Revista Medica Clinica Las Condes最新文献

Cáncer de mama HER2-bajo: una nueva era en terapias dirigidas 低her2乳腺癌：靶向治疗的新时代

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Revista Medica Clinica Las Condes Pub Date : 2025-05-01 DOI: 10.1016/j.rmclc.2025.05.003

Benjamín Walbaum MD , Francisco Acevedo MD, MSc , Lidia Medina RN , César Sánchez MD

{"title":"Cáncer de mama HER2-bajo: una nueva era en terapias dirigidas","authors":"Benjamín Walbaum MD , Francisco Acevedo MD, MSc , Lidia Medina RN , César Sánchez MD","doi":"10.1016/j.rmclc.2025.05.003","DOIUrl":"10.1016/j.rmclc.2025.05.003","url":null,"abstract":"<div><div>Breast cancer is a heterogeneous disease that goes beyond traditional clinicopathological classifications. Identifying low and ultra-low levels of HER2 expression through immunohistochemistry, in tumors previously classified as HER2-negative, has led to a paradigm shift in patient management. This reclassification has expanded therapeutic options for a significant proportion of patients, with estimates indicating that over 60% of patients with hormone receptor-positive breast cancers fall into the HER2-low category.</div><div>Trastuzumab deruxtecan, an antibody-drug conjugate, has demonstrated significant survival benefits in patients with advanced HER2-low breast cancer, who, in most cases, were previously candidates solely for chemotherapy following hormonal treatment. However, this therapy is not exempt from toxicity, notably interstitial lung disease/pneumonitis, which can be severe and even fatal in some instances. Early detection of these toxicities and their interdisciplinary management are crucial to optimize clinical outcomes in these patients.</div><div>This article provides an overview of recent advancements in treating patients with HER2-low breast cancer, highlighting pivotal studies and emphasizing the importance of stringent monitoring for toxicities associated with new therapies.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"36 3","pages":"Pages 210-220"},"PeriodicalIF":0.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144572255","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

Hospitalización en los pacientes con enfermedad de parkinson 帕金森氏症住院治疗

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Revista Medica Clinica Las Condes Pub Date : 2025-05-01 DOI: 10.1016/j.rmclc.2025.06.005

Marcos E. Franchello MD , Juan José Paz MD, MSc

引用次数: 0

Encefalitis autoinmune asociada a anticuerpos anti-LGI1: revisión de sus aspectos clínicos, diagnósticos y terapéuticos 与LGI1抗体相关的自身免疫性脑炎：临床、诊断和治疗方面的回顾

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Revista Medica Clinica Las Condes Pub Date : 2025-05-01 DOI: 10.1016/j.rmclc.2025.06.004

Dianelys Herrada-de la Cruz MD , Luis Alberto A. Bustamante-Canales , Catalina Paz Silva-Carrasco , Rocío A. Faúndez-Silva

{"title":"Encefalitis autoinmune asociada a anticuerpos anti-LGI1: revisión de sus aspectos clínicos, diagnósticos y terapéuticos","authors":"Dianelys Herrada-de la Cruz MD , Luis Alberto A. Bustamante-Canales , Catalina Paz Silva-Carrasco , Rocío A. Faúndez-Silva","doi":"10.1016/j.rmclc.2025.06.004","DOIUrl":"10.1016/j.rmclc.2025.06.004","url":null,"abstract":"<div><div>Autoimmune encephalitis associated with anti-LGI1 antibodies is one of the most recognized forms of immune-mediated limbic encephalitis. This condition typically presents with a subacute course of focal seizures, behavioral disturbances, and memory impairment, often accompanied by faciobrachial dystonic seizures. Unlike other types of autoimmune encephalitis, its association with neoplasms is uncommon; however, early recognition is essential due to its favorable prognosis when promptly treated. Diagnosis relies on characteristic clinical features, supportive neuroimaging findings, cerebrospinal fluid abnormalities, and detection of anti-LGI1 antibodies in serum or cerebrospinal fluid. First-line treatment includes immunotherapy with corticosteroids, intravenous immunoglobulin, or plasma exchange. In refractory cases, rituximab has demonstrated positive clinical outcomes and lower relapse rates. This article summarizes the epidemiological, pathophysiological, clinical, diagnostic, and therapeutic aspects of this entity, emphasizing the importance of early clinical suspicion. Moreover, it highlights that there are cases with highly suggestive clinical manifestations where antibody titers may be low or undetectable, underscoring the critical role of clinical judgment in the diagnostic process.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"36 3","pages":"Pages 192-197"},"PeriodicalIF":0.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144572252","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

cefalea por uso excesivo de fármacos 药物滥用头痛

IF 0.2

Revista Medica Clinica Las Condes Pub Date : 2025-05-01 DOI: 10.1016/j.rmclc.2025.06.006

Alex R. Espinoza MD

{"title":"cefalea por uso excesivo de fármacos","authors":"Alex R. Espinoza MD","doi":"10.1016/j.rmclc.2025.06.006","DOIUrl":"10.1016/j.rmclc.2025.06.006","url":null,"abstract":"<div><div>Medication overuse headache (MOH) is a complex and still-developing entity, with diagnostic criteria established in the 3rd edition of the International Classification of Headache Disorders (ICHD-3). It has a prevalence of 2.2% in the general population and produces a severe burden of disease in those who suffer from it. Patients are heterogeneous in several respects; it has not been determined whether the patient's genetic makeup triggers a chronic headache, or if the medications themselves are the sole cause of the chronicity of the patient's primary baseline headache. There are complicated and uncomplicated MOH. Treatment must be multidisciplinary. Abrupt detoxification, associated with the early initiation of preventive therapy, has been shown to be most effective. New therapies for the preventive treatment of migraine have generated new paradigms in the management of MOH, and there are currently several therapeutic alternatives. There are three detoxification regimens: outpatient regimen, hospitalization in a health center, and day hospitalization. The medium and long-term prognosis is positive, but a follow-up program is required for these patients over time due to their high relapse rate, especially during the first year.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"36 3","pages":"Pages 169-180"},"PeriodicalIF":0.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144572250","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

Complicaciones neurológicas relacionadas con la inmunoterapia en pacientes oncológicos 癌症患者与免疫治疗有关的神经系统并发症

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Revista Medica Clinica Las Condes Pub Date : 2025-05-01 DOI: 10.1016/j.rmclc.2025.06.001

Gabriela Montecinos MD, Florencia del Río MD

引用次数: 0

Crisis miasténica, diagnóstico y tratamiento 肌无力危机的诊断和治疗

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Revista Medica Clinica Las Condes Pub Date : 2025-05-01 DOI: 10.1016/j.rmclc.2025.06.003

Luis Gutiérrez Panchana MD , Luis Pedraza Castillo MD

引用次数: 0

COLEDOCOCELE en adulto mayor: una causa inusual de pancreatitis aguda a repetición. Reporte de caso 成人蛔虫：急性复发胰腺炎的一种不寻常的病因。案例报告

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Revista Medica Clinica Las Condes Pub Date : 2025-05-01 DOI: 10.1016/j.rmclc.2025.05.001

Eduardo Segovia-Vergara , María Goitia-Inojosa MD , Sebastián Bravo-Cuvia MD , Renato Carrasco-Farías MD , Rodrigo Mansilla-Vivara MD, MHA

{"title":"COLEDOCOCELE en adulto mayor: una causa inusual de pancreatitis aguda a repetición. Reporte de caso","authors":"Eduardo Segovia-Vergara , María Goitia-Inojosa MD , Sebastián Bravo-Cuvia MD , Renato Carrasco-Farías MD , Rodrigo Mansilla-Vivara MD, MHA","doi":"10.1016/j.rmclc.2025.05.001","DOIUrl":"10.1016/j.rmclc.2025.05.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Choledochal cysts refer to the cystic dilation of a segment of the bile duct. They have an incidence of 1 in 100,000-150,000 individuals, being more common in women. Twenty percent are diagnosed in adulthood and may complicate various pancreatobiliary diseases, including recurrent acute pancreatitis. If left untreated, it may lead to significant complications in adulthood. This case emphasizes the need to consider anatomical causes in patients with pancreatitis of unclear etiology in order to improve diagnosis and management.</div></div><div><h3>Case Report</h3><div>A 69-year-old woman with a history of previous cholecystectomy and two episodes of non-alcoholic acute pancreatitis, presented with epigastric pain radiating in band, associated with vomiting and abdominal distension. The patient did not refer drug or alcohol consumption. Laboratory parameters revealed hyperamylasemia. Magnetic resonance cholangiopancreatography indicated cystic dilation of the distal common bile duct. Endoscopic sphincterotomy and unroofing of the choledochocele were performed under endoscopic retrograde cholangiopancreatography (ERCP), with complete clinical recovery.</div></div><div><h3>Discussion and Conclusion</h3><div>Choledochocele is an uncommon pathology in adults and difficult to suspect as the primary cause of recurrent acute pancreatitis. Treatment depends on its classification, with ERCP being the treatment of choice in this case. This approach allows resolution and prevents recurrence of complications and potential malignancy of the lesion.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"36 3","pages":"Pages 205-209"},"PeriodicalIF":0.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144572254","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

Injuria cerebral precoz en la hemorragia subaracnoidea aneurismática: comprendiendo la ﬁsiopatología para optimizar el manejo intensivo 动脉瘤亚颈动脉出血的早期脑损伤：了解滤波器病理以优化强化治疗

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Revista Medica Clinica Las Condes Pub Date : 2025-05-01 DOI: 10.1016/j.rmclc.2025.06.009

Andrés Reccius-Meza MD

{"title":"Injuria cerebral precoz en la hemorragia subaracnoidea aneurismática: comprendiendo la ﬁsiopatología para optimizar el manejo intensivo","authors":"Andrés Reccius-Meza MD","doi":"10.1016/j.rmclc.2025.06.009","DOIUrl":"10.1016/j.rmclc.2025.06.009","url":null,"abstract":"<div><div>Early brain injury (EBI) following aneurysmal subarachnoid hemorrhage represents a critical phase of brain damage occurring within the first 72hours after aneurysmal rupture. Traditionally underestimated in favor of delayed cerebral ischemia, EBI has emerged as a key determinant of both functional and vital prognosis in these patients.</div><div>EBI is characterized by a multifactorial cascade of events, including intracranial hypertension, global cerebral ischemia, disruption of the blood–brain barrier, cerebral edema, neurovascular inflammation, oxidative stress, and apoptosis, as well as alterations in cerebral blood flow autoregulation. Moreover, EBI is not confined to the brain: it triggers a systemic response that affects the cardiovascular system, lungs, immune system, and other peripheral organs, thereby amplifying secondary cerebral injury.</div><div>A comprehensive understanding of these mechanisms has driven the development of physiopathologically targeted therapeutic strategies aimed at preserving cerebral perfusion, oxygenation, and metabolism, controlling intracranial pressure, preventing epileptic seizures, and avoiding multiorgan failure. In this context, multimodal neuromonitoring has become an essential tool for tailoring real-time, individualized treatments.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"36 3","pages":"Pages 181-191"},"PeriodicalIF":0.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144572262","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

Duelo perinatal, salud mental y la importancia del acompañamiento psicológico 围产期丧亲、心理健康和心理支持的重要性

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Revista Medica Clinica Las Condes Pub Date : 2025-05-01 DOI: 10.1016/j.rmclc.2025.05.002

Francisca Cortés-Cataldo , Marcia Olhaberry-Huber , Catalina Sieverson-Raddatz , Macarena Romero-Jiménez , María Trinidad Tagle-Silva , Constanza Mena-Silva , Carolina Honorato-Miranda , Angélica Muñoz Anguita , Daniela Iribarren-Jaramillo

{"title":"Duelo perinatal, salud mental y la importancia del acompañamiento psicológico","authors":"Francisca Cortés-Cataldo , Marcia Olhaberry-Huber , Catalina Sieverson-Raddatz , Macarena Romero-Jiménez , María Trinidad Tagle-Silva , Constanza Mena-Silva , Carolina Honorato-Miranda , Angélica Muñoz Anguita , Daniela Iribarren-Jaramillo","doi":"10.1016/j.rmclc.2025.05.002","DOIUrl":"10.1016/j.rmclc.2025.05.002","url":null,"abstract":"<div><div>Grief is a normal, emotional and psychological adaptive response to a significant loss. Particularly, mourning the death of a child is considered one of the most stressful and devastating situations that a human being can experience. Perinatal grief is defined as the reaction after the death of a baby during pregnancy and up to the first month of life. Not receiving specialized care to cope with perinatal grief has been associated with an increased risk of developing mental health disorders. In the last decade there has been a significant increase in national and international initiatives that promote the validation of perinatal grief and its support. The objective of this article is to provide a review of the evidence regarding perinatal grief and its impact on mental health, considering its definition and approach throughout history and current proposals for its support and elaboration. Despite the advances in making visible the psychological impact of perinatal grief, greater systematization of experiences at the national level in different health care centers, both public and private, is still required.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"36 3","pages":"Pages 221-227"},"PeriodicalIF":0.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144572256","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

“una sala de hospital durante la visita del médico jefe” 1889 “一个病房在首席医生的访问”1889年

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Revista Medica Clinica Las Condes Pub Date : 2025-05-01 DOI: 10.1016/j.rmclc.2025.06.011

引用次数: 0