Pub Date : 2022-12-29DOI: 10.5354/2735-7996.2022.69336
César Antonio Romero U., Nicole Rogers C., Carol San Martín R., Mercedes López N., M. Behrens P.
Alzheimer disease (AD) is the main cause of dementia worldwide and a source of important population morbidity and mortality. It is estimate that its prevalence will increase dramatically in the upcoming years. The classical clinical presentation of AD is an amnesic hippocampal syndrome, and Mild Cognitive impairment (MCI) is considered the initial stage between normal cognition and dementia. The most accepted pathogenesis establishes amyloid beta (Ab) deposition in brain parenchyma as the initial mechanism, followed by the intracellular accumulation of hyperphosphorylated tau finally leading to the loss of synapses and neurons. Recently, the study of AD pathogenesis is focusing on immune mechanisms as main actors of disease development. Microglia is the macrophagic resident cell in the central nervous system (CNS), and initiates the inflammatory response and Ab phagocytosis, interacting with other glia and recruiting diverse immune cells to the CNS. The role of the adaptive immune system, and, especially T lymphocytes’ role, is still controversial. We hypothesize that the pathogenesis of AD is dynamic; with a preponderant proinflammatory activity initially, but later on, the persistent presence of Ab due to the lack of its proper elimination leads to a phenomena of lymphocyte dysfunction and immunological tolerance that have a deleterious role at advanced stages of the disease.
{"title":"Disfunción inmunológica en enfermedad de Alzheimer; proinflamatoria en etapas iniciales y regulatoria, y exhausta en etapas avanzadas","authors":"César Antonio Romero U., Nicole Rogers C., Carol San Martín R., Mercedes López N., M. Behrens P.","doi":"10.5354/2735-7996.2022.69336","DOIUrl":"https://doi.org/10.5354/2735-7996.2022.69336","url":null,"abstract":"Alzheimer disease (AD) is the main cause of dementia worldwide and a source of important population morbidity and mortality. It is estimate that its prevalence will increase dramatically in the upcoming years. The classical clinical presentation of AD is an amnesic hippocampal syndrome, and Mild Cognitive impairment (MCI) is considered the initial stage between normal cognition and dementia. The most accepted pathogenesis establishes amyloid beta (Ab) deposition in brain parenchyma as the initial mechanism, followed by the intracellular accumulation of hyperphosphorylated tau finally leading to the loss of synapses and neurons. Recently, the study of AD pathogenesis is focusing on immune mechanisms as main actors of disease development. Microglia is the macrophagic resident cell in the central nervous system (CNS), and initiates the inflammatory response and Ab phagocytosis, interacting with other glia and recruiting diverse immune cells to the CNS. The role of the adaptive immune system, and, especially T lymphocytes’ role, is still controversial. We hypothesize that the pathogenesis of AD is dynamic; with a preponderant proinflammatory activity initially, but later on, the persistent presence of Ab due to the lack of its proper elimination leads to a phenomena of lymphocyte dysfunction and immunological tolerance that have a deleterious role at advanced stages of the disease.","PeriodicalId":287456,"journal":{"name":"Revista Hospital Clínico Universidad de Chile","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116832475","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}
Pub Date : 2022-12-29DOI: 10.5354/2735-7996.2022.69348
S. Valenzuela P.
The paper proposes, as the topic of analysis, the emergence of telemedicine, a tool that has been intensively used by doctors and other professionals during the covid pandemic. The essay, divided into two parts, first describes the current situation of telemedicine and afterwards proposes a few precautionary theses, related to telemedicine and the doctor-patient relationship according to the undestanding that the latter has been inherited and transmitted by medical anthropology and the medical humanities.
{"title":"Bioética y virtualidad en la relación médico-paciente","authors":"S. Valenzuela P.","doi":"10.5354/2735-7996.2022.69348","DOIUrl":"https://doi.org/10.5354/2735-7996.2022.69348","url":null,"abstract":"The paper proposes, as the topic of analysis, the emergence of telemedicine, a tool that has been intensively used by doctors and other professionals during the covid pandemic. The essay, divided into two parts, first describes the current situation of telemedicine and afterwards proposes a few precautionary theses, related to telemedicine and the doctor-patient relationship according to the undestanding that the latter has been inherited and transmitted by medical anthropology and the medical humanities.","PeriodicalId":287456,"journal":{"name":"Revista Hospital Clínico Universidad de Chile","volume":"26 6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130415116","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}
Pub Date : 2022-12-29DOI: 10.5354/2735-7996.2022.69344
L. Contreras S, F. Marin C., Daniel Galdames C, Hernán Delso P, Bayron Valenzuela C
Objective: Case report of posterior communicating artery aneurysm (ACoP) related unilateral oculomotor nerve palsy (ONP). Introduction: The ACoP aneurysms represents the 25% of all aneurysms. It could cause ONP because of his close relation of the aneurysm and the oculomotor nerve. The treatment in symptomatic patients should be the exclusion of the aneurysm. Case report: 38-year-old woman with headache of 15 days of evolution and acute ONP. CT angiography shows a 3x7 mm ACoP aneurysm. Microsurgery and clipping were considered the best treatment and were realized without complications. The patient evolves with complete recovery of his ONP with complete exclusion of the aneurysm. Discussion: ACoP aneurysm should be considered in ONP working diagnosis. The treatment is exclusion of the aneurism either by endovascular or microsurgical techniques. Microsurgical clipping has shown better functional outcomes than endovascular therapy.
{"title":"Aneurisma de la arteria comunicante posterior y parálisis del III nervio craneal. Caso clínico y revisión de la literatura","authors":"L. Contreras S, F. Marin C., Daniel Galdames C, Hernán Delso P, Bayron Valenzuela C","doi":"10.5354/2735-7996.2022.69344","DOIUrl":"https://doi.org/10.5354/2735-7996.2022.69344","url":null,"abstract":"Objective: Case report of posterior communicating artery aneurysm (ACoP) related unilateral oculomotor nerve palsy (ONP). Introduction: The ACoP aneurysms represents the 25% of all aneurysms. It could cause ONP because of his close relation of the aneurysm and the oculomotor nerve. The treatment in symptomatic patients should be the exclusion of the aneurysm. Case report: 38-year-old woman with headache of 15 days of evolution and acute ONP. CT angiography shows a 3x7 mm ACoP aneurysm. Microsurgery and clipping were considered the best treatment and were realized without complications. The patient evolves with complete recovery of his ONP with complete exclusion of the aneurysm. Discussion: ACoP aneurysm should be considered in ONP working diagnosis. The treatment is exclusion of the aneurism either by endovascular or microsurgical techniques. Microsurgical clipping has shown better functional outcomes than endovascular therapy.","PeriodicalId":287456,"journal":{"name":"Revista Hospital Clínico Universidad de Chile","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114477125","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}
Pub Date : 2022-12-29DOI: 10.5354/2735-7996.2022.69341
V. Vera G., Catalina Jahr A, Dinko Vuskovic R, L. Araníbar D.
Neurofibromatosis type 1 (NF1) is the most common neurocutaneous syndrome. Diagnosis is based on clinical findings that meets the criteria developed by the NIH in 1997, which remain highly sensitive and specific in adults, but not in children, in which the manifestations vary with age. In children under 2 years in the pretumoral stage with a negative family history, it would be useful to have additional clinical diagnostic criteria. Genetic testing is not widely available and although café-au-lait spots remain the cardinal and most frequent clinical sign, they cannot make the diagnosis of NF-1 on their own.
{"title":"Neurofibromatosis tipo 1. Más allá de las manchas café con leche: ¿es necesario actualizar criterios?","authors":"V. Vera G., Catalina Jahr A, Dinko Vuskovic R, L. Araníbar D.","doi":"10.5354/2735-7996.2022.69341","DOIUrl":"https://doi.org/10.5354/2735-7996.2022.69341","url":null,"abstract":"Neurofibromatosis type 1 (NF1) is the most common neurocutaneous syndrome. Diagnosis is based on clinical findings that meets the criteria developed by the NIH in 1997, which remain highly sensitive and specific in adults, but not in children, in which the manifestations vary with age. In children under 2 years in the pretumoral stage with a negative family history, it would be useful to have additional clinical diagnostic criteria. Genetic testing is not widely available and although café-au-lait spots remain the cardinal and most frequent clinical sign, they cannot make the diagnosis of NF-1 on their own.","PeriodicalId":287456,"journal":{"name":"Revista Hospital Clínico Universidad de Chile","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128134374","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}
Pub Date : 2022-12-29DOI: 10.5354/2735-7996.2022.69351
Danny Mendoza G, Catalina Hitchfeld B, María Inés Luco M, Francisco Vargas B, Rodrigo Carvajal G
No abstract available
没有摘要
{"title":"Estudio de la pareja infértil","authors":"Danny Mendoza G, Catalina Hitchfeld B, María Inés Luco M, Francisco Vargas B, Rodrigo Carvajal G","doi":"10.5354/2735-7996.2022.69351","DOIUrl":"https://doi.org/10.5354/2735-7996.2022.69351","url":null,"abstract":"No abstract available","PeriodicalId":287456,"journal":{"name":"Revista Hospital Clínico Universidad de Chile","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129969298","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}
Pub Date : 2022-12-29DOI: 10.5354/2735-7996.2022.69356
Revista Hospital Clínico Universidad de Chile
No abstract available
没有摘要
{"title":"Abstracts presentaciones orales Jornadas de Investigación HCUCH 2021","authors":"Revista Hospital Clínico Universidad de Chile","doi":"10.5354/2735-7996.2022.69356","DOIUrl":"https://doi.org/10.5354/2735-7996.2022.69356","url":null,"abstract":"No abstract available","PeriodicalId":287456,"journal":{"name":"Revista Hospital Clínico Universidad de Chile","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121670586","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}
Pub Date : 2022-12-29DOI: 10.5354/2735-7996.2022.69342
Maximiliano Barahona V., C. Barrientos M., Macarena Barahona V., Mauricio Guzmán G., Marcela Ramírez P.
Osteoarthrosis of the knee is one of the most important causes of disability around the world, being total knee arthroplasty (TKA) a cost-effective surgical procedure for treating its severe stage when all knee compartments are compromised. Despite the good functional results and good survival of the implants and of the patients, still, 15 to 20% of the patients are dissatisfied after surgery. One of the causes of dissatisfaction is persistent pain located in the anterior part of the knee, which leads to controversy over whether to perform the patellar replacement. Advantages and complications are described in both scenarios, and neither is superior to the other in pain and implant survival. In the case of TKA without patellar replacement, the position of the femoral component plays a crucial role in achieving normal patellar tracking. The current challenge is to determine those clinical and radiological variables that allow us to predict the absence of long-term anterior pain in patients who require TKA and who do not undergo patellar replacement.
{"title":"Predictores de dolor anterior de rodilla en pacientes operados de artroplastia total de rodilla sin reemplazo patelar","authors":"Maximiliano Barahona V., C. Barrientos M., Macarena Barahona V., Mauricio Guzmán G., Marcela Ramírez P.","doi":"10.5354/2735-7996.2022.69342","DOIUrl":"https://doi.org/10.5354/2735-7996.2022.69342","url":null,"abstract":"Osteoarthrosis of the knee is one of the most important causes of disability around the world, being total knee arthroplasty (TKA) a cost-effective surgical procedure for treating its severe stage when all knee compartments are compromised. Despite the good functional results and good survival of the implants and of the patients, still, 15 to 20% of the patients are dissatisfied after surgery. One of the causes of dissatisfaction is persistent pain located in the anterior part of the knee, which leads to controversy over whether to perform the patellar replacement. Advantages and complications are described in both scenarios, and neither is superior to the other in pain and implant survival. In the case of TKA without patellar replacement, the position of the femoral component plays a crucial role in achieving normal patellar tracking. The current challenge is to determine those clinical and radiological variables that allow us to predict the absence of long-term anterior pain in patients who require TKA and who do not undergo patellar replacement.","PeriodicalId":287456,"journal":{"name":"Revista Hospital Clínico Universidad de Chile","volume":"54 11","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133356861","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}
Pub Date : 2022-12-29DOI: 10.5354/2735-7996.2022.69349
J. Medel F, D. Ugalde C
Severity meaning the risk of adverse outcomes, death or disability, varies along disease’s characteristics and patient related factors. Its evaluation is complex and besides subjective perception several, more objective, clinical tools exist along with laboratory data that independently or used in combination, allows the clinician to approach severity of a given patient’s condition or a particular disease. We will review several aspects of the evaluation of severity, clinical and laboratory based in addition of some scoring systems, emphasizing perfusion and organ dysfunction evaluation as key elements to assess severity particularly in critical situations.
{"title":"Evaluación de gravedad en pacientes agudos","authors":"J. Medel F, D. Ugalde C","doi":"10.5354/2735-7996.2022.69349","DOIUrl":"https://doi.org/10.5354/2735-7996.2022.69349","url":null,"abstract":"Severity meaning the risk of adverse outcomes, death or disability, varies along disease’s characteristics and patient related factors. Its evaluation is complex and besides subjective perception several, more objective, clinical tools exist along with laboratory data that independently or used in combination, allows the clinician to approach severity of a given patient’s condition or a particular disease. We will review several aspects of the evaluation of severity, clinical and laboratory based in addition of some scoring systems, emphasizing perfusion and organ dysfunction evaluation as key elements to assess severity particularly in critical situations.","PeriodicalId":287456,"journal":{"name":"Revista Hospital Clínico Universidad de Chile","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122556904","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}
Pub Date : 2022-12-29DOI: 10.5354/2735-7996.2022.69352
Joaquín Cánepa G, Joaquín Manosalva P, Carolina Simonetti I, Loreto Solo de Zaldívar A, G. Valenzuela T., Felipe Carvajal V, J. González M.
Patients with SARS-Cov-2 infection and lung cancer have an unfavorable prognosis, characterized by higher rates of respiratory failure, use of invasive mechanical ventilation and higher mortality rates. Due to similarities in affected organs in Covid-19 and lung cancer, the radiological accurate diagnosis has become a challenge for physicians. Radiologic findings of lung cancer, such as parenchymal consolidation, spiculation and microlobulations are not specific. Imaging findings of Covid-19 in patients with lung cancer consist of multiple patchy multifocal bilateral ground-glass opacities and consolidations, being hardly distinguishable from an underlying lung malignancy. Differential radiological diagnosis in patients with lung cancer and Covid-19 must include pneumonitis and lung toxicity caused by chemotherapy, target therapies and radiotherapy. Follow-up and simulation tomography in radiotherapy have become an unexpected ally in the early detection of Covid-19 in asymptomatic stages in lung cancer patients. Patients with lung cancer should have particular considerations due to their high risk and the adverse effects of systemic therapies and radiotherapy.
{"title":"Consideraciones radiológicas del cáncer de pulmón y Covid-19: una mirada oncológica","authors":"Joaquín Cánepa G, Joaquín Manosalva P, Carolina Simonetti I, Loreto Solo de Zaldívar A, G. Valenzuela T., Felipe Carvajal V, J. González M.","doi":"10.5354/2735-7996.2022.69352","DOIUrl":"https://doi.org/10.5354/2735-7996.2022.69352","url":null,"abstract":"Patients with SARS-Cov-2 infection and lung cancer have an unfavorable prognosis, characterized by higher rates of respiratory failure, use of invasive mechanical ventilation and higher mortality rates. Due to similarities in affected organs in Covid-19 and lung cancer, the radiological accurate diagnosis has become a challenge for physicians. Radiologic findings of lung cancer, such as parenchymal consolidation, spiculation and microlobulations are not specific. Imaging findings of Covid-19 in patients with lung cancer consist of multiple patchy multifocal bilateral ground-glass opacities and consolidations, being hardly distinguishable from an underlying lung malignancy. Differential radiological diagnosis in patients with lung cancer and Covid-19 must include pneumonitis and lung toxicity caused by chemotherapy, target therapies and radiotherapy. Follow-up and simulation tomography in radiotherapy have become an unexpected ally in the early detection of Covid-19 in asymptomatic stages in lung cancer patients. Patients with lung cancer should have particular considerations due to their high risk and the adverse effects of systemic therapies and radiotherapy.","PeriodicalId":287456,"journal":{"name":"Revista Hospital Clínico Universidad de Chile","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123587709","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}
Pub Date : 2022-12-29DOI: 10.5354/2735-7996.2022.69354
Tomás Neumann F, Carolina Olea-Gangas
No abstract available
没有摘要
{"title":"Cáncer cervicouterino y lesiones preinvasoras de cuello","authors":"Tomás Neumann F, Carolina Olea-Gangas","doi":"10.5354/2735-7996.2022.69354","DOIUrl":"https://doi.org/10.5354/2735-7996.2022.69354","url":null,"abstract":"No abstract available","PeriodicalId":287456,"journal":{"name":"Revista Hospital Clínico Universidad de Chile","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127614595","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}
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