Revista Medica Clinica Las Condes最新文献

{"title":"Revisión de artrodesis subtalar por no unión: a propósito de un caso","authors":"Gregorio Verschae MD ,&nbsp;Valentín Val MD ,&nbsp;Vicente Alba MD ,&nbsp;Andrés Cáceres MD ,&nbsp;Sebastián Pavez MD ,&nbsp;Nicolás Cid MD","doi":"10.1016/j.rmclc.2025.01.002","DOIUrl":"10.1016/j.rmclc.2025.01.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Subtalar arthrodesis is a surgical procedure aimed at fusing the subtalar joint. One of the most common complications of this procedure is non-union. This article aims to analyze the study and management of non-union in general, as well as its specific approach in the context of subtalar arthrodesis. Given that this is a common complication, it is crucial to enhance knowledge on this topic.</div></div><div><h3>Case Report</h3><div>42-year-old healthy male patient with a background of post-traumatic osteoarthritis of the left ankle, initially treated with tibiotalar arthrodesis in 2022 with subsequent revisions due to poor outcomes, presenting osteoarthritis of the subtalar joint that required management with a subtalar arthrodesis. The latter evolved with symptomatic non-union and it was decided to perform a revision subtalar arthrodesis in July 2024.</div></div><div><h3>Result</h3><div>The patient showed a favourable postoperative clinical evolution, with adequate alignment and position of the osteosynthesis elements, with no signs of infection. At the last check-up (one month postoperatively), protected loading with an orthopaedic boot was started, showing a good recovery.</div></div><div><h3>Conclusions</h3><div>Non-unions in joint fusions, particularly in subtalar arthrodesis, represent a significant challenge in traumatology, with high complication rates. Evaluation of non-unions should include a thorough clinical examination, laboratory testing and imaging techniques. Identification of risk factors, both systemic and local, along with proper surgical planning, are essential in preventing complications. Treatment strategies should address the underlying causes; surgical options and their success should have a multidimensional approach that addresses both technical and biological aspects of the procedure. Finally, the implementation of well-structured diagnostic and therapeutic algorithms is crucial to improve functional outcomes and ensure successful bone fusion.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"36 1","pages":"Pages 13-20"},"PeriodicalIF":0.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143453417","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":"Hipertensión pulmonar y enfermedad del tejido conectivo, una grave presentación","authors":"Neguith Marrugo MD ,&nbsp;Elián Giordanino MD ,&nbsp;Gerardo Palma MD ,&nbsp;Juan Carlos Venegas MD","doi":"10.1016/j.rmclc.2025.01.004","DOIUrl":"10.1016/j.rmclc.2025.01.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Pulmonary arterial hypertension (PAH) is a rare condition characterized by elevated pulmonary artery pressure (&gt;20<!--> <!-->mmHg) and increased vascular resistance. It affects 5 to 15 adults per million, causing dyspnea, chest pain, risk of right heart failure and death. Below, we describe a case of severe pulmonary arterial hypertension whose diagnosis was established after a recovered cardiac arrest.</div></div><div><h3>Clinical Case</h3><div>A 48-year-old man presented with edema, presyncope, and progressive dyspnea over 6 months. He suffered a cardiorespiratory arrest due to pulseless electrical activity and subsequent asystole, requiring resuscitation, norepinephrine, and mechanical ventilation. Echocardiography revealed severe pulmonary hypertension (pulmonary artery systolic pressure of 59<!--> <!-->mmHg), preserved left ventricular function, and severe right ventricular dilation. Computed tomography angiography ruled out pulmonary embolism. Treatment with dobutamine and negative fluid balance improved his hemodynamics. Right heart catheterization confirmed precapillary pulmonary hypertension. Sildenafil, nitric oxide, and later, ambrisentan were initiated. Rheumatologic studies identified rheumatoid arthritis with overlapping Sjögren syndrome as the likely etiology of his pulmonary hypertension. The patient improved with targeted pulmonary hypertension therapy and prednisone, was successfully weaned off mechanical ventilation and was discharged, remaining stable at the one-month follow-up.</div></div><div><h3>Discussion</h3><div>PAH associated with connective tissue diseases, such as Sjögren syndrome and rheumatoid arthritis is rare. Treatments include endothelin receptor antagonists, phosphodiesterase-5 inhibitors, prostanoids, and drug combinations. Appropriate immunological treatment for underlying rheumatologic diseases, like rheumatoid arthritis, may improve PAH. In this case, an integral approach, including pulmonary vasodilators and preload control, was key to the patient's recovery.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"36 1","pages":"Pages 31-35"},"PeriodicalIF":0.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143452710","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":"Leiomioma anal: reporte de un caso","authors":"Alejandro Zárate MD ,&nbsp;María Trinidad Triat MD","doi":"10.1016/j.rmclc.2025.02.001","DOIUrl":"10.1016/j.rmclc.2025.02.001","url":null,"abstract":"<div><h3>Objective</h3><div>To present the clinical characteristics, diagnostic study and treatment of a patient with a perianal mass, ultimately diagnosed as a leiomyoma.</div></div><div><h3>Clinical case</h3><div>43-year-old female patient, who consulted because of discomfort and a non-bleeding perianal mass found 3 months prior that had been treated as inflamed hemorrhoids. Upon examination by a specialist, a nodule measuring 3<!--> <!-->×<!--> <!-->3<!--> <!-->×<!--> <!-->3<!--> <!-->cm, with semi-solid consistency and no inflammatory signs, stands out in the right lateral perianal area. The MRI shows a solid tumor adjacent to the external anal sphincter. The colonoscopy did not reveal intraluminal lesions. Surgical procedure: right lateral perianal incision, surrounding and completely resecting the tumor. The patient was discharged the next day.</div></div><div><h3>Results</h3><div>Pathological report: Well-defined tumor composed by fused cells with oval-elongated nuclei, blunt edges and small amount of eosinophilic cytoplasm, arranged as disorganized fascicles intertwined in a fibrous stroma. Histochemical study: desmin: positive, DOG1: negative, S100: negative; confirming the diagnosis of this leiomyoma. After a 2-year follow-up, no clinical or radiological recurrence is observed.</div></div><div><h3>Conclusion</h3><div>This case displays the need to consider differential diagnoses in patients with a perianal mass that do not respond to classic treatment.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"36 1","pages":"Pages 47-50"},"PeriodicalIF":0.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143452775","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":"Reunidos en torno al paciente, un espacio de encuentro y colaboración atemporal","authors":"","doi":"10.1016/j.rmclc.2025.02.004","DOIUrl":"10.1016/j.rmclc.2025.02.004","url":null,"abstract":"","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"36 1","pages":"Page 6"},"PeriodicalIF":0.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143453069","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":"Dermatitis psoriasiforme por inhibidores de los puntos de control Inmunitarios","authors":"José González-Fernández MD ,&nbsp;Sergio García-González MD ,&nbsp;Mariano Ara-Martín MD, PhD ,&nbsp;Francesc Felipo Berlanga MD ,&nbsp;Victoria Lezcano-Biosca MD","doi":"10.1016/j.rmclc.2025.02.003","DOIUrl":"10.1016/j.rmclc.2025.02.003","url":null,"abstract":"","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"36 1","pages":"Pages 51-54"},"PeriodicalIF":0.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143453135","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":"Evaluación de la eficacia del consejo nutricional y suplemento dietético en el control de la neuropatía periférica inducida por quimioterapia","authors":"Laura Fernández Madrigal MD,&nbsp;Matilde Bolaños Naranjo MD,&nbsp;Juan Bayo Calero MD","doi":"10.1016/j.rmclc.2025.01.007","DOIUrl":"10.1016/j.rmclc.2025.01.007","url":null,"abstract":"<div><div>Chemotherapy-induced peripheral neuropathy (CIPN) is a heterogeneous group of neuropathies caused by oncological treatments and is the most common neurological complication related to chemotherapy. Currently, there are few treatment alternatives. The objective of our study is the assessment and control of CIPN, through nutritional advice associated with a dietary supplement (DS) based on non-enzymatic antioxidants (Neuronuva®).</div><div>A quasi-experimental study with a six month follow-up was carried out in 31 patients. Measurements that included a questionnaire and physical examination were performed at baseline, at 3 and 6 months, in patients with acute or chronic CIPN grade 2 or higher on the NCI-CTCAE scale. NPIQ was caused by oxaliplatin in 54.8%, by paclitaxel in 19.4%, by cisplatin, carboplatin or nabpaclitaxel in 6.5% each and by docetaxel or eribulin in 3.2% respectively. At three months after the start of nutritional advice and SD, 24 patients showed improvement in NPIQ with an objective response rate of 77.4% (95% CI 0.61-0.93), 5 patients (16.1%) showed no changes, and 2 patients discontinued SD. After administration of SD, NPIQ showed improvement at three months (p<!--> <!-->=<!--> <!-->0.001) and at six months (p<!--> <!-->=<!--> <!-->0.002). Although there is no effective therapy thats completely controls CIPN, the data obtained in our study are favourable, showing a clear improvement in CIPN in more than 2/3 of patients. We propose carrying out larger multicentre confirmatory studies. In addition, the use of this DS, together with nutritional measures, could be considered as prophylaxis in chemotherapies that are more neurotoxic.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"36 1","pages":"Pages 55-61"},"PeriodicalIF":0.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143453393","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":"Fe de errata de “Manejo de la epoc en la era moderna” [REV. MED. CLIN. CONDES - 2024; 35(3-4) 209-220]","authors":"Jorge Dreyse","doi":"10.1016/j.rmclc.2025.02.002","DOIUrl":"10.1016/j.rmclc.2025.02.002","url":null,"abstract":"","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"36 1","pages":"Pages 62-63"},"PeriodicalIF":0.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143453414","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":"Enseñar activamente","authors":"","doi":"10.1016/j.rmclc.2024.10.008","DOIUrl":"10.1016/j.rmclc.2024.10.008","url":null,"abstract":"","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"35 5","pages":"Page 548"},"PeriodicalIF":0.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142651266","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":"Restauración volumétrica autóloga en pacientes con hemiatrofia adiposa facial","authors":"Alicia María Tamayo-Carbón MD ,&nbsp;Gloribeth Carrasco MD ,&nbsp;Melvis Anaya-Blanco MD ,&nbsp;Zainela Labordes-López MD ,&nbsp;Miguel del Toro-Pazos MD ,&nbsp;Diana Katherine Cuastumal-Figueroa MD","doi":"10.1016/j.rmclc.2024.08.005","DOIUrl":"10.1016/j.rmclc.2024.08.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Facial lipoatrophy lacks standard clinical criteria for its diagnosis and treatment; however, patients with hemifacial atrophy increase, affecting the mental health of patients who suffer from it. Lipografting has been rescued as an effective and safe treatment option.</div></div><div><h3>Objective</h3><div>To show the results of autologous volumetric restoration in patients with facial adipose hemiatrophy.</div></div><div><h3>Method</h3><div>Multicenter, descriptive, longitudinal and prospective study carried out on 29 patients treated at the Hermanos Ameijeiras Hospital, Cuba and the EIMEC clinic, Spain in the period from July 2018 to July 2023. Both sexes were included, between 19 and 75 years old, with facial asymmetry due to unilateral decrease in subcutaneous cellular tissue.</div></div><div><h3>Results</h3><div>The average age was 47.9 years. Women predominated with 79.3%. The most common etiologies were idiopathic, autoimmune and orbital trauma, each accounting for 17.2%. According to the degree of severity, grade II was the highest, with 65.5%, and grade III represented 34.5% of the total. Regarding the amount of grafted adipose tissue, 62.1% of the cases were 31 to 60<!--> <!-->ml, and 27.6% more than 60<!--> <!-->ml. According to the number of graft applications, 72.4% required one and 27.6% two applications. 93.1% had no complications and 6.9% reported 50% reabsorption of the graft. Patient satisfaction reached 100% and the results were classified as good in 86.21%; when there was improvement, without complications as well as patient satisfaction.</div></div><div><h3>Conclusion</h3><div>Autologous lipotransfer assisted with adipose tissue stem cells is a safe treatment option that offers good results in correcting asymmetry caused by hemifacial lipoatrophy.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"35 5","pages":"Pages 535-542"},"PeriodicalIF":0.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142651264","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":"Autorregulación del aprendizaje en estudiantes chilenos de nivel técnico superior de Odontología: diferencias entre género y semestre de estudio","authors":"Pia Dortty Huguette Chieyssal Martineau MA ,&nbsp;Abdul Hernández Cortina MA, MSc, PhD","doi":"10.1016/j.rmclc.2024.09.004","DOIUrl":"10.1016/j.rmclc.2024.09.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Self-regulated learning is associated with educational and demographic variables. However, few studies have associated gender with study profiles of self-regulated learning (SRL) in a population of students attending a technical education institute. To address the gaps in previous self-regulated learning profile research, the current study describes the levels of self-regulated learning in students attending odontology courses at a technical education institute. We also analyze the possible relationship between gender and SRL, and we identify the self-regulated learning differences between 2nd and 4th semester students.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted on 84 students enrolled in a professional technical institution in Santiago, Chile. The self-regulated learninǵs questionnaire was used for data collection. Statistical analysis of self-regulated learning included central tendency (mean), step-to-step variability (standard deviation), and distribution (skewness and kurtosis). The Mann-Whitney U test and the Student's t-test were calculated to compare groups.</div></div><div><h3>Results</h3><div>Out of 259 contacted students, 84 students (mean age 23.8<!--> <!-->±<!--> <!-->7.4 years, 91.7% female) participated. The self-regulated learning average was high and more positive among males (293.6 SD<!--> <!-->=<!--> <!-->64.8) than females (292.4 SD<!--> <!-->=<!--> <!-->45.0). There were no significant differences in self-regulated learning between students's genders (U<!--> <!-->=<!--> <!-->704). There were not any significant differences in this variable by semester either (t<!--> <!-->=<!--> <!-->9993, 95% CI<!--> <!-->=<!--> <!-->−20.5-20.3).</div></div><div><h3>Conclusions</h3><div>The results expand our understanding of self-regulated learning for students enrolled in a Technical Education Institute. In the future, the relationship between the students’ self-regulated learning and gender should be studied further.</div><div>.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"35 5","pages":"Pages 429-437"},"PeriodicalIF":0.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142651122","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}