Pub Date : 2021-12-13DOI: 10.5354/2735-7996.2021.69655
Andrea Bretón I, R. Tordecilla F
The current SARS-CoV-2 pandemic originated in China in late 2019, when an outbreak of pneumonia cases of unknown cause raised suspicions of an emerging infectious agent. More than 1 year after the identification of this new coronavirus, it has already caused more than 100 million cases worldwide. Coronavirus Disease 2019 (Covid-19), as defined by the WHO in February 2020, has a diverse clinical presentation from asymptomatic individuals to multi-organ failure and death. In this review, we will describe the main clinical manifestations of Covid-19 in adults.
{"title":"Manifestaciones clínicas Covid-19","authors":"Andrea Bretón I, R. Tordecilla F","doi":"10.5354/2735-7996.2021.69655","DOIUrl":"https://doi.org/10.5354/2735-7996.2021.69655","url":null,"abstract":"The current SARS-CoV-2 pandemic originated in China in late 2019, when an outbreak of pneumonia cases of unknown cause raised suspicions of an emerging infectious agent. More than 1 year after the identification of this new coronavirus, it has already caused more than 100 million cases worldwide. Coronavirus Disease 2019 (Covid-19), as defined by the WHO in February 2020, has a diverse clinical presentation from asymptomatic individuals to multi-organ failure and death. In this review, we will describe the main clinical manifestations of Covid-19 in adults.","PeriodicalId":287456,"journal":{"name":"Revista Hospital Clínico Universidad de Chile","volume":"98 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132866846","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 : 2021-12-13DOI: 10.5354/2735-7996.2021.69539
T. González A., Rodrigo Parra M, Alfredo San Martín O, H. Salinas P.
Hysterectomy is the most common gynecological surgery in non-pregnant women. There are different surgical approaches for total hysterectomy, abdominal, vaginal, laparoscopic and robotic routes. The choice is determined by different factors such as uterine size, malformations, surgical risks, skill of the surgeon, expected postoperative quality of life, and monetary costs. The surgical technique is well described in the literature, however, there are certain anatomical and functional considerations that must be known before performing the hysterectomy to avoid complications. The most frequent complications are hemorrhage, infections, thromboembolism, urinary and gastrointestinal tract injuries. Majority can be avoided with an adequate procedure and management of pre-existing comorbidities.
{"title":"Histerectomía total vía abdominal: revisión de la literatura","authors":"T. González A., Rodrigo Parra M, Alfredo San Martín O, H. Salinas P.","doi":"10.5354/2735-7996.2021.69539","DOIUrl":"https://doi.org/10.5354/2735-7996.2021.69539","url":null,"abstract":"Hysterectomy is the most common gynecological surgery in non-pregnant women. There are different surgical approaches for total hysterectomy, abdominal, vaginal, laparoscopic and robotic routes. The choice is determined by different factors such as uterine size, \u0000malformations, surgical risks, skill of the surgeon, expected postoperative quality of life, and monetary costs. The surgical technique is well described in the literature, however, there are certain anatomical and functional considerations that must be known before performing the hysterectomy to avoid complications. The most frequent complications are hemorrhage, infections, thromboembolism, urinary and gastrointestinal tract injuries. Majority can be avoided with an adequate procedure and management of pre-existing comorbidities.","PeriodicalId":287456,"journal":{"name":"Revista Hospital Clínico Universidad de Chile","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130975067","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 : 2021-12-13DOI: 10.5354/2735-7996.2021.69662
C. Pérez N., Gisselle Escobar A, Pablo Soto B, Camila Ibarra C, M. Larrondo L, J. Alfaro L.
Platelet rich plasma (PRP) is used to speed up tissue repair. Despite its widespread use, the therapeutic application of PRP generates controversies in clinical results due to the variability in methods of obtaining the different preparations and differences between the components of different types of PRP, so it’s recommended to mention the type of platelet preparation used. In this article, we describe technical and biologics characteristics of our platelet product, and we compare them to different commercial preparations described in order to validate their clinical use. Our results determine that the preparation can be considered a platelet rich plasma with biological activity in vivo and in vitro, which supports its use as a valid therapeutic tool, alternative to products currently available in Regenerative Medicine.
{"title":"Obtención de plasma rico en plaquetas (PRP) en el Laboratorio de Terapia Celular para uso como herramienta terapéutica en medicina regenerativa","authors":"C. Pérez N., Gisselle Escobar A, Pablo Soto B, Camila Ibarra C, M. Larrondo L, J. Alfaro L.","doi":"10.5354/2735-7996.2021.69662","DOIUrl":"https://doi.org/10.5354/2735-7996.2021.69662","url":null,"abstract":"Platelet rich plasma (PRP) is used to speed up tissue repair. Despite its widespread use, the therapeutic application of PRP generates controversies in clinical results due to the variability in methods of obtaining the different preparations and differences between the components of different types of PRP, so it’s recommended to mention the type of platelet preparation used. In this article, we describe technical and biologics characteristics of our platelet product, and we compare them to different commercial preparations described in order to validate their clinical use. Our results determine that the preparation can be considered a platelet rich plasma with biological activity in vivo and in vitro, which supports its use as a valid therapeutic tool, alternative to products currently available in Regenerative Medicine.","PeriodicalId":287456,"journal":{"name":"Revista Hospital Clínico Universidad de Chile","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131690618","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 : 2021-12-13DOI: 10.5354/2735-7996.2021.69654
Nicole Hunt P, C. Bastías O
SARS-CoV-2 infection in the people has been characterized by great variability in the clinical manifestations, ranging from an asymptomatic infection in some individuals to a fatal disease in others. Recently, the importance of human genetics in determining clinical response has been highlighted. Within this context there are patients who don’t become infected despite viral exposure and others who, being young without comorbidities, develop a severe disease. On the other hand, it’s under constant investigation whether the presence of a concomitant primary or secondary immunodeficiency determines a different clinical course.
{"title":"Respuesta inmune innata y adaptativa frente al SARS-CoV-2. Diagnóstico: PCR y serología","authors":"Nicole Hunt P, C. Bastías O","doi":"10.5354/2735-7996.2021.69654","DOIUrl":"https://doi.org/10.5354/2735-7996.2021.69654","url":null,"abstract":"SARS-CoV-2 infection in the people has been characterized by great variability in the clinical manifestations, ranging from an asymptomatic infection in some individuals to a fatal disease in others. Recently, the importance of human genetics in determining clinical response has been highlighted. Within this context there are patients who don’t become infected despite viral exposure and others who, being young without comorbidities, develop a severe disease. On the other hand, it’s under constant investigation whether the presence of a concomitant primary or secondary immunodeficiency determines a different clinical course.","PeriodicalId":287456,"journal":{"name":"Revista Hospital Clínico Universidad de Chile","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129286117","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 : 2021-12-13DOI: 10.5354/2735-7996.2021.69670
P. Matus R., S. Tapia S.
Communication is an essential part of our social participation and the need to know how to evaluate and deal with its alterations is essential when working with people with neurological pathologies such as Multiple Sclerosis (MS). Purpose: to carry out a bibliographic review and group information related to communication problems, describing useful instruments for timely evaluation in the different areas involved. Material and method: bibliographic review related to the subject. Results: People with MS can face differents communication problems (aphasia, dysarthria or cognitive communicative disorder), it is important to have the characterization of these disorders and with tools that specifically carry out a pertinent evaluation with common language among experts. Conclusions: considering the importance of communication, its disorders as a consequence of MS and the forms of evaluation are a priority when intervening with this population.
{"title":"Trastornos de la comunicación en personas con esclerosis múltiple e instrumentos de evaluación","authors":"P. Matus R., S. Tapia S.","doi":"10.5354/2735-7996.2021.69670","DOIUrl":"https://doi.org/10.5354/2735-7996.2021.69670","url":null,"abstract":"Communication is an essential part of our social participation and the need to know how to evaluate and deal with its alterations is essential when working with people with neurological pathologies such as Multiple Sclerosis (MS). Purpose: to carry out a bibliographic review and group information related to communication problems, describing useful instruments for timely evaluation in the different areas involved. Material and method: bibliographic review related to the subject. Results: People with MS can face differents communication problems (aphasia, dysarthria or cognitive communicative disorder), it is important to have the characterization of these disorders and with tools that specifically carry out a pertinent evaluation with common language among experts. Conclusions: considering the importance of communication, its disorders as a consequence of MS and the forms of evaluation are a priority when intervening with this population.","PeriodicalId":287456,"journal":{"name":"Revista Hospital Clínico Universidad de Chile","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116546085","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 : 2021-12-13DOI: 10.5354/2735-7996.2021.69658
Nicole Hunt P, C. Bastías O
The main treatment for patients with severe Covid-19 is to maintain adequate ventilatory support and monitor the possible progression of the disease. Therapeutic strategies such as High Flow Nasal Cannula, awake prone position, antithrombotic prophylaxis and the use of dexamethasone. There have improved the probability of not presenting complications and not requiring invasive mechanical ventilation. The use of convalescent plasma is still under investigation and is currently only recommended in clinical trials. Finding antivirals that allow treating the infection and clinically improving patients has led to mounting studies with different methodologies, and currently there are specific and limited indications for their routine use, as in the case of Remdesivir, which has been approved by the FDA as emergency treatment in severe cases. Immunomodulatory treatments are still under study. An example of this is Tocilizumab and Anakinra, which have shown promising results for the management of seriously ill patients. It should be noted that there are many therapies that are being tested and that every day the information about the results obtained is changing.
{"title":"Tratamiento Covid-19","authors":"Nicole Hunt P, C. Bastías O","doi":"10.5354/2735-7996.2021.69658","DOIUrl":"https://doi.org/10.5354/2735-7996.2021.69658","url":null,"abstract":"The main treatment for patients with severe Covid-19 is to maintain adequate ventilatory support and monitor the possible progression of the disease. Therapeutic strategies such as High Flow Nasal Cannula, awake prone position, antithrombotic prophylaxis and the use of dexamethasone. There have improved the probability of not presenting complications and not requiring invasive mechanical ventilation. The use of convalescent plasma is still under investigation and is currently only recommended in clinical trials. Finding antivirals that allow treating the infection and clinically improving patients has led to mounting studies with different methodologies, and currently there are specific and limited indications for their routine use, as in the case of Remdesivir, which has been approved by the FDA as emergency treatment in severe cases. Immunomodulatory treatments are still under study. An example of this is Tocilizumab and Anakinra, which have shown promising results for the management of seriously ill patients. It should be noted that there are many therapies that are being tested and that every day the information about the results obtained is changing.","PeriodicalId":287456,"journal":{"name":"Revista Hospital Clínico Universidad de Chile","volume":"119 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122480267","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 : 2021-12-13DOI: 10.5354/2735-7996.2021.69535
Leopoldo Córdova P
Priapism is a persistent erection, often painful, lasting more than 4 hours and unrelated to sexual stimulation. Based on clinical and pathophysiological features, priapism can be classified as ischemic, nonischemic and stuttering. Ischemic priapism is the most frequent form and represents a urological emergency. Although it is described as a low frequency entity, its timely diagnosis and immediate intervention are essential in the reestablishment of cavernous blood flow and in the prevention of necrosis and permanent erectile dysfunction. Intracavernous blood aspiration and injection of a-adrenergic agents correspond to the first-line options for the management of cases of ischemic priapism. Surgical shunts continue to be the most widely used surgical option for the management of prolonged ischemic priapism refractory to non-invasive management, with emerging evidence supporting the early implantation of a penile prosthesis. The objective of this review article is to describe the keys to the clinical approach and acute management of priapism in the emergency department.
{"title":"Priapismo: abordaje clínico y manejo de urgencia","authors":"Leopoldo Córdova P","doi":"10.5354/2735-7996.2021.69535","DOIUrl":"https://doi.org/10.5354/2735-7996.2021.69535","url":null,"abstract":"Priapism is a persistent erection, often painful, lasting more than 4 hours and unrelated to sexual stimulation. Based on clinical and pathophysiological features, priapism can be classified as ischemic, nonischemic and stuttering. Ischemic priapism is the most frequent form and represents a urological emergency. Although it is described as a low frequency entity, its timely \u0000diagnosis and immediate intervention are essential in the reestablishment of cavernous blood flow and in the prevention of necrosis and permanent erectile dysfunction. Intracavernous blood aspiration and injection of a-adrenergic agents correspond to the first-line options for the management of cases of ischemic priapism. Surgical shunts continue to be the most widely used surgical option for the management of prolonged ischemic priapism refractory to non-invasive management, with emerging evidence supporting the early implantation of a penile prosthesis. The objective of this review article is to describe the keys to the clinical approach and acute management of priapism in the emergency department.","PeriodicalId":287456,"journal":{"name":"Revista Hospital Clínico Universidad de Chile","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132925218","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 : 2021-12-13DOI: 10.5354/2735-7996.2021.69441
Eusebio Bravo C, Gonzalo Rivera-Lillo, Sebastián Gallegos B, Paula Horta M, Rocío Navarro A, H. Puppo G., Rodrigo Torres-Castro
One year after the first case reported by a new coronavirus (COVID-19), the evidence has shown a series of persistent signs and symptoms once the acute process has been overcome. Under the WHO’s framework for health and disability, these impairments at cardiorespiratory, cognitive, and musculoskeletal body functions and structures lead, at least in the short and mid-term, to activity limitations and participation restriction. In this review, we discussed the main alterations generating disability and the challenges of implementing effective evaluation strategies in this disease. Along with their role in the health emergency, rehabilitation teams are challenged to design and deliver timely intervention strategies to reduce post-COVID-19 disability.
{"title":"Capacidad funcional y desempeño de pacientes con neumonía por Covid-19","authors":"Eusebio Bravo C, Gonzalo Rivera-Lillo, Sebastián Gallegos B, Paula Horta M, Rocío Navarro A, H. Puppo G., Rodrigo Torres-Castro","doi":"10.5354/2735-7996.2021.69441","DOIUrl":"https://doi.org/10.5354/2735-7996.2021.69441","url":null,"abstract":"One year after the first case reported by a new coronavirus (COVID-19), the evidence has \u0000shown a series of persistent signs and symptoms once the acute process has been overcome. \u0000Under the WHO’s framework for health and disability, these impairments at cardiorespiratory, \u0000cognitive, and musculoskeletal body functions and structures lead, at least in the short and \u0000mid-term, to activity limitations and participation restriction. In this review, we discussed the \u0000main alterations generating disability and the challenges of implementing effective evaluation \u0000strategies in this disease. Along with their role in the health emergency, rehabilitation teams \u0000are challenged to design and deliver timely intervention strategies to reduce post-COVID-19 \u0000disability.","PeriodicalId":287456,"journal":{"name":"Revista Hospital Clínico Universidad de Chile","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131909655","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 : 2021-12-13DOI: 10.5354/2735-7996.2021.69651
Nicolás Faúndes G, Karen Genskowsky V, R. Tordecilla F
Covid-19 is an infectious disease whose etiological agent called SARS-CoV-2. It has a high contagion rate, high morbidity and mortality, and potential multi-organ compromise. Its main route of infection is by droplets, however, the infection can be acquired by other routes such as aerosols, fecal-oral and contact with fomites. Although the immune response is essential for defense against any infection, in severe Covid-19 infection, a dysregulation of the immune system occurs, which leads to marked increases of cytokines and the consequent systemic inflammatory state. Inflammation, infection, and viral shedding can compromise the lungs, blood vessels, brain, gastrointestinal (GI) tract, kidneys, heart, and liver, ultimately leading to multiple organ dysfunction and failure.
{"title":"Patogenia de la infección por SARS-CoV-2","authors":"Nicolás Faúndes G, Karen Genskowsky V, R. Tordecilla F","doi":"10.5354/2735-7996.2021.69651","DOIUrl":"https://doi.org/10.5354/2735-7996.2021.69651","url":null,"abstract":"Covid-19 is an infectious disease whose etiological agent called SARS-CoV-2. It has a high \u0000contagion rate, high morbidity and mortality, and potential multi-organ compromise. Its main \u0000route of infection is by droplets, however, the infection can be acquired by other routes such \u0000as aerosols, fecal-oral and contact with fomites. Although the immune response is essential \u0000for defense against any infection, in severe Covid-19 infection, a dysregulation of the immune \u0000system occurs, which leads to marked increases of cytokines and the consequent systemic \u0000inflammatory state. Inflammation, infection, and viral shedding can compromise the lungs, \u0000blood vessels, brain, gastrointestinal (GI) tract, kidneys, heart, and liver, ultimately leading to \u0000multiple organ dysfunction and failure.","PeriodicalId":287456,"journal":{"name":"Revista Hospital Clínico Universidad de Chile","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114316933","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 : 2021-12-13DOI: 10.5354/2735-7996.2021.69660
Andrea Bretón I, Alejandro Afani S
Vaccines are biological products that stimulate the immune system to generate specific responses and immune memory. Faced with the magnitude of the problem caused by the Covid-19 pandemic, there is an urgent need to find an effective and safe preventive intervention. The race to find the ideal vaccine against this new coronavirus has required optimizing research times on this topic. Currently, more than 200 SARS-CoV-2 vaccine candidates are in development, 177 in preclinical evaluation, 63 in clinical evaluation and 16 of them in phase 3 of clinical trials. In our country, 3 SARS-CoV-2 vaccines are already authorized for administration, which have demonstrated safety and efficacy in clinical trials.
{"title":"Vacunas SARS-CoV-2","authors":"Andrea Bretón I, Alejandro Afani S","doi":"10.5354/2735-7996.2021.69660","DOIUrl":"https://doi.org/10.5354/2735-7996.2021.69660","url":null,"abstract":"Vaccines are biological products that stimulate the immune system to generate specific responses and immune memory. Faced with the magnitude of the problem caused by the Covid-19 pandemic, there is an urgent need to find an effective and safe preventive intervention. The race to find the ideal vaccine against this new coronavirus has required optimizing research times on this topic. Currently, more than 200 SARS-CoV-2 vaccine candidates are in development, 177 in preclinical evaluation, 63 in clinical evaluation and 16 of them in phase 3 of clinical trials. In our country, 3 SARS-CoV-2 vaccines are already authorized for administration, which have demonstrated safety and efficacy in clinical trials.","PeriodicalId":287456,"journal":{"name":"Revista Hospital Clínico Universidad de Chile","volume":"136 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116308094","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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