Revista Medica Clinica Las Condes最新文献_第4页

Hemolytic anemia as an initial presentation of gastric signet ring cell carcinoma- a case report 溶血性贫血是胃印戒细胞癌的最初表现- 1例报告

IF 0.2

Revista Medica Clinica Las Condes Pub Date : 2026-05-01 Epub Date: 2026-06-27 DOI: 10.1016/j.rmclc.2026.05.001

Pedro Moules MD, Marta Ferreira MD, Carolina Cabrita Abreu Azevedo MD, Rita Palma Féria MD, Ana Grilo MD

引用次数: 0

Ictericia obstructiva

IF 0.2

Revista Medica Clinica Las Condes Pub Date : 2026-05-01 Epub Date: 2026-06-27 DOI: 10.1016/j.rmclc.2026.05.003

Hanns Lembach MD

{"title":"Ictericia obstructiva","authors":"Hanns Lembach MD","doi":"10.1016/j.rmclc.2026.05.003","DOIUrl":"10.1016/j.rmclc.2026.05.003","url":null,"abstract":"<div><div>Obstructive jaundice is a clinical condition characterized by yellow discoloration of the skin and mucous membranes due to increased plasma bilirubin, usually caused by post-hepatic biliary obstruction. This condition can lead to severe complications such as acute cholangitis, considered a surgical emergency. Biliary obstruction increases pressure in the ducts, impairs liver function, and produces systemic effects: hepatocyte toxicity, altered drug metabolism, increased infection risk, coagulopathy, and renal dysfunction.</div><div>Causes may be benign (choledocholithiasis, biliary stricture, sclerosing cholangitis, parasitosis) or malignant (gallbladder cancer, pancreatic cancer, cholangiocarcinoma). Diagnosis is based on clinical findings (jaundice, dark urine, pale stools, pruritus), laboratory tests (direct hyperbilirubinemia, elevated alkaline phosphatase and gamma-glutamyl transferase), and imaging (initial ultrasound, magnetic resonance cholangiopancreatography, computed tomography, magnetic resonance imaging). The presence of fever, hypotension, and altered mental status suggests acute cholangitis.</div><div>Treatment depends on the cause and patient condition. In cholangitis, stabilization and urgent biliary drainage (endoscopic retrograde cholangiopancreatography, percutaneous drainage, or surgery) are required. For benign obstructions, endoscopic management is preferred; for malignant cases, resectability or palliative drainage is assessed. A multidisciplinary approach is essential to optimize diagnosis and treatment.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"37 3","pages":"Pages 338-346"},"PeriodicalIF":0.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148558374","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}

引用次数: 0

Manejo inicial de la quemadura en urgencias: criterios de evaluación, derivación y tratamiento actualizado 紧急烧伤的初步管理：评估标准、转诊和更新的治疗

IF 0.2

Revista Medica Clinica Las Condes Pub Date : 2026-05-01 Epub Date: 2026-06-27 DOI: 10.1016/j.rmclc.2026.05.008

Juan Pablo Camacho MD, Brenda Gámez MD, Leonardo Parada MD, MHA

引用次数: 0

Urgencias proctológicas 急诊室proctológicas

IF 0.2

Revista Medica Clinica Las Condes Pub Date : 2026-05-01 Epub Date: 2026-06-27 DOI: 10.1016/j.rmclc.2026.05.010

Alejandro J. Zarate MD, Pastora Roca MD, Roberto Salas MD, Camila Leiva EU

引用次数: 0

Infecciones cervicales profundas: de la sospecha clínica a la intervención oportuna 深颈感染：从临床怀疑到及时干预

IF 0.2

Revista Medica Clinica Las Condes Pub Date : 2026-05-01 Epub Date: 2026-06-27 DOI: 10.1016/j.rmclc.2026.05.011

Matías Minassian Munster MD

{"title":"Infecciones cervicales profundas: de la sospecha clínica a la intervención oportuna","authors":"Matías Minassian Munster MD","doi":"10.1016/j.rmclc.2026.05.011","DOIUrl":"10.1016/j.rmclc.2026.05.011","url":null,"abstract":"<div><div>Deep neck infections are uncommon but potentially severe entities that may become life-threatening. They typically arise from septic foci in the head and neck, most frequently of odontogenic origin, and exhibit a polymicrobial etiology dominated by anaerobes and streptococci. The complex fascial anatomy of the neck facilitates their spread into deep spaces and, in advanced cases, into the mediastinum. Clinically, odynophagia, dysphagia, fever, and cervical pain predominate, and airway compromise may occur in more advanced presentations. Contrast-enhanced computed tomography is the diagnostic modality of choice. Management involves broad-spectrum empirical antibiotic therapy, strict airway monitoring, and surgical or image-guided drainage depending on patient characteristics and the extent of disease. Despite therapeutic advances, complications such as mediastinitis, Lemierre's syndrome and vascular erosions continue to be associated with high morbidity and mortality. The objective of this review is to provide a comprehensive overview of deep neck infections, emphasizing the importance of early clinical suspicion and prompt intervention.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"37 3","pages":"Pages 303-313"},"PeriodicalIF":0.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148558367","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}

引用次数: 0

Patología aguda de la vesícula biliar en urgencias 急性胆囊疾病急诊

IF 0.2

Revista Medica Clinica Las Condes Pub Date : 2026-05-01 Epub Date: 2026-06-27 DOI: 10.1016/j.rmclc.2026.05.005

Ignacio Obaid Carrion MD

{"title":"Patología aguda de la vesícula biliar en urgencias","authors":"Ignacio Obaid Carrion MD","doi":"10.1016/j.rmclc.2026.05.005","DOIUrl":"10.1016/j.rmclc.2026.05.005","url":null,"abstract":"<div><div>Acute gallbladder diseases, particularly acute cholecystitis, are among the most common surgical emergencies. In Chile, the high prevalence of gallstone disease leads to a substantial burden of emergency visits, admissions, and urgent surgery. Acute cholecystitis is usually triggered by persistent cystic duct obstruction, leading to gallbladder distension, chemical inflammation, microvascular compromise, ischemia, and secondary bacterial infection, with potential progression to empyema, gangrene, or perforation. Although less frequent, acute acalculous cholecystitis mainly affects critically ill patients and carries higher mortality. Diagnosis relies on clinical findings, systemic inflammation, and imaging, with ultrasound as the first-line modality. Current international guidelines (Tokyo Guidelines and World Society of Emergency Surgery) provide standardized diagnostic criteria, severity grading, and evidence-based management. Early laparoscopic cholecystectomy during the same hospitalization is the definitive treatment for most patients. In those with organ dysfunction or prohibitive surgical risk, gallbladder drainage is a source-control bridge to delayed surgery. This review summarizes evidence and discusses its applicability in Chile, excluding biliary pancreatitis and cholangitis.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"37 3","pages":"Pages 347-352"},"PeriodicalIF":0.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148558362","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}

引用次数: 0

Rehabilitación temprana en cáncer: propuesta de un modelo interdisciplinario basado en vigilancia prospectiva y navegación clínica 癌症早期康复：基于前瞻性监测和临床导航的跨学科模式的建议

IF 0.4

Revista Medica Clinica Las Condes Pub Date : 2026-03-01 Epub Date: 2026-05-02 DOI: 10.1016/j.rmclc.2026.03.004

Francisca Madrid PT, Inés Fuentealba SLP, Patricia Simian OT, Olga Rincón PT

{"title":"Rehabilitación temprana en cáncer: propuesta de un modelo interdisciplinario basado en vigilancia prospectiva y navegación clínica","authors":"Francisca Madrid PT, Inés Fuentealba SLP, Patricia Simian OT, Olga Rincón PT","doi":"10.1016/j.rmclc.2026.03.004","DOIUrl":"10.1016/j.rmclc.2026.03.004","url":null,"abstract":"<div><div>Individuals diagnosed with cancer experience limitations in activities of daily living and usual roles due to the side effects of the disease and its treatments, which may emerge early and persist long term. Despite this, referrals to rehabilitation remain delayed and predominantly reactive. Key barriers include both individual and health system factors, such as age, geographic distance, poor coordination between services, limited awareness of rehabilitation benefits, and the lack of structured referral pathways. This context underscores the need to integrate rehabilitation early into oncologic care.</div><div>In this setting, an interdisciplinary model of early cancer rehabilitation based on prospective surveillance is proposed, aimed at facilitating timely referral and optimizing functional outcomes. International evidence supports the integration of rehabilitation professionals throughout the continuum of cancer care, including oncology physical therapy, pelvic floor rehabilitation, speech-language pathology, and occupational therapy. The prospective surveillance model, widely used in breast cancer, has demonstrated effectiveness in the early detection of functional impairments, supporting its potential extension to other cancer types. Additionally, a rehabilitation navigation role is incorporated, led by a professional with oncology training, responsible for conducting functional screening, providing education, and coordinating referrals based on functional risk in collaboration with the treating team.</div><div>The implementation of this interdisciplinary model, grounded in prospective surveillance and clinical navigation, represents a strategy for early detection of functional limitations, optimization of function, and improvement in quality of life. Future studies are needed to evaluate its implementation and impact across diverse clinical settings.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"37 2","pages":"Pages 204-212"},"PeriodicalIF":0.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147801633","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. Tema central. Oncología centrada en el paciente: de la teoría a la práctica real 出版商。中心问题。以患者为中心的肿瘤学：从理论到实际实践

IF 0.4

Revista Medica Clinica Las Condes Pub Date : 2026-03-01 Epub Date: 2026-05-02 DOI: 10.1016/j.rmclc.2026.04.013

引用次数: 0

Detección precoz del cáncer de mama: impacto clínico, sanitario y desafíos en Chile 乳腺癌的早期发现：智利的临床影响、健康和挑战

IF 0.4

Revista Medica Clinica Las Condes Pub Date : 2026-03-01 Epub Date: 2026-05-02 DOI: 10.1016/j.rmclc.2026.04.005

Paola Andrea Ruiz de Viñaspre Alvear MD, José Luis Soto Noriega MD, Hernando Paredes Farto MD, Nuvia Aliaga Molina MD

引用次数: 0

Guía práctica de tratamiento con SBRT para el carcinoma de células renales 肾细胞癌SBRT治疗实用指南

IF 0.4

Revista Medica Clinica Las Condes Pub Date : 2026-03-01 Epub Date: 2026-05-02 DOI: 10.1016/j.rmclc.2026.04.012

Mariana Alberdi MD, Lorena Vargas MD, Francisca Barahona MD, Pelayo Besa MD, Rodrigo Barrientos MD

引用次数: 0