitments are needed to align healthcare with global environmental sustainability goals, ensuring a healthier future for both people and the planet.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"36 4","pages":"Pages 364-372"},"PeriodicalIF":0.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912501","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
“Sun and Life” 1947 《太阳与生命》,1947年
IF 0.4
Revista Medica Clinica Las Condes Pub Date : 2025-07-01 DOI: 10.1016/j.rmclc.2025.08.015
{"title":"“Sun and Life” 1947","authors":"","doi":"10.1016/j.rmclc.2025.08.015","DOIUrl":"10.1016/j.rmclc.2025.08.015","url":null,"abstract":"","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"36 4","pages":"Page 373"},"PeriodicalIF":0.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912502","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
Enfrentamiento actual del nódulo tiroideo 甲状腺结节的当前处理
IF 0.4
Revista Medica Clinica Las Condes Pub Date : 2025-07-01 DOI: 10.1016/j.rmclc.2025.08.009
Iván Solis MD
{"title":"Enfrentamiento actual del nódulo tiroideo","authors":"Iván Solis MD","doi":"10.1016/j.rmclc.2025.08.009","DOIUrl":"10.1016/j.rmclc.2025.08.009","url":null,"abstract":"<div><div>A thyroid nodule is a lesion structurally distinguishable from the thyroid parenchyma and is highly prevalent in the general population. Its detection has increased due to the widespread use of cervical ultrasonography. Although most nodules are benign, approximately 7–15% may correspond to cancer. The initial evaluation includes a detailed medical history, an assessment of risk factors, and a physical examination focused on signs of thyroid dysfunction or malignancy.</div><div>Thyroid ultrasound is the diagnostic method of choice due to its accuracy, safety, and low cost. Certain sonographic features allow estimation of malignancy risk, classified through systems such as TI-RADS. TSH measurement helps determine the functional status of the nodule.</div><div>Fine-needle aspiration biopsy (FNAB), guided by ultrasound, enables cytological analysis according to the Bethesda System (categories I–VI), which informs clinical management. For nodules with indeterminate cytology (Bethesda III and IV), molecular studies provide predictive value for malignancy.</div><div>Therapeutic decisions must consider the patient's age, comorbidities, the nodule's sonographic and cytological characteristics, and patient preferences. Management options range from ultrasound monitoring to surgical or ablative treatments.</div><div>In conclusion, the approach to thyroid nodules is based on an integrated and sequential strategy, guided by diagnostic tools and updated clinical guidelines, aimed at achieving personalized and safe decision-making.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"36 4","pages":"Pages 260-266"},"PeriodicalIF":0.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912548","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
Diabesidad: concepto e implicancias
IF 0.4
Revista Medica Clinica Las Condes Pub Date : 2025-07-01 DOI: 10.1016/j.rmclc.2025.08.010
Rodolfo Lahsen MD
{"title":"Diabesidad: concepto e implicancias","authors":"Rodolfo Lahsen MD","doi":"10.1016/j.rmclc.2025.08.010","DOIUrl":"10.1016/j.rmclc.2025.08.010","url":null,"abstract":"<div><div>The purpose of this review is to raise awareness and educate physicians about the concept, pathogenesis, and general aspects of diabesity treatment. The concept of diabesity is based on the twin epidemics of obesity and diabetes. Given a positive caloric balance, the inability of subcutaneous adipose tissue to expand leads to the deposition of visceral and ectopic fat, which favors lipotoxicity and inflammation, causing insulin resistance in the liver and muscle. At early stages, pancreatic beta cells compensate insulin resistance with hyperinsulinemia. However, lipotoxicity and inflammation trigger beta cell apoptosis, rendering them unable to compensate, resulting in hyperglycemia, first in the prediabetic range and later, full-blown diabetes. Furthermore, lipotoxicity and inflammation affect other organs and systems, such as the heart, circulatory system, and kidneys, which in turn are targets for the complications of diabetes, thus constituting a metabolic-cardio-renal syndrome. Weight loss through a healthy lifestyle, the eventual use of antidiabetic drugs that produce weight loss, and endoscopic or surgical interventional procedures, can reduce the morbidity and mortality associated with diabesity.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"36 4","pages":"Pages 340-347"},"PeriodicalIF":0.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912556","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
Enfrentamiento del incidentaloma hipofisiario 处理脑下垂体事件
IF 0.4
Revista Medica Clinica Las Condes Pub Date : 2025-07-01 DOI: 10.1016/j.rmclc.2025.08.007
Francisco Cordero MD
{"title":"Enfrentamiento del incidentaloma hipofisiario","authors":"Francisco Cordero MD","doi":"10.1016/j.rmclc.2025.08.007","DOIUrl":"10.1016/j.rmclc.2025.08.007","url":null,"abstract":"<div><div>Pituitary incidentalomas (PI) are pituitary lesions identified incidentally through imaging. They have become common in clinical practice due to the increased use of imaging and radiological advances with improved resolution. Most PI in adults are pituitary adenomas, and since their nomenclature has recently changed to PitNET, we will focus on this type of tumor, its definition, functional study, and management. Emphasis is also placed on the need for patients to be evaluated by a multidisciplinary team with experience in medical and surgical management</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"36 4","pages":"Pages 237-244"},"PeriodicalIF":0.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912686","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: Actualización en Endocrinología 社论:内分泌学最新进展
IF 0.4
Revista Medica Clinica Las Condes Pub Date : 2025-07-01 DOI: 10.1016/j.rmclc.2025.08.016
{"title":"Editorial: Actualización en Endocrinología","authors":"","doi":"10.1016/j.rmclc.2025.08.016","DOIUrl":"10.1016/j.rmclc.2025.08.016","url":null,"abstract":"","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"36 4","pages":"Page 236"},"PeriodicalIF":0.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912685","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
Carcinoma medular de tiroides: genética, diagnóstico, opciones terapéuticas y seguimiento 甲状腺髓细胞癌:遗传学、诊断、治疗方案和随访
IF 0.4
Revista Medica Clinica Las Condes Pub Date : 2025-07-01 DOI: 10.1016/j.rmclc.2025.08.002
Pedro Pineda MD
{"title":"Carcinoma medular de tiroides: genética, diagnóstico, opciones terapéuticas y seguimiento","authors":"Pedro Pineda MD","doi":"10.1016/j.rmclc.2025.08.002","DOIUrl":"10.1016/j.rmclc.2025.08.002","url":null,"abstract":"<div><div>Medullary thyroid cancer (MTC) is an infrequent neuroendocrine malignant tumor that presents significant challenges in its diagnosis, therapy, and follow-up. The preoperative diagnosis is based on clinical suspicion, measurement of calcitonin (Ct) levels, and careful analysis of cytology obtained by fine needle aspiration. Once the diagnosis is confirmed, genetic testing of RET proto-oncogene should be performed to define prognosis, complementary studies and genetic counseling. Pre and postoperative staging is essential to perform adequate therapy. Cervical surgery is the only potentially curative therapy for MTC. Follow-up should be systematic, with measurement of Ct and CEA levels and appropriate imaging according to disease staging. Systemic therapy should be evaluated on an individual basis, considering the evolution and progression of the disease. As this is a low-frequency malignant tumor with variable behavior, it is recommended that these cases should be managed by experienced multidisciplinary groups.</div><div>The objective of this article is to describe the main characteristics of this neoplasia, highlighting its genetic aspects, clinical manifestations, diagnostic methods, and current treatment and follow-up options.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"36 4","pages":"Pages 288-294"},"PeriodicalIF":0.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912551","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
Hipertensión arterial mineralocorticoidea
IF 0.4
Revista Medica Clinica Las Condes Pub Date : 2025-07-01 DOI: 10.1016/j.rmclc.2025.08.006
Thomas Uslar MD , Rene Baudrand MD , Cristian A. Carvajal PhD , Carlos E. Fardella MD
{"title":"Hipertensión arterial mineralocorticoidea","authors":"Thomas Uslar MD ,&nbsp;Rene Baudrand MD ,&nbsp;Cristian A. Carvajal PhD ,&nbsp;Carlos E. Fardella MD","doi":"10.1016/j.rmclc.2025.08.006","DOIUrl":"10.1016/j.rmclc.2025.08.006","url":null,"abstract":"<div><div>Mineralocorticoid-dependent hypertension is a common form of secondary hypertension that encompasses various disorders sharing a common feature: hyperactivation of the mineralocorticoid receptor. The most relevant causes include primary aldosteronism (PA), 11β-hydroxysteroid dehydrogenase type 2 (11β-HSD2) deficiency, and the hypertensive forms of classic congenital adrenal hyperplasia. PA is an adrenal disorder characterized by inappropriate aldosterone production that is independent of its physiological regulators. It is a frequent cause of secondary hypertension and is associated with higher cardiovascular risks compared to primary (essential) hypertension. Despite the availability of effective diagnostic and therapeutic methods, PA remains underdiagnosed, preventing many patients from receiving personalized, effective, and potentially curative treatments. The aim of this review is to provide healthcare professionals managing patients with arterial hypertension with an updated and practical overview of the main causes of mineralocorticoid-dependent secondary hypertension, with a particular focus on PA. It addresses its pathophysiology, diagnostic criteria, genetic advances, and therapeutic strategies, with the goal of improving its detection and timely management in clinical practice, ultimately reducing the associated morbidity and mortality burden.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"36 4","pages":"Pages 331-339"},"PeriodicalIF":0.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912557","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
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