Revista Medica Clinica Las Condes最新文献

{"title":"Opciones de tratamiento para la apnea obstructiva del sueño leve y moderada","authors":"Jorge Jorquera ,&nbsp;Constanza Salas-Cossio ,&nbsp;Juan Fernando Oyarzo ,&nbsp;Constanza Pacheco ,&nbsp;Margarita Del Favero ,&nbsp;Montserrat Sánchez","doi":"10.1016/j.rmclc.2024.04.001","DOIUrl":"10.1016/j.rmclc.2024.04.001","url":null,"abstract":"<div><p>Obstructive sleep apnea (OSA) is a common disease that causes daytime symptoms, decreased quality of life, increased risk of cardio and cerebrovascular morbidity and mortality, neurocognitive impairments, and higher traffic accident rates. Continuous positive airway pressure therapy (CPAP) is highly effective and has been the treatment of choice for patients with severe disease and those with moderate disease accompanied by daytime symptoms and/or cardiovascular comorbidity. However, CPAP has limitations in terms of acceptance and treatment adherence. There are various treatment options available, such as weight loss, the use of oral devices, positional devices, surgery and emerging therapies like myofunctional therapy. These personalized treatments have shown promising results, particularly in patients with mild to moderate OSA or those seeking an effective alternative to standard treatment. It is increasingly recognized that OSA is a disorder with diverse risk factors, clinical presentations, pathophysiology, and comorbidities. A better understanding of patient heterogeneity will allow for more personalized treatment approaches and ensure the effectiveness of interventions through advanced and precision medicine. This review provides an overview of current approaches to non-surgical treatment of mild to moderate OSA in patients without an indication for CPAP treatment or who reject that option. Additionally, it proposes a therapeutic algorithm to guide the management of these patients.</p></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"35 3","pages":"Pages 281-289"},"PeriodicalIF":0.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0716864024000385/pdfft?md5=7e7d24e906c7478b2b23d3d690d7edf7&pid=1-s2.0-S0716864024000385-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142011942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Características de la enfermedad inflamatoria intestinal pediátrica en un hospital de la capital de Córdoba, Argentina","authors":"Daniel A. Anriquez ,&nbsp;María Alejandra Maidana ,&nbsp;Domingo Balderramo ,&nbsp;María Laura Daruich ,&nbsp;Raquel Furnes","doi":"10.1016/j.rmclc.2024.04.003","DOIUrl":"10.1016/j.rmclc.2024.04.003","url":null,"abstract":"<div><p>Respiratory illnesses are an important cause of morbidity and mortality. Lung cancer is the leading cause of cancer and the leading cause of cancer mortality. Worldwide, chronic obstructive pulmonary disease (COPD) is the third leading cause of death, after cardiovascular and neoplastic diseases. Fibrosing interstitial lung disease has maintained a progressive increase in incidence, with high mortality. This is how respiratory palliative care has acquired relevance in this area of medicine, improving not only quality of life, but also, as is the case with lung cancer, survival. The aim of this article is to demonstrate the need for respiratory palliative care in cancer and non-cancer lung disease, allowing for an earlier and more timely referral for our patients.</p></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"35 3","pages":"Pages 347-354"},"PeriodicalIF":0.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0716864024000452/pdfft?md5=5410d5bde092383085ce3faec1153b41&pid=1-s2.0-S0716864024000452-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142011949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patrones radiológicos en enfermedades pulmonares intersticiales","authors":"Francisca Furnaro L. ,&nbsp;Paulina Sepúlveda P.","doi":"10.1016/j.rmclc.2024.05.003","DOIUrl":"10.1016/j.rmclc.2024.05.003","url":null,"abstract":"<div><p>This article explores the role of high-resolution computed tomography (HRCT) in the diagnosis of diffuse interstitial lung diseases (ILD), discussing key tomographic findings, parenchymal changes, and the importance of identifying various radiological patterns, with a special focus on the usual interstitial pneumonia (UIP) pattern. Given the complexity and diversity of manifestations of diffuse ILD, the collaborative evaluation of a multidisciplinary team, in which the radiologist plays a fundamental role in the diagnostic chain using HRCT, is essential. This exam enables the detection of parenchymal alterations in DILD, such as ground-glass opacities, consolidation, reticular patterns, traction bronchiectasis/bronchiectasis, and honeycombing. The interpretation and association of these findings, along with their distribution, facilitate the establishment of specific radiological patterns that, in addition to indicating possible etiologies, guide the most appropriate therapeutic options. The adoption of specific imaging protocols and the use of standardized language are essential to increase diagnostic accuracy. Moreover, the incorporation of technological innovations, such as advanced photon counting technology and automated analysis through artificial intelligence, promise to significantly improve the identification and quantification of interstitial alterations, shaping the future of thoracic radiology.</p></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"35 3","pages":"Pages 255-261"},"PeriodicalIF":0.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0716864024000348/pdfft?md5=3f60bbe067d997641be283e089428bc7&pid=1-s2.0-S0716864024000348-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142012821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Manejo de la EPOC en la era moderna","authors":"Jorge Dreyse","doi":"10.1016/j.rmclc.2024.05.002","DOIUrl":"10.1016/j.rmclc.2024.05.002","url":null,"abstract":"<div><p>Chronic obstructive pulmonary disease (COPD) is a heterogeneous pathology that impacts more than 380 million people globally, being the third leading cause of death worldwide. Since its recognition in the 1960s, the understanding and management of COPD have significantly evolved, thanks to advances in knowledge about its etiopathogenesis and treatment. The guidelines from the Global Initiative for COPD (GOLD COPD) represent an effort to standardize diagnosis and treatment, with its review in 2023 updating the disease's definition. Proper management of COPD includes accurate diagnosis, pharmacological and non-pharmacological therapies, and prevention strategies focused especially on smoking cessation, the main cause of the disease.</p><p>Diagnosis is based on the history of exposure to noxious particles or gases, with spirometry as a key exam to confirm not completely reversible bronchial obstruction. The treatment strategy has improved with the development of new drugs and administration devices, focusing on reducing symptoms and the risk of exacerbations. Pharmacological therapy is adapted according to the GOLD classification of the patient, with options ranging from bronchodilator therapies to combinations of multiple drugs for more severe cases. The importance of detecting and treating comorbidities is critical, given their high prevalence in patients with COPD and their impact on mortality.</p><p>Non-pharmacological strategies include smoking cessation, long-term oxygen therapy, physical activity, and pulmonary rehabilitation, as well as ensuring adequate immunization. The management of exacerbations must be appropriate and early, as they are associated with an increase in morbidity and mortality.</p><p>This review seeks to provide an evidence based integral approach to the management of COPD.</p></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"35 3","pages":"Pages 209-220"},"PeriodicalIF":0.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0716864024000336/pdfft?md5=10ce4ae73894abdbb1ba377b713b695f&pid=1-s2.0-S0716864024000336-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142011864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paciente que consulta por tos","authors":"Rodrigo Gil-Dib","doi":"10.1016/j.rmclc.2024.05.008","DOIUrl":"10.1016/j.rmclc.2024.05.008","url":null,"abstract":"<div><p>Cough is one of the most common reasons for outpatient medical consultation. Most of the time it is self-limiting so doctors tend not to give it much importance. However, cough can be caused by serious pathologies such as cancer, fibrosis and pulmonary tuberculosis. Furthermore, when the cough is intense or prolonged it can cause significant alterations in the quality of life of patients. In this article we will review the main guidelines for diagnosis and treatment of cough, how to suspect serious etiologies, when to define a treatment according to clinical information and when to request tests. Finally, we will discuss two clinical cases in order to illustrate some concepts.</p></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"35 3","pages":"Pages 201-208"},"PeriodicalIF":0.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0716864024000415/pdfft?md5=b6e0cb5e5f8a294bf3ef09cc6f431f46&pid=1-s2.0-S0716864024000415-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142011930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fragilidad en pacientes con enfermedades respiratorias crónicas: ¿cómo modificarla?","authors":"Francisca Silva-González","doi":"10.1016/j.rmclc.2024.05.009","DOIUrl":"10.1016/j.rmclc.2024.05.009","url":null,"abstract":"<div><p>Frailty is a multidimensional state characterized by a decrease in physiological reserves and resistance to stressors. Its physical dimension is highly recognized and increases vulnerability for developing greater dependency and/or death. Patients with chronic respiratory diseases have a higher risk of developing frailty and among the risk factors are comorbidities, smoking, low levels of physical activity, exacerbations of their underlying pathology, recurrent hospitalizations, poor nutrition and polypharmacy. Frailty is a dynamic and modifiable process. Timely referral to pulmonary rehabilitation programs is one of the different treatments available. The present article describes fragility in chronic respiratory disease patients, and offers tools to evaluate and modify it.</p></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"35 3","pages":"Pages 319-324"},"PeriodicalIF":0.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0716864024000427/pdfft?md5=9cc5359e7ebdb72f107a8ddff71300ca&pid=1-s2.0-S0716864024000427-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142011945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exposición laboral a citostáticos en el equipo de enfermería de atención primaria","authors":"Francisco Miguel Escandell-Rico ,&nbsp;Lucia Pérez-Fernández ,&nbsp;José Martínez-Ribera","doi":"10.1016/j.rmclc.2024.06.002","DOIUrl":"10.1016/j.rmclc.2024.06.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Cytostatic drugs are classified as potentially dangerous to health when handled. Methotrexate is a cytostatic and immunosuppressive drug increasingly used in primary care for the treatment of various rheumatological and dermatological problems. Therefore, those workers, such as nurses, who may be exposed to these risks, as a consequence of their professional work must be observed.</p></div><div><h3>Objectives</h3><p>Describe the management and exposure of methotrexate in the primary care nursing team of Orihuela Health Department, Spain.</p></div><div><h3>Methodology</h3><p>It corresponds to a descriptive observational study, carried out in the period from April 1 to 25, 2023. An observation guide was applied during a direct visit with nursing and following the recommendations of the current protocols for the management and exposure to cytostatics. Sampling was non-probabilistic for convenience. The sample size was calculated based on the nursing staff by estimating a proportion considering 7 health care areas and 31 auxiliary offices. As an inclusion criterion, a minimum of one year's experience in the administration of medication in the units under study was taken into account.</p></div><div><h3>Results</h3><p>Of a total of 124 nurses who provide services in primary care at the Orihuela Health Department, a total of 66 nurses participated. The mean age was 37.34 (SD 12.66). Two groups of nurses were created according to basic health zones with inhabitants of more than 25,000 or less than 25,000. It was considered that the Health Planning of the Territory in the autonomous communities of the Information System defined by Royal Decree 137/1984 of 22, on basic health structures for the improvement of Primary Care. In the observation guide, the lowest values were obtained in the evaluation/information of the patient regarding the management and exposure of methotrexate in the nurses. All nurses in both groups successfully applied the 5 rights of medication administration (route, dose, time, patient, and medication) for the safe management of methotrexate.</p></div><div><h3>Conclusion</h3><p>The results obtained in our research highlight the need to describe the management and exposure of methotrexate in the nursing team and the relevance of seeking methods to improve knowledge and skills. In this sense, this study could, through the observation guide used, improve the management and exposure to methotrexate in the primary care nursing team and avoid unnecessary risks that can have serious consequences for nurses and patients.</p></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"35 3","pages":"Pages 355-363"},"PeriodicalIF":0.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0716864024000476/pdfft?md5=57b8e9cb6aee5d5b894977665ccf146c&pid=1-s2.0-S0716864024000476-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142011952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circadian rest-activity pattern and cardiometabolic illnesses","authors":"Mario Henríquez-Beltrán ,&nbsp;Claudia Jeria ,&nbsp;Eduardo Cruces-Andrews ,&nbsp;Thalía Belmonte","doi":"10.1016/j.rmclc.2024.04.002","DOIUrl":"10.1016/j.rmclc.2024.04.002","url":null,"abstract":"<div><h3>Background</h3><p>A regular circadian rest-activity pattern is essential for optimal health. Any disruption or irregularity can lead to alterations in circadian rhythms, which in turn can trigger cardiometabolic illnesses. This review presents an approach to the literature on the circadian rest-activity pattern and its association with cardiometabolic illnesses.</p></div><div><h3>Method</h3><p>Narrative review.</p></div><div><h3>Results</h3><p>Circadian rest-activity pattern alterations, such as lower stability, reduced robustness, and higher fragmentation of circadian rest-activity rhythms, may be detrimental to human health. Furthermore, objective methods such as wrist actigraphy, questionnaires, and sleep diaries, as well as “dim light melatonin onset” (DLMO), have been proposed as feasible methods to assess the circadian rest-activity pattern.</p></div><div><h3>Conclusion</h3><p>In medical practice, it is crucial to view the circadian rest-activity pattern as a clinical biomarker related to human health. Additionally, alterations in the circadian rest-activity pattern have been linked to cardiometabolic illnesses.</p></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"35 3","pages":"Pages 290-298"},"PeriodicalIF":0.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0716864024000397/pdfft?md5=59aed268732afc10269ea8368a3f32f8&pid=1-s2.0-S0716864024000397-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142011943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neumopaliativo: el cuidado paliativo en patología respiratoria","authors":"Cecilia V. Amigo","doi":"10.1016/j.rmclc.2024.05.007","DOIUrl":"10.1016/j.rmclc.2024.05.007","url":null,"abstract":"<div><p>Respiratory illnesses are an important cause of morbidity and mortality. Lung cancer is the leading cause of cancer and the leading cause of cancer mortality. Worldwide, chronic obstructive pulmonary disease (COPD) is the third leading cause of death, after cardiovascular and neoplastic diseases. Fibrosing interstitial lung disease has maintained a progressive increase in incidence, with high mortality. This is how respiratory palliative care has acquired relevance in this area of medicine, improving not only quality of life, but also, as is the case with lung cancer, survival. The aim of this article is to demonstrate the need for respiratory palliative care in cancer and non-cancer lung disease, allowing for an earlier and more timely referral for our patients.</p></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"35 3","pages":"Pages 325-329"},"PeriodicalIF":0.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0716864024000403/pdfft?md5=3019a3991a0bdaa9fba725b3b118ab73&pid=1-s2.0-S0716864024000403-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142011946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Funciones ejecutivas: ¿cómo impactan en el trastorno del desarrollo del lenguaje? Una revisión narrativa","authors":"Manuel Matías Ambiado-Lillo ,&nbsp;Mariano Guillermo Blake","doi":"10.1016/j.rmclc.2024.07.007","DOIUrl":"10.1016/j.rmclc.2024.07.007","url":null,"abstract":"<div><h3>Introduction</h3><p>The study of communicative cognitive functions in children has been a focus of interest over the decades, aiming to explain the intricate relationships between language and executive functions (EF).</p></div><div><h3>Objective</h3><p>To historically reconstruct the relationship between developmental language disorder (DLD) and executive functions (EF).</p></div><div><h3>Method</h3><p>A narrative review was conducted of articles addressing the association between executive functions and developmental language disorder/specific language impairment. The search was performed in the databases of the “American Speech-Language-Hearing Association” and “PubMed” using the following syntax: (((executive function) AND (developmental language disorder)) OR (executive function)) AND (specific language impairment), without considering publication year restrictions.</p></div><div><h3>Conclusions</h3><p>The convergence of evidence over the decades and the contemporary focus on EF provide a more comprehensive view of the relationship between DLD and executive skills. These conclusions not only enrich the understanding of the underlying processes of DLD but also have crucial implications for clinical practice.</p></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"35 3","pages":"Pages 341-346"},"PeriodicalIF":0.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0716864024000567/pdfft?md5=bcbd3f53f1af4579e8f7832796e3f546&pid=1-s2.0-S0716864024000567-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142011948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}