Revista Medica Clinica Las Condes最新文献_第9页

Probable coinfección por hantavirus variante Andes y Legionella en un paciente crítico: primera descripción en la literatura de un caso y revisión de la literatura 危重患者可能合并感染安第斯变异汉坦病毒和军团菌:首次在文献中描述一个病例和文献综述

Revista Medica Clinica Las Condes Pub Date : 2023-11-01 DOI: 10.1016/j.rmclc.2023.09.009

Andrés Giglio , Claudio de la Hoz , Cesar Pedreros , Andrés Ferre , Jorge Dreyse

引用次数: 0

Unexpected Discoveries: Uncovering Incidental Tumors in Simple Nephrectomy Specimens 意外发现:在单纯肾切除标本中发现偶发肿瘤

Revista Medica Clinica Las Condes Pub Date : 2023-11-01 DOI: 10.1016/j.rmclc.2023.09.010

Ganime Coban, Büşra Coşanay Tekden, Nurhan Şahin, Özlem Toluk, Hüseyin Toprak, Pelin Yıldız, Abdullah İlktaç

{"title":"Unexpected Discoveries: Uncovering Incidental Tumors in Simple Nephrectomy Specimens","authors":"Ganime Coban, Büşra Coşanay Tekden, Nurhan Şahin, Özlem Toluk, Hüseyin Toprak, Pelin Yıldız, Abdullah İlktaç","doi":"10.1016/j.rmclc.2023.09.010","DOIUrl":"https://doi.org/10.1016/j.rmclc.2023.09.010","url":null,"abstract":"<div><h3>Objectives</h3><p>We aimed to evaluate the characteristics of patients with incidental kidney tumors detected in the pathological examination performed after simple nephrectomy due to a non-functioning kidney.</p></div><div><h3>Patients and methods</h3><p>The pathology results of nephrectomy specimens from patients who underwent simple nephrectomy with the diagnosis of non-functioning kidney between January 2012 and March 2021 were retrospectively analyzed. Data regarding demographic information, imaging methods, and clinical and histopathological features of the patients were collected. The number of patients with incidental renal tumors was determined.</p></div><div><h3>Results</h3><p>A total of 163 patients with nonfunctioning kidneys who underwent simple nephrectomy between January 2012 and March 2021 were included in the study. Sixty-nine (42.3%) patients were male and 94 (57.7%) patients were female. The most common complaint was flank pain (60.7%). The cause of the nonfunctioning kidney was urinary stones in 116 (71.2%) patients and ureteropelvic/ureterovesical junction stenosis in 21 (10.1%) patients. Incidental renal tumors were detected in 21 (12.9%) patients. Papillary adenoma was the most common renal tumor and was detected in 11 patients. Four patients had renal cell carcinoma and 4 patients had urothelial cell carcinoma (UCC). Three of the patients with UCC had high grade invasive UCC with squamous differentiation and 1 patient had low grade papillary UCC.</p></div><div><h3>Conclusion</h3><p>In non-functioning kidneys, kidney tumors may be overlooked due to radiological and clinical diagnostic difficulties. Therefore, careful macroscopic and microscopic histopathological evaluation is necessary to detect incidental renal tumors.</p></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"34 6","pages":"Pages 421-426"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0716864023000913/pdfft?md5=bc391caddae52bb299b00c7cd3d8c2a7&pid=1-s2.0-S0716864023000913-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138466176","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

fÍstula yeyuno-colónica por linfoma mesentérico: una causa inusual de diarrea 肠系膜淋巴瘤引起的肠瘘:腹泻的一种不寻常的原因

Revista Medica Clinica Las Condes Pub Date : 2023-11-01 DOI: 10.1016/j.rmclc.2023.10.002

Alessandra Cassana , Mario Abedrapo , Ricardo Villalón C. , Diego Zamorano , Sofía Abedrapo

{"title":"fÍstula yeyuno-colónica por linfoma mesentérico: una causa inusual de diarrea","authors":"Alessandra Cassana , Mario Abedrapo , Ricardo Villalón C. , Diego Zamorano , Sofía Abedrapo","doi":"10.1016/j.rmclc.2023.10.002","DOIUrl":"https://doi.org/10.1016/j.rmclc.2023.10.002","url":null,"abstract":"<div><p>Enterocolonic fistula is a rare complication of lymphoma of mesenteric origin and an unusual cause of chronic diarrhea in patients without immunosuppression or inflammatory bowel disease. We report the case of a 68-year-old female patient with abdominal pain and chronic diarrhea that revealed a jejunocolonic fistula on imaging and endoscopic evaluation. Surgical block resection was performed and the histological and immunohistochemical analysis of the surgical specimen evidenced a high-grade B non-Hodgkin lymphoma originating from a lymph node of the mesentery with secondary extension to the jejunum and colon. The diagnosis is challenging due to the non-specific clinical picture and the wide differential diagnosis, for which an adequate anamnesis, physical examination and imaging evaluation are essential in order to characterize the lesion and schedule surgery. The prognosis and adjuvant treatment will depend on the type of tumor and its staging. This is the first local case report of a patient with a jejuno-colonic fistula secondary to a high-grade B-type non-Hodgkin lymphoma originating from a mesenteric lymph node with extension to the small intestine and colon.</p></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"34 6","pages":"Pages 427-430"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0716864023000883/pdfft?md5=6fff1668ef4a2b1f6fa7ef645990dc8a&pid=1-s2.0-S0716864023000883-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138466177","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

Actinomicosis pélvica, relevancia de la sospecha diagnóstica y seguimiento clínico: reporte de un caso 盆腔放线菌病，诊断怀疑的相关性和临床随访:1例报告

Revista Medica Clinica Las Condes Pub Date : 2023-11-01 DOI: 10.1016/j.rmclc.2023.10.001

Antonia Fontana Ostornol , Josefina Calvo Cruzat , Pablo Sandoval González

{"title":"Actinomicosis pélvica, relevancia de la sospecha diagnóstica y seguimiento clínico: reporte de un caso","authors":"Antonia Fontana Ostornol , Josefina Calvo Cruzat , Pablo Sandoval González","doi":"10.1016/j.rmclc.2023.10.001","DOIUrl":"https://doi.org/10.1016/j.rmclc.2023.10.001","url":null,"abstract":"<div><p>Actinomycosis is a chronic granulomatous bacterial infection caused by the Actinomyces species which frequently manifests as cervicofacial, thoracoabdominal or pelvic infections, the latter being the least frequent. There is a strong association between long term intrauterine device (IUD) use and the development of this infection.</p><p>It is characterized by the formation of slow-growing abscesses that can reach large dimensions, generating an insidious and non-specific clinical presentation.</p><p>Due to the above, the diagnosis is commonly late with a direct impact on the associated complications. Antibiotic treatment is usually prolonged and surgical interventions are sometimes required. We present the case of an IUD using patient who, after several months of symptoms, was hospitalized with the diagnosis of pelvic actinomycosis. The patient evolves favorably with abbreviated antibiotic treatments and outpatient clinical follow-up.</p></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"34 6","pages":"Pages 436-439"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0716864023000871/pdfft?md5=685a0cc546d1238f9584ce8cfcc841b8&pid=1-s2.0-S0716864023000871-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138466178","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

Mucocele apendicular: a propósito de un caso 阑尾黏液囊肿:关于一个病例

Revista Medica Clinica Las Condes Pub Date : 2023-11-01 DOI: 10.1016/j.rmclc.2023.09.001

Meriem Boui, Zakaria Abide, Nadia Boujida, Tarik Salaheddine, Jamal El Fenni, Mohamed Lahkim

引用次数: 0

estimulación cerebral profunda como tratamiento de la agresividad refractaria: una revisión bibliográfica 脑深部刺激治疗难治性侵袭性:文献综述

Revista Medica Clinica Las Condes Pub Date : 2023-11-01 DOI: 10.1016/j.rmclc.2023.09.008

Liseth Bravo , Josselyne Cantos , José Manuel Campos , Rómulo Fuentes-Flores

{"title":"estimulación cerebral profunda como tratamiento de la agresividad refractaria: una revisión bibliográfica","authors":"Liseth Bravo , Josselyne Cantos , José Manuel Campos , Rómulo Fuentes-Flores","doi":"10.1016/j.rmclc.2023.09.008","DOIUrl":"https://doi.org/10.1016/j.rmclc.2023.09.008","url":null,"abstract":"<div><h3>Introduction</h3><p>Deep brain stimulation (DBS) consists of the administration of electrical micropulses towards specific subcortical locations. Initially used as a treatment for motor disorders; It is also effective in neuropsychiatric pathologies, including aggressiveness refractory to conventional treatment. This study aims to review experiences with DBS for refractory aggressiveness and identify the most frequent stimulation parameters.</p></div><div><h3>Methods</h3><p>A review of databases Scopus, Cochrane, ScienceDirect and PubMed was carried out, identifying reports or case series in humans where DBS was used to manage refractory aggressive behavior and which contained stimulation parameters.</p></div><div><h3>Results</h3><p>17 papers with a total of 58 patients were included, according to the established criteria. The posteromedial hypothalamus was the most frequently used target. Most of the patients improved significantly after starting DBS. The predominant frequency range was between 180-185Hz (75.8% of cases) and the predominant pulse width range was between 60-90μs (84.4% of cases).</p></div><div><h3>Conclusions</h3><p>DBS of the posteromedial hypothalamus at high frequencies and relatively low pulse width seems to be effective for the treatment of refractory aggression; but the optimal setting for treatment is unknown. More studies are required on the physiological basis on which it operates, as well as larger cohorts of individuals for follow-up.</p></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"34 6","pages":"Pages 411-420"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S071686402300086X/pdfft?md5=64a9ce73e31f54f530fa456cd199517f&pid=1-s2.0-S071686402300086X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138466204","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

Autoestigma y estigma por búsqueda de ayuda en estudiantes y profesionales de la salud: una revisión de la literatura 学生和卫生专业人员的自我污名化和寻求帮助的污名化:文献综述

Revista Medica Clinica Las Condes Pub Date : 2023-11-01 DOI: 10.1016/j.rmclc.2023.11.001

Joan Sneider Durango , Paulina Jaramillo Echeverri , Jenny Garcia Valencia , Esteban Uribe , Leonor Galindo Cárdenas

{"title":"Autoestigma y estigma por búsqueda de ayuda en estudiantes y profesionales de la salud: una revisión de la literatura","authors":"Joan Sneider Durango , Paulina Jaramillo Echeverri , Jenny Garcia Valencia , Esteban Uribe , Leonor Galindo Cárdenas","doi":"10.1016/j.rmclc.2023.11.001","DOIUrl":"https://doi.org/10.1016/j.rmclc.2023.11.001","url":null,"abstract":"<div><h3>Background</h3><p>Stigma is a disqualifying act where negative attitudes and labels towards an individual generate feelings of shame, guilt, and social exclusion. In mental health, there are three basic types of stigma: social stigma, self-stigma, and help-seeking stigma. In this review, we present the literature on self-stigma and help-seeking stigma in health personnel; placing special emphasis on existing interventions and projects to reduce stigma.</p></div><div><h3>Methodology</h3><p>Narrative review carried out in scientific databases between January 2005 and February 2022, including articles in English and Spanish.</p></div><div><h3>Results</h3><p>Only 38% of patients with mental health conditions seek professional care, with self-stigma and help-seeking stigma being important contributors to this phenomenon. These data sets include both health professions students and health professionals. Different interventions have been published in the last 10 years mainly based on education and contact with this population group. The results have shown small benefits in reducing stigma, but it is unclear if this lasts over time.</p></div><div><h3>Discussion</h3><p>Health professionals, including medical students, represent a population vulnerable to mental health conditions; which could be explained by their high academic, healthcare, and social burden. The interventions described so far manage to reduce certain types of stigma in mental health. Still, in the future, more focused approaches are needed to adapt the medical curriculum on this topic. In addition, the development of more standardized instruments that will permit objective measurement of the impact of these interventions is required.</p></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"34 6","pages":"Pages 400-410"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0716864023000925/pdfft?md5=46193aef57a0a20d7f83e615312be47e&pid=1-s2.0-S0716864023000925-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138466203","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

Cirugía de cataratas hoy: una actualización 今天的白内障手术:更新

Revista Medica Clinica Las Condes Pub Date : 2023-09-01 DOI: 10.1016/j.rmclc.2023.09.003

Mauricio Cabezas

{"title":"Cirugía de cataratas hoy: una actualización","authors":"Mauricio Cabezas","doi":"10.1016/j.rmclc.2023.09.003","DOIUrl":"https://doi.org/10.1016/j.rmclc.2023.09.003","url":null,"abstract":"<div><p>Cataracts represents one of the main causes of moderate to severe reversible vision impairment in the world, being an important public health problem in Chile. The only solution is to remove the cataract and implant an intraocular lens (IOL). The main risk factor for cataracts is age, which will lead to a progressive increase in prevalence due to the increase in life expectancy. There are several modifiable risk factors that can be intervened such as diabetes, arterial hypertension, smoking, uncontrolled use of systemic or topical corticosteroids, among others. Although the diagnosis is clinical, we must always perform a detailed study to rule out problems in other ocular structures that may be contributing to poor vision. This study will also allow us to better choose the most appropriate IOL for the patient. We must know the patient's needs and expectations after the surgery, especially if we plan to use toric IOLs, extended depth of focus or multifocal IOLs, which provide more spectacle independence than regular monofocal lenses. This review will describe the preoperative preparation, the technology used in an ultrasonic phacoemulsification surgery and the postoperative follow-up of the patient. Cataract surgery is one of the safest and cost-effective surgeries in modern medicine. More than 90% of the eyes achieve best corrected visual acuity of 20/25, and with the greater precision incorporated in new technologies more than 80% of the patients are left with +/- 0,5 residual diopters, so that today we can offer personalized visual results according to specific patient needs.</p></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"34 5","pages":"Pages 344-358"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49904291","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

Tratamiento actual de la degeneración macular relacionada con la edad 目前老年性黄斑变性的治疗

Revista Medica Clinica Las Condes Pub Date : 2023-09-01 DOI: 10.1016/j.rmclc.2023.08.005

Juan Ignacio Verdaguer Díaz

引用次数: 0

“Esta es mi banda, son mis hermanos. Sin ellos no soy nada”, Totoy Zamudio 2023 “这是我的乐队，他们是我的兄弟。没有他们，我什么都不是”，Totoy Zamudio 2023

Revista Medica Clinica Las Condes Pub Date : 2023-09-01 DOI: 10.1016/j.rmclc.2023.09.007

引用次数: 0