{"title":"Inteligencia artificial aplicada al cuidado del ataque cerebrovascular: una descripción del estado del arte y expectativas futuras","authors":"Esteban Basáez-Miranda MD","doi":"10.1016/j.rmclc.2025.06.007","DOIUrl":"10.1016/j.rmclc.2025.06.007","url":null,"abstract":"<div><div>Stroke is the second leading cause of death and the first cause of disability in Chile. Given the epidemiological behavior of our country, it is projected that the number of stroke patients will continue to increase in the future, so it is essential to have new public health strategies to address this scenario of high healthcare burden. Artificial intelligence has thus become an extremely useful tool in the management of stroke in its different stages (detection, management, primary and secondary prevention, and rehabilitation). In a narrative way, the different modalities of artificial intelligence are described and, based on their foundations, applications are presented as shown in various clinical works according to the different phases of stroke. Finally, potentials and projections are explored, along with future perspectives and the associated ethical, technical, and public health policy challenges.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"36 3","pages":"Pages 156-162"},"PeriodicalIF":0.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144572260","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}
{"title":"Golpe de calor: claves para el reconocimiento y manejo precoz en tiempos de cambio climático","authors":"Eva Araya MD","doi":"10.1016/j.rmclc.2025.06.002","DOIUrl":"10.1016/j.rmclc.2025.06.002","url":null,"abstract":"<div><div>Heat-related illness includes a continuum of syndromes, the most severe extreme of which is heatstroke. It usually occurs epidemically in relation to heat waves, especially affecting frail older adults, with high mortality. In the face of climate change, an increase in the frequency and intensity of heat waves is expected, and in this scenario it is essential to know the population at greatest risk together with the clinical manifestations of heat stroke, in order to initiate early treatment to reduce mortality.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"36 3","pages":"Pages 198-204"},"PeriodicalIF":0.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144572253","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}
{"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}
{"title":"“¡Y LOS MÉDICOS... OTRA VEZ ASÍ!” 2021","authors":"","doi":"10.1016/j.rmclc.2025.04.007","DOIUrl":"10.1016/j.rmclc.2025.04.007","url":null,"abstract":"","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"36 2","pages":"Page 128"},"PeriodicalIF":0.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143878437","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}
{"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}
{"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}
{"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}
{"title":"Reporte de caso: mioclonias inducidas por quetiapina","authors":"Marcos Franchello MD , Ximena Sagues MD , Jerónimo Cossio MD , Griselda Alvarado MD","doi":"10.1016/j.rmclc.2025.03.005","DOIUrl":"10.1016/j.rmclc.2025.03.005","url":null,"abstract":"<div><div>Quetiapine is an atypical antipsychotic, derived from dibenzothiazepine, widely used for its improved safety profile, particularly in patients with Parkinson's disease. Despite its favorable profile, there have been isolated reports of myoclonus induced by this drug, even at low doses. We present the case of a 71-year-old patient with Parkinson's disease who developed myoclonus after administration of quetiapine at subtherapeutic levels (12.5<!--> <!-->mg). The myoclonus completely resolved after discontinuation of the drug and the introduction of clonazepam, highlighting the importance of recognizing this rare adverse effect.</div><div>.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"36 2","pages":"Pages 84-87"},"PeriodicalIF":0.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143878521","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}
{"title":"Drug-induced hypersensitivity syndrome associated with minocycline prescribed for acne treatment. Case report","authors":"Rodolfo Valenzuela MD , Paola Aravena MD , Katerine Garcia MD , Eduardo Cerda MD , Andrés Ferre MD, MSc","doi":"10.1016/j.rmclc.2025.03.003","DOIUrl":"10.1016/j.rmclc.2025.03.003","url":null,"abstract":"<div><div>Adverse drug reactions (ADR) are unexpected, unpleasant, and comprise a diagnostic challenge for any physician. Some ADRs occur instantly after being exposed to a certain medication, but others, as described in this case, can present weeks after treatment is started. We present a case of severe drug-induced hypersensitivity syndrome after exposure to minocycline prescribed for acne treatment.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"36 2","pages":"Pages 93-97"},"PeriodicalIF":0.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143878523","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}
{"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}