Revista Medica Clinica Las Condes最新文献_第5页

Ki67 como factor pronóstico dependiente de la edad en cáncer de mama rh positivo/HER2 negativo en etapa temprana Ki67作为早期rh阳性/HER2阴性乳腺癌的年龄依赖性预后因素

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Revista Medica Clinica Las Condes Pub Date : 2026-03-01 Epub Date: 2026-05-02 DOI: 10.1016/j.rmclc.2026.04.001

B. Christine Constabel MD , Francisco Acevedo MD , Alejandro Cataldo , Pablo A. Rey , César Sánchez MD , Antoine Sauré , Benjamín Walbaum MD

{"title":"Ki67 como factor pronóstico dependiente de la edad en cáncer de mama rh positivo/HER2 negativo en etapa temprana","authors":"B. Christine Constabel MD , Francisco Acevedo MD , Alejandro Cataldo , Pablo A. Rey , César Sánchez MD , Antoine Sauré , Benjamín Walbaum MD","doi":"10.1016/j.rmclc.2026.04.001","DOIUrl":"10.1016/j.rmclc.2026.04.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Breast cancer (BC) incidence in young women has increased. However, a few studies have examined prognostic factors specific to this population.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study of stage I–III HR+/HER2– BC patients diagnosed between 2012 and 2021. We compared clinicopathological features and invasive disease-free survival (IDFS) between women aged<50 and =50 years.</div></div><div><h3>Results</h3><div>Among 2,826 patients, 819 (29%) were under 50. Younger patients had higher Ki67 and lower IDFS compared to older women. Stage III disease was associated with worse IDFS in both age groups. Ki67 significantly predicted recurrence in patients =50 years (p=0.016), but not in those<50 (p=0.454).</div></div><div><h3>Discussion and Conclusion</h3><div>Clinical stage was a strong prognostic factor regardless of age. Women<50 with HR+/HER2– BC had poorer outcomes and higher tumor proliferation. These findings highlight the need for age-specific prognostic biomarkers in young women with luminal breast cancer.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"37 2","pages":"Pages 253-262"},"PeriodicalIF":0.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147801639","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

Más allá del antígeno prostático específico: actualización sobre la detección precoz del cáncer de próstata 超越前列腺特异性抗原：前列腺癌早期检测的最新情况

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Revista Medica Clinica Las Condes Pub Date : 2026-03-01 Epub Date: 2026-05-02 DOI: 10.1016/j.rmclc.2026.04.002

Pablo Rojas-Ruz MD , Norman Zambrano-Aravena MD

{"title":"Más allá del antígeno prostático específico: actualización sobre la detección precoz del cáncer de próstata","authors":"Pablo Rojas-Ruz MD , Norman Zambrano-Aravena MD","doi":"10.1016/j.rmclc.2026.04.002","DOIUrl":"10.1016/j.rmclc.2026.04.002","url":null,"abstract":"<div><div>Prostate cancer (PCa) is one of the most common malignancies and a significant cause of male mortality. The routine use of prostate-specific antigen (PSA) has contributed to a reduction in disease-specific mortality; however, its low specificity has led to overdiagnosis and overtreatment. The aim of this review is to summarize recent evidence on early detection strategies within the context of personalized medicine.</div><div>PCa risk is primarily determined by age, family history, modifiable factors (e.g., obesity and high-fat diets), and genetic alterations such as BRCA2 and HOXB13, which are associated with more aggressive disease. Current screening strategies focus on detecting clinically significant cancer. PSA-based screening reduces disease-specific mortality but does not impact overall mortality, and digital rectal examination has limited value as a screening tool.</div><div>International guidelines recommend a risk-adapted, individualized approach, typically starting between 45–50 years of age or earlier in high-risk populations. Multiparametric magnetic resonance imaging (mpMRI) has become a key tool, reducing unnecessary biopsies and the detection of clinically insignificant tumors.</div><div>Blood- and urine-based biomarkers may improve risk stratification, although their use remains limited. Emerging strategies such as liquid biopsy and artificial intelligence show promise in optimizing early detection. Current screening strategies are based on a multimodal model that prioritizes the detection of clinically significant disease while reducing unnecessary interventions.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"37 2","pages":"Pages 170-177"},"PeriodicalIF":0.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147801598","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

Importancia de los estudios genéticos germinales en la terapia oncológica: más allá del cáncer hereditario 生殖系遗传学研究在癌症治疗中的重要性：超越遗传性癌症

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Revista Medica Clinica Las Condes Pub Date : 2026-03-01 Epub Date: 2026-05-02 DOI: 10.1016/j.rmclc.2026.04.006

Elsa Cabrera Acosta MD

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Cáncer de pulmón: el sueño de detectar en etapas precoces 肺癌：早期发现的梦想

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Revista Medica Clinica Las Condes Pub Date : 2026-03-01 Epub Date: 2026-05-02 DOI: 10.1016/j.rmclc.2026.04.010

Patricia Bitar MD , María Paz Saavedra Md

引用次数: 0

Evolución en el tratamiento de la leucemia mieloide aguda no promielocítica, de la investigación a la práctica clínica 急性非粒细胞性骨髓性白血病从研究到临床实践的治疗进展

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Revista Medica Clinica Las Condes Pub Date : 2026-03-01 Epub Date: 2026-05-02 DOI: 10.1016/j.rmclc.2026.04.003

Paola Aravena MD

{"title":"Evolución en el tratamiento de la leucemia mieloide aguda no promielocítica, de la investigación a la práctica clínica","authors":"Paola Aravena MD","doi":"10.1016/j.rmclc.2026.04.003","DOIUrl":"10.1016/j.rmclc.2026.04.003","url":null,"abstract":"<div><div>Acute myeloid leukemia is a heterogeneous clonal hematologic malignancy and the most common leukemia in adults, with an incidence of approximately 4 cases per 100 000 inhabitants per year, increasing with age. In Chile, overall survival remains limited, particularly among patients over 60 years old, due to restricted access to molecular diagnostics, targeted therapies, and transplantation.</div><div>In recent decades, advances in molecular biology have reshaped the understanding and management of acute myeloid leukemia. Recurrent mutations have led to the development of targeted therapies that significantly improve outcomes. The introduction of Fms-like tyrosine kinase 3 inhibitors like midostaurina or gilteritinib, B cell lymphoma 2 inhibitors like venetoclax and hypomethylating agents like azacytidine or decitabine (has expanded treatment options and increased survival in patients unfit for intensive chemotherapy.</div><div>In Chile, challenges remain regarding the implementation of next-generation sequencing delayed cytogenetic results, and inequitable access to new therapies. Strengthening diagnostic infrastructure and national collaborative groups is crucial to ensure equitable, biology-driven AML care.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"37 2","pages":"Pages 178-185"},"PeriodicalIF":0.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147801599","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

Mejorando la formación médica mediante evaluaciones de 360 grados: Una revisión y propuesta para la formación en la UCI 通过360度评估加强医疗培训：统一医疗中心培训的审查和建议

IF 0.4

Revista Medica Clinica Las Condes Pub Date : 2026-03-01 Epub Date: 2026-05-02 DOI: 10.1016/j.rmclc.2026.03.005

Andrés Giglio MD, MSc, MHA, MPH , Andrés Ferre MD, MSc , César Pedreros MD , Valentina Vuletin RN , Soledad Armijo-Rivera MD, MSc

{"title":"Mejorando la formación médica mediante evaluaciones de 360 grados: Una revisión y propuesta para la formación en la UCI","authors":"Andrés Giglio MD, MSc, MHA, MPH , Andrés Ferre MD, MSc , César Pedreros MD , Valentina Vuletin RN , Soledad Armijo-Rivera MD, MSc","doi":"10.1016/j.rmclc.2026.03.005","DOIUrl":"10.1016/j.rmclc.2026.03.005","url":null,"abstract":"<div><div>The training of medical residents requires educational strategies that foster the comprehensive development of clinical, communication, and professional competencies. In this context, 360-degree evaluations have emerged as an alternative to traditional assessment methods, enabling a more comprehensive appraisal of performance. This narrative review aimed to analyze their implementation, effectiveness, challenges, and long-term outcomes in medical education. A comprehensive literature search was conducted using terms related to “360-degree evaluation,” “multisource feedback,” and “health education,” identifying 34 studies across diverse training settings.</div><div>Findings indicate that 360-degree evaluations provide a holistic perspective by integrating feedback from multiple sources, including peers, supervisors, patients, and self-assessment. Their use is associated with improvements in clinical competencies, communication skills, professionalism, and overall performance. Additionally, continuous feedback promotes reflective practice and sustained professional development, contributing to improved quality of care and patient satisfaction.</div><div>However, several challenges were identified, including evaluator bias, logistical complexities, and difficulties in effectively integrating feedback into training programs. Successful implementation strategies include structured evaluator training, the use of standardized tools, regular feedback sessions, and strong institutional support supported by appropriate technological platforms.</div><div>In conclusion, 360-degree evaluations represent a valuable complement to traditional assessment methods by providing a multidimensional view of resident performance. Careful implementation can maximize their benefits and contribute to both professional development and the quality of healthcare delivery.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"37 2","pages":"Pages 263-274"},"PeriodicalIF":0.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147801640","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

Drogas oncológicas de alto costo: entre la innovación terapéutica, la justicia distributiva y la sostenibilidad de los sistemas de salud 高成本癌症药物：在治疗创新、分配公平和卫生系统可持续性之间

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Revista Medica Clinica Las Condes Pub Date : 2026-03-01 Epub Date: 2026-05-02 DOI: 10.1016/j.rmclc.2026.04.008

Moises Russo Namias MD

引用次数: 0

On preventive scopes for alzheimer's disease: towards decreasing it's incidence on high-risk populations 关于阿尔茨海默病的预防范围：减少其在高危人群中的发病率

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Revista Medica Clinica Las Condes Pub Date : 2026-03-01 Epub Date: 2026-05-02 DOI: 10.1016/j.rmclc.2026.03.006

Andrea González PhD , Gerardo Fasce MD , Ricardo Maccioni PhD

{"title":"On preventive scopes for alzheimer's disease: towards decreasing it's incidence on high-risk populations","authors":"Andrea González PhD , Gerardo Fasce MD , Ricardo Maccioni PhD","doi":"10.1016/j.rmclc.2026.03.006","DOIUrl":"10.1016/j.rmclc.2026.03.006","url":null,"abstract":"<div><div>Alzheimer's disease (AD) is currently the leading cause of dementia among older adults. Indeed, this multifactorial neurodegenerative disease accounts for approximately 60-70% of all dementia cases among adults aged 80 years and older. Over the past decade, AD has emerged as a major public health matter, driven by an exponential increase in the number of individuals affected by dementia. As of 2022, approximately 52 million people worldwide were living with dementia, and this number is projected to exceed 152 million by 2050.</div><div>In the absence of effective treatments and with early diagnostic methods still under investigation, preventive measures represent the most viable approach to curbing the exponential increase in the number of individuals affected by AD.</div><div>These preventive measures include cognitive stimulation, social interaction, meditation and mindfulness practices, regular physical activity, a healthy diet, and the use of nutraceuticals.</div><div>Collectively, these interventions confer multiple beneficial effects that may prevent and/or delay the progression of AD. The common pathway is that they regulate the inflammatory processes in the brain, a key driver of neurodegeneration and AD progression.</div><div>This review provides a comprehensive examination of current preventive measures and their potential impact on the projected prevalence of AD.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"37 2","pages":"Pages 244-252"},"PeriodicalIF":0.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147801638","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

Detección precoz del cáncer colorrectal 结直肠癌的早期发现

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Revista Medica Clinica Las Condes Pub Date : 2026-03-01 Epub Date: 2026-05-02 DOI: 10.1016/j.rmclc.2026.04.004

Alejandro J. Zárate MD , Suraj Samtani MD , Roberto Salas MD , Camila Leiva EU

引用次数: 0

Espiritualidad: un elemento clave en el estándar de cuidados del paciente oncológico 灵性：癌症患者护理标准的关键要素

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Revista Medica Clinica Las Condes Pub Date : 2026-03-01 Epub Date: 2026-05-02 DOI: 10.1016/j.rmclc.2026.03.003

Maite Kiser Martínez Psych, María José Díaz-Osses Psych, MSc, Loreto Fernández-González Psych, PhD

引用次数: 0