Revista Medica Clinica Las Condes最新文献

{"title":"Actualización en detección precoz del cáncer de próstata","authors":"Pablo A. Rojas ,&nbsp;Benjamín García-Bloj ,&nbsp;Enrique Elias ,&nbsp;Fernando Marchant","doi":"10.1016/j.rmclc.2024.02.001","DOIUrl":"https://doi.org/10.1016/j.rmclc.2024.02.001","url":null,"abstract":"<div><p>Prostate cancer (PCa) is the most frequent cancer in men in Chile and ranks fourth with regards to mortality according to the latest Globocan 2022 statistics. The aim of this review is to clarify what methods exist for preventing PCa, as well as updating screening recommendations based on the latest available evidence. Numerous risk factors have been described for PCa, including non-modifiable factors such as age, race, and family history. In this context, PCa screening becomes more relevant. Despite certain controversy regarding the usefulness of prostate-specific antigen (PSA), screening has shown that it increases the diagnosis of PCa in early stages, reducing mortality by up to 30%. The object of this review is to comment on the known risk factors for PCa and the usefulness of PCa screening, considering the use of new tools such as magnetic resonance imaging in the diagnosis of the disease.</p></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"35 2","pages":"Pages 88-94"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0716864024000142/pdfft?md5=768b6c02221fb0f29ef24cbd328ba11d&pid=1-s2.0-S0716864024000142-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140346985","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":"Factores de riesgo y prevención en cáncer de vesícula","authors":"Jorge Gallardo E.,&nbsp;Rocío Solervicens","doi":"10.1016/j.rmclc.2024.03.002","DOIUrl":"https://doi.org/10.1016/j.rmclc.2024.03.002","url":null,"abstract":"<div><p>Gallbladder cancer is a very rare disease in Europe and North America, reason why there is scarce scientific research about it. At the same time, it is very common throughout the Andean region of South America, especially in Chile which once had the highest incidence and mortality rates in the world. Women account for 75% of patients, with cases being strongly related to long standing cholelithiasis, as well as chronic infection. Gallbladder cancer rarely exists without cholelitiasis. It is also closely associated with obesity and a diet high in fat and sugar. It is more common in some native populations, especially the Mapuche population, frequently associated with a low socioeconomic level and less access to the health system. In Chile, the mortality rate decreased by more than 50% in the last 20 years. Prophylactic cholecystectomy in high-risk population, implemented as a national policy in Chile, is reducing incidence and mortality from this disease which, for a long time, was the leading cause of death by cancer in Chilean women. The objective of this article is to outline the epidemiological history of gallbladder cancer in the world and in Chile as well as describe the risk factors and measures for its prevention.</p></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"35 2","pages":"Pages 117-124"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0716864024000178/pdfft?md5=6a43212f13eaae10ea2e296620f1f737&pid=1-s2.0-S0716864024000178-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140348169","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":"Inhibidores del punto de control inmune en cáncer pulmonar de células no pequeñas en etapa temprana: ¿Nuevo estándar de tratamiento?","authors":"Martín Vidal C. ,&nbsp;Suraj Samtani","doi":"10.1016/j.rmclc.2024.03.005","DOIUrl":"https://doi.org/10.1016/j.rmclc.2024.03.005","url":null,"abstract":"<div><p>Worldwide, lung cancer is the first cancer in incidence and mortality. The most common histological type is non-small cell lung cancer (NSCLC). At an early stage, resection is the standard curative treatment, but relapse is high, which could be explained by micrometastatic disease. Adjuvant and neoadjuvant chemotherapy have little benefit in disease-free survival and overall survival, which is why new strategies have been studied. Immune checkpoint inhibitors (ICI) act by increasing the surveillance of the immune system. They have been used for years in advanced stage NSCLC, however, new schemes in earlier stages, be it as adjuvant therapy, neoadjuvant therapy or both, have demonstrated an important benefit in the endpoints studied. This review aims to describe the biologic rationale of ICIs in early-stage NSCLC and discuss the selected trials and endpoints.</p></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"35 2","pages":"Pages 74-81"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0716864024000245/pdfft?md5=d803a6e65f4d2c5c46690fbcf5d520b0&pid=1-s2.0-S0716864024000245-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140347031","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":"Prevención y detección precoz del cáncer de páncreas","authors":"Hanns Lembach Jahnsen","doi":"10.1016/j.rmclc.2024.03.001","DOIUrl":"https://doi.org/10.1016/j.rmclc.2024.03.001","url":null,"abstract":"<div><p>In western countries, pancreatic ductal adenocarcinoma (PDAC) has shown a rising incidence and is currently one of the leading causes of cancer related mortality. Due to its aggressive biology, most patients diagnosed with PDAC present with advanced disease not suitable for curative treatment. An early detection strategy could potentially improve results by detecting more PDAC patients within the initial stages of the disease.</p><p>Currently, diagnosis of PDAC is mostly based in cross sectional imaging, including computed tomography and magnetic resonance imaging (MRI) as well as biomarkers such as CA 19-9. Selected cases might be further studied using endoscopic ultrasound (EUS) with the option of EUS guided biopsy if histology is needed to confirm diagnosis.</p><p>Due to its low incidence, screening general population for PDAC has been shown to be an ineffective and expensive approach. For this reason, efforts have shifted towards surveillance of specific groups of patients known to be at risk for development of PDAC. In these groups, screening has shown to have a higher yield for early cases and improved results in terms of resection rates and survival. These groups include carriers of certain oncogenic germline mutations, patients with strong family history for PDAC, and patients diagnosed with mucinous cystic neoplasms of the pancreas. Patients over 50 years old diagnosed with new-onset diabetes and patients living with chronic pancreatitis are also considered to be at risk for PDAC development. Patients selected for surveillance should be included in screening protocols including periodic imaging with MRI or EUS.</p><p>Development of biomarkers is an area of active research in the field of pancreatic cancer. New genetic or molecular biomarkers, to be measured in an isolated or combined manner, are an interesting approach looking to improve current diagnostic capabilities and to provide new tools for effective screening in wider groups of patients.</p><p>The aim of this article is to describe strategies currently available for early detection of PDAC, including promising research areas for the near future.</p></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"35 2","pages":"Pages 106-116"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0716864024000154/pdfft?md5=37f8e842b1d1a842bdfd8ace5a7c70ba&pid=1-s2.0-S0716864024000154-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140346987","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":"Prevención y detección precoz del cáncer cervicouterino","authors":"Oscar Puga ,&nbsp;Francisco Belmar ,&nbsp;Emiliano Pertossi","doi":"10.1016/j.rmclc.2024.03.003","DOIUrl":"https://doi.org/10.1016/j.rmclc.2024.03.003","url":null,"abstract":"<div><p>Cervical cancer is a global health challenge, with high incidence and mortality rates, particularly in countries with lower levels of human development. The progression of cervical cancer is well understood, from human papillomavirus infection to precancerous lesions and invasive cancer. This disease can be prevented through effective vaccination and early detection programs, which allow timely treatments, especially for pre-invasive conditions. In 2020, the World Health Organization launched a global initiative to eliminate cervical cancer, introducing the 90-70-90 strategy. This intervention seeks 90% vaccination coverage in girls under 15 years of age, at least two HPV screenings before the age of 45, and timely treatment for 90% of diagnosed patients. This paper aims to describe national and international updates in cervical cancer prevention, highlighting the progress of primary and secondary prevention with regards to decreasing its incidence.</p></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"35 2","pages":"Pages 95-105"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0716864024000208/pdfft?md5=242e34a07498a47f07ec15a78e5e4532&pid=1-s2.0-S0716864024000208-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140346986","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":"Necesidades y niveles de satisfacción de pacientes con cáncer de mama","authors":"Sylvia Ramis ,&nbsp;Francisco Acevedo ,&nbsp;M. Loreto Bravo ,&nbsp;José Peña ,&nbsp;Paulina Bravo ,&nbsp;Lidia Medina ,&nbsp;Sabrina Muñiz ,&nbsp;Carolina Ibañez ,&nbsp;Benjamín Walbaum ,&nbsp;Tomas Merino ,&nbsp;Erick Marin-Olivo ,&nbsp;Mauricio P. Pinto ,&nbsp;César Sánchez","doi":"10.1016/j.rmclc.2024.02.002","DOIUrl":"https://doi.org/10.1016/j.rmclc.2024.02.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Knowing and satisfying the needs of breast cancer (BC) patients (P) and their caregivers (CG) during treatment can help to improve their quality of life. This study assessed the needs of BC-P, their CG and health professionals (HP) and their perception before and after an intervention aiming to improve healthcare. Methods. The study included an academic center (AC) and a public hospital (PH). Data were obtained from interviews, focus groups and self-completed surveys. A content analysis was performed using Nvivo software. Due to COVID19 restrictions, educational videos were delivered to HPs describing the identified needs. Finally, satisfaction surveys were applied to P and CG, before and after this intervention.</p></div><div><h3>Results</h3><p>A total of 22 participants were interviewed (7P, 5CG and 10HP). Three main needs were identified: 1) Healthcare related needs, 2) Financial issues and 3) Social support. Subsequently, a satisfaction survey was applied to users (stage I; n<!--> <!-->=<!--> <!-->93) and the identified needs were used to design an intervention that consisted of educational videos directed towards HP. Following the intervention a second survey was applied (stage II; n<!--> <!-->=<!--> <!-->71). Both surveys revealed high levels of satisfaction among users. Following the second survey, we noticed the emergence of other needs, mainly related to nutrition and the improvement of facilities.</p></div><div><h3>Conclusions</h3><p>This is the first study in Chile assessing BC-P needs from the perspective of P, their CG and HP. All participants indicated that information and social/financial support were the most relevant needs.</p></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"35 2","pages":"Pages 129-139"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0716864024000166/pdfft?md5=7cea52f0325c7c463caffd796aa94126&pid=1-s2.0-S0716864024000166-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140348171","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":"Radioterapia profiláctica para prevención de complicaciones en metástasis óseas de alto riesgo","authors":"Rodrigo Barrientos,&nbsp;Lorena Vargas,&nbsp;Pelayo Besa","doi":"10.1016/j.rmclc.2024.03.004","DOIUrl":"https://doi.org/10.1016/j.rmclc.2024.03.004","url":null,"abstract":"<div><p>Bone metastases are frequent in cancer patients and are a frequent cause of complications due to the structural damage they cause at bone level, generating complications called “skeletal-related events” (SREs), which lead to significant deterioration in patient quality of life.</p><p>In the management of bone metastases, one of the objectives is to reduce pain and manage complications when they have already occurred, but another objective, no less important, is the prevention of SREs. Regarding the prevention of SRE, there is extensive knowledge and literature that supports the use of surgery and systemic treatments such as hormone therapy, bisphosphonates, radiopharmaceuticals and other agents. However, radiotherapy also has a role in the prevention of SRE in cancer patients with bone metastases since it has been shown to produce a greater latency for the occurrence of an SRE and a lower hospitalization rate, which translates into lower treatment costs and better. quality of life for patients. For this reason, the objective of the present work is to comment on the indications and benefits of prophylactic radiotherapy in the context of SRE prevention.</p></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"35 2","pages":"Pages 125-128"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0716864024000233/pdfft?md5=bd0b65608c15fe30be48b2c8b58e350b&pid=1-s2.0-S0716864024000233-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140348170","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":"Paro cardiorrespiratorio secundario a miocardiopatía periparto: reporte de un caso","authors":"Jorge Rodríguez Zúñiga,&nbsp;Karen Elena Ortega Verdugo,&nbsp;Diego Ernesto Pacheco Zavala","doi":"10.1016/j.rmclc.2024.02.003","DOIUrl":"https://doi.org/10.1016/j.rmclc.2024.02.003","url":null,"abstract":"<div><h3>Objective</h3><p>To report a case of peripartum cardiomyopathy with cardiogenic shock and cardiorespiratory arrest, which presented an adequate response to treatment with minimal sequelae.</p></div><div><h3>Clinical case</h3><p>31-year-old female, with a full-term pregnancy, without comorbidities. A scheduled cesarean section was performed due to a double circular cord. During the procedure, the patient presented cardiorespiratory arrest with return to spontaneous circulation. The patient later presents cardiogenic shock, arrhythmias and thromboembolic events, requiring management in the intensive care unit. The patient had a favorable clinical evolution, allowing for withdrawal of support measures and outpatient management of minor complications.</p><p>Peripartum cardiomyopathy is a pathology with an infrequent presentation. In order to be addressed in a timely manner, high suspicion is required to reach an early diagnosis. The use of implements such as echocardiography is essential in the initial evaluation. Multidisciplinary management in a specialized center is required.</p></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"35 2","pages":"Pages 145-149"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0716864024000191/pdfft?md5=58629e6003821d2c84fd572d088ad6e7&pid=1-s2.0-S0716864024000191-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140348220","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":"Tamizaje de cáncer colorrectal: pruebas emergentes no invasivas","authors":"Alessandra Cassana ,&nbsp;Mario Abedrapo ,&nbsp;Mauricio Diaz ,&nbsp;Diego Zamorano ,&nbsp;Alejandro Zárate","doi":"10.1016/j.rmclc.2024.03.006","DOIUrl":"https://doi.org/10.1016/j.rmclc.2024.03.006","url":null,"abstract":"<div><p>Colorectal cancer (CRC) is the second cause of cancer in Chile and represents a public health problem due to its high morbidity and mortality. In the last 20 years, a progressive increase in its incidence has been described in patients under 50 years old. Early screening in general population is indicated in asymptomatic patients over 45 years old and has been shown to have an impact on mortality. The genetic and pathophysiological features of CRC make it susceptible to be screened using many strategies. The objective of this work is to review the latest emerging non-invasive screening methodologies currently being studied and developed using fecal, blood and urine samples, which may improve patient adherence to colorectal cancer screening programs.</p></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"35 2","pages":"Pages 82-87"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S071686402400021X/pdfft?md5=d5907926c38dad7eeda68af8256dc752&pid=1-s2.0-S071686402400021X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140346984","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":"Comentario de Portada","authors":"","doi":"10.1016/j.rmclc.2024.03.008","DOIUrl":"https://doi.org/10.1016/j.rmclc.2024.03.008","url":null,"abstract":"","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"35 2","pages":"Page 150"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0716864024000269/pdfft?md5=97e05cdd0ea5cc2b97533d36a7771fb7&pid=1-s2.0-S0716864024000269-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140348221","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}