Pub Date : 2021-12-13DOI: 10.5354/2735-7996.2021.69442
F. Maldonado C., Catalina Valdés A, Catalina Díaz P, Nicolás Valls J, Carlos Romero P, Óscar Cerda A, Mónica Cáceres Ll
Endothelium is the inner layer of vessels that separates circulating blood from the rest of the body tissues. Since its discovery, it has been involved in various functions, both systemic and organ specific. Currently, endothelial damage and failure in its functions is considered a key element in pathophysiology of various clinical scenarios, among which we may find COVID-19. Hence, it has been a target in development of strategies that seek to maintain, enhance or repair its function. The purpose of the following review is to describe what an endothelial function is about, its relation with current medical practice, and its implications in the SARSCoV-2 pandemic.
{"title":"Disfunción endotelial. Mecanismos e implicancias en Covid-19","authors":"F. Maldonado C., Catalina Valdés A, Catalina Díaz P, Nicolás Valls J, Carlos Romero P, Óscar Cerda A, Mónica Cáceres Ll","doi":"10.5354/2735-7996.2021.69442","DOIUrl":"https://doi.org/10.5354/2735-7996.2021.69442","url":null,"abstract":"Endothelium is the inner layer of vessels that separates circulating blood from the rest of the \u0000body tissues. Since its discovery, it has been involved in various functions, both systemic and \u0000organ specific. Currently, endothelial damage and failure in its functions is considered a key \u0000element in pathophysiology of various clinical scenarios, among which we may find COVID-19. \u0000Hence, it has been a target in development of strategies that seek to maintain, enhance or \u0000repair its function. The purpose of the following review is to describe what an endothelial \u0000function is about, its relation with current medical practice, and its implications in the SARSCoV-2 pandemic.","PeriodicalId":287456,"journal":{"name":"Revista Hospital Clínico Universidad de Chile","volume":"6 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":"133990772","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: 10.5354/2735-7996.2021.69645
Dayanne Isler I., V. Palma P.
Coronaviruses (CoVs) were identified in 1937, they were considered innocuous viruses until the appearance of three highly pathogenic variants, SARS-CoV, MERS-CoV and SARS-CoV-2 causing the current pandemic of Covid-19, so far it is known that its origin is zoonotic, the main reservoir could be bats considering the high homology of CoVs that inhabit this species. Its transmissibility is much higher than that of previous CoVs, possibly in the process of natural selection; it has acquired some or all the mutations necessary for a much more efficient transmission in our species. This condition is specifically attributed to unique characteristics of the SARS-CoV-2 Spike protein that allow it greater affinity and therefore greater infectivity by binding to the angiotensin receptor 2 (ACE-2) present in the host cells. Since the Covid-19 outbreak began at the end of 2019, more than 1,500 mutations have been detected throughout the SARS-CoV-2 genome, however the most significant are those that occur near or in the receptor binding domain (RBD) that could provide variations between 4x to 100x greater infectivity, such is the case of the new variants identified in the United Kingdom, South Africa, Brazil and Japan that force us to take extreme preventive measures and continue research to elucidate strategies to combat the current crisis.
{"title":"Características de los coronavirus, origen del SARS-CoV-2, características estructurales, proteínas y factores de virulencia, variantes genéticas","authors":"Dayanne Isler I., V. Palma P.","doi":"10.5354/2735-7996.2021.69645","DOIUrl":"https://doi.org/10.5354/2735-7996.2021.69645","url":null,"abstract":"Coronaviruses (CoVs) were identified in 1937, they were considered innocuous viruses until the \u0000appearance of three highly pathogenic variants, SARS-CoV, MERS-CoV and SARS-CoV-2 causing \u0000the current pandemic of Covid-19, so far it is known that its origin is zoonotic, the main reservoir \u0000could be bats considering the high homology of CoVs that inhabit this species. Its transmissibility \u0000is much higher than that of previous CoVs, possibly in the process of natural selection; it has \u0000acquired some or all the mutations necessary for a much more efficient transmission in our \u0000species. This condition is specifically attributed to unique characteristics of the SARS-CoV-2 \u0000Spike protein that allow it greater affinity and therefore greater infectivity by binding to the \u0000angiotensin receptor 2 (ACE-2) present in the host cells. Since the Covid-19 outbreak began at \u0000the end of 2019, more than 1,500 mutations have been detected throughout the SARS-CoV-2 \u0000genome, however the most significant are those that occur near or in the receptor binding \u0000domain (RBD) that could provide variations between 4x to 100x greater infectivity, such is the \u0000case of the new variants identified in the United Kingdom, South Africa, Brazil and Japan that \u0000force us to take extreme preventive measures and continue research to elucidate strategies to \u0000combat the current crisis.","PeriodicalId":287456,"journal":{"name":"Revista Hospital Clínico Universidad de Chile","volume":"42 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":"114199118","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: 10.5354/2735-7996.2021.69673
V. Zemelman D., Hans Gubelin A
Obesity is a growing global health problem; it may even be one of the worst public health issues. In Chile, 34.4% of the population is obese, therefore, is it important for clinicians to be aware of all the consequences of obesity. In this review, we will address the relation of four main dermatologic conditions with obesity: psoriasis, hidradenitis suppurativa, acanthosis nigricans and malignant melanoma. Material and methods: Search in pubmed for obesity and psoriasis, hidradenitis suppurativa, acanthosis nigricans and malignant melanoma. Results: Obesity has a direct impact in the prevalence and severity of psoriasis, hidradenitis suppurativa, acanthosis nigricans. The reduction on body weight has proven to reduce severity of psoriasis and hidradenitis suppurativa. Obese patients with psoriasis have a higher risk on adverse effects due to medication and less effectiveness of biological medications. Acanthosis nigricans is a clinical indicator of insulin resistance and a risk predictor for those with greater risk to develop diabetes in the future. The relationship between obesity and malignant melanoma is not clear and needs further research. Conclusion: Obesity is increasing, dermatologist will face this condition more frequently, it has a great impact over psoriasis, hidradenitis suppurativa, acanthosis nigricans and malignant melanoma, thus it should be considered in treatment decisions.
{"title":"Obesidad y piel","authors":"V. Zemelman D., Hans Gubelin A","doi":"10.5354/2735-7996.2021.69673","DOIUrl":"https://doi.org/10.5354/2735-7996.2021.69673","url":null,"abstract":"Obesity is a growing global health problem; it may even be one of the worst public health issues. In Chile, 34.4% of the population is obese, therefore, is it important for clinicians to be aware of all the consequences of obesity. In this review, we will address the relation of four main dermatologic conditions with obesity: psoriasis, hidradenitis suppurativa, acanthosis nigricans and malignant melanoma. Material and methods: Search in pubmed for obesity and psoriasis, hidradenitis suppurativa, acanthosis nigricans and malignant melanoma. Results: Obesity has a direct impact in the prevalence and severity of psoriasis, hidradenitis suppurativa, acanthosis nigricans. The reduction on body weight has proven to reduce severity of psoriasis and hidradenitis suppurativa. Obese patients with psoriasis have a higher risk on adverse effects due to medication and less effectiveness of biological medications. Acanthosis nigricans is a clinical indicator of insulin resistance and a risk predictor for those with greater risk to develop diabetes in the future. The relationship between obesity and malignant melanoma is not clear and needs further research. Conclusion: Obesity is increasing, dermatologist will face this condition more frequently, it has a great impact over psoriasis, hidradenitis suppurativa, acanthosis nigricans and malignant melanoma, thus it should be considered in treatment decisions.","PeriodicalId":287456,"journal":{"name":"Revista Hospital Clínico Universidad de Chile","volume":"183 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":"121937551","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: 10.5354/2735-7996.2021.69656
Dayanne Isler I, M. Guzmán M
Atopic diseases, especially asthma may confer increased susceptibility to viral infections, however, such patients have been largely unaffected in the current Covid-19 pandemic. This favorable course could be explained by a protective role of cytokines and cells involved in an immune response with a T2 profile. In spite of the favorable course observed, it is a priority to maintain with its basic treatments to ensure a good control of the pathology. With respect the immunization process being carried out in patients with a history of allergic reactions in different degrees, the recommendation of the type of vaccine and the protocol for its administration should be individualized according to a risk stratification prior to its administration.
{"title":"Alergia y Covid-19","authors":"Dayanne Isler I, M. Guzmán M","doi":"10.5354/2735-7996.2021.69656","DOIUrl":"https://doi.org/10.5354/2735-7996.2021.69656","url":null,"abstract":"Atopic diseases, especially asthma may confer increased susceptibility to viral infections, however, such patients have been largely unaffected in the current Covid-19 pandemic. This favorable course could be explained by a protective role of cytokines and cells involved in an immune response with a T2 profile. In spite of the favorable course observed, it is a priority to maintain with its basic treatments to ensure a good control of the pathology. With respect the immunization process being carried out in patients with a history of allergic reactions in different degrees, the recommendation of the type of vaccine and the protocol for its administration should be individualized according to a risk stratification prior to its administration.","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":"130041229","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: 10.5354/2735-7996.2021.69440
D. Ugalde C, Nicole Rossel B, Tamara Lillo A, Sedric Gonzalez G, Luis Gallegos M
Background: Anaemia and transfusions are frequent in critically ill patients and there are avoidable causes such as routine laboratory tests. Patients and methods: Descriptive study during one continuous week including patients over 18-years old in a medical-surgical ICU. Results: 18 patients were included during a week in 12 beds in our unit, median age 62,5 years, 50% male. Median daily blood loss was 35ml, 45% in laboratory samples and 27% related to renal replacement therapy. 3 patients required 1 transfusion of red blood cells. Conclusions: There is a pattern of continuous blood loss in critically ill patients, primarily in routine laboratory tests.
{"title":"Pérdidas hemáticas en UCI: Breve estudio descriptivo","authors":"D. Ugalde C, Nicole Rossel B, Tamara Lillo A, Sedric Gonzalez G, Luis Gallegos M","doi":"10.5354/2735-7996.2021.69440","DOIUrl":"https://doi.org/10.5354/2735-7996.2021.69440","url":null,"abstract":"Background: Anaemia and transfusions are frequent in critically ill patients and there are avoidable causes such as routine laboratory tests. Patients and methods: Descriptive study during one continuous week including patients over 18-years old in a medical-surgical ICU. Results: 18 patients were included during a week in 12 beds in our unit, median age 62,5 years, 50% male. Median daily blood loss was 35ml, 45% in laboratory samples and 27% related to renal replacement therapy. 3 patients required 1 transfusion of red blood cells. Conclusions: There is a pattern of continuous blood loss in critically ill patients, primarily in routine laboratory tests.","PeriodicalId":287456,"journal":{"name":"Revista Hospital Clínico Universidad de Chile","volume":"89 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":"124562197","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: 10.5354/2735-7996.2021.69536
J. Arocha R.
Sedentary behavior is spreading among society, especially since the rise of technology and progress. The sedentary lifestyle habits are being transmitted to young people, who increase the time they spend in sedentary activities like video games or TV. It has been demonstrated that both sedentary behavior and physical inactivity have negative cardiometabolic consequences for the health, and they become a serious problem for public health, as it has been claimed in several studies and by scientific statements. This review intent to make a call of attention to this problem that will have profound impact in the near future in many countries in Latin America.
{"title":"Riesgo cardiometabólico del sedentarismo","authors":"J. Arocha R.","doi":"10.5354/2735-7996.2021.69536","DOIUrl":"https://doi.org/10.5354/2735-7996.2021.69536","url":null,"abstract":"Sedentary behavior is spreading among society, especially since the rise of technology and progress. The sedentary lifestyle habits are being transmitted to young people, who increase the time they spend in sedentary activities like video games or TV. It has been demonstrated that both sedentary behavior and physical inactivity have negative cardiometabolic consequences for the health, and they become a serious problem for public health, as it has been claimed in several studies and by scientific statements. This review intent to make a call of attention to this problem that will have profound impact in the near future in many countries in Latin \u0000America.","PeriodicalId":287456,"journal":{"name":"Revista Hospital Clínico Universidad de Chile","volume":"23 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":"125155544","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: 10.5354/2735-7996.2021.69669
J. Valdevenito S., Mauricio Olea C, Francisco Moya G, Pablo Lizana V, Hugo Toro M, Simon Baloian C
Voiding dysfunction is defined as an abnormally slow and/or incomplete micturition, and can be divided in bladder outlet obstruction (BOO) and detrusor underactivity (or hypocontractility). BOO is characterized by reduced urine flow rate and increased detrusor pressure, and can be of anatomical or functional origin. Detrusor underactivity encompasses a reduced urine flow rate associated to low pressure and/or poorly sustained detrusor contraction, and its etiology is multifactorial. Lower urinary tract symptoms are classified as storage, voiding and post micturition symptoms, may be objectively quantified with specific questionnaires, and don’t correlate properly with voiding dysfunction. Patients’ evaluation requires a directed physical examination of the abdomen, pelvis and genitals focused to detect anatomical and neurological abnormalities. Voiding dysfunction can be demonstrated non-invasively using uroflowmetry and pelvic ultrasound. Uroflowmetry allows determining urinary flow characteristics and their most important parameters are voided volume, maximum flow rate and shape of the curve. Pelvic ultrasound permits to estimate prostatic size and post void residual, suspect detrusor hypertrophy (due to BOO) and detect bladder stones. Invasive test must be reserved for special cases of confirmed voiding dysfunction: cystoscopy when there is concomitant hematuria, urethrocystography to study urethral stenosis and urodynamics to differentiate BOO from detrusor underactivity.
{"title":"Disfunción miccional en el adulto. Un artículo docente","authors":"J. Valdevenito S., Mauricio Olea C, Francisco Moya G, Pablo Lizana V, Hugo Toro M, Simon Baloian C","doi":"10.5354/2735-7996.2021.69669","DOIUrl":"https://doi.org/10.5354/2735-7996.2021.69669","url":null,"abstract":"Voiding dysfunction is defined as an abnormally slow and/or incomplete micturition, and can \u0000be divided in bladder outlet obstruction (BOO) and detrusor underactivity (or hypocontractility). \u0000BOO is characterized by reduced urine flow rate and increased detrusor pressure, and can be \u0000of anatomical or functional origin. Detrusor underactivity encompasses a reduced urine flow rate \u0000associated to low pressure and/or poorly sustained detrusor contraction, and its etiology is \u0000multifactorial. Lower urinary tract symptoms are classified as storage, voiding and post micturition \u0000symptoms, may be objectively quantified with specific questionnaires, and don’t correlate \u0000properly with voiding dysfunction. Patients’ evaluation requires a directed physical examination of \u0000the abdomen, pelvis and genitals focused to detect anatomical and neurological abnormalities. \u0000Voiding dysfunction can be demonstrated non-invasively using uroflowmetry and pelvic ultrasound. \u0000Uroflowmetry allows determining urinary flow characteristics and their most important parameters \u0000are voided volume, maximum flow rate and shape of the curve. Pelvic ultrasound permits to \u0000estimate prostatic size and post void residual, suspect detrusor hypertrophy (due to BOO) and \u0000detect bladder stones. Invasive test must be reserved for special cases of confirmed voiding \u0000dysfunction: cystoscopy when there is concomitant hematuria, urethrocystography to study \u0000urethral stenosis and urodynamics to differentiate BOO from detrusor underactivity.","PeriodicalId":287456,"journal":{"name":"Revista Hospital Clínico Universidad de Chile","volume":"7 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":"127005155","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: 10.5354/2735-7996.2021.69676
Rodrigo Parra M, T. González A., Tomás Neumann F, H. Salinas P.
OBJETIVOS DE LA GUÍA CLÍNICA 1. Conocer la epidemiología, fisiopatología y factores de riesgo asociados al cáncer cervicouterino. 2. Aplicar las medidas de prevención secundaria de lesiones preinvasoras y cáncer cervicouterino. 3. Aplicar las estrategias de screening de VPH para lesiones preinvasoras y cáncer cervicouterino. 4. Conocer las proyecciones epidemiológicas de cáncer cervicouterino, entregadas por organismos internacionales, posterior a la vacunación universal y las estrategias de screening VPH.
{"title":"Screening virus papiloma humano en cáncer cervicouterino","authors":"Rodrigo Parra M, T. González A., Tomás Neumann F, H. Salinas P.","doi":"10.5354/2735-7996.2021.69676","DOIUrl":"https://doi.org/10.5354/2735-7996.2021.69676","url":null,"abstract":"OBJETIVOS DE LA GUÍA CLÍNICA \u00001. Conocer la epidemiología, fisiopatología y factores de riesgo asociados al cáncer cervicouterino. \u00002. Aplicar las medidas de prevención secundaria de lesiones preinvasoras y cáncer cervicouterino. \u00003. Aplicar las estrategias de screening de VPH para lesiones preinvasoras y cáncer cervicouterino. \u00004. Conocer las proyecciones epidemiológicas de cáncer cervicouterino, entregadas por organismos internacionales, posterior a la vacunación universal y las estrategias de screening VPH.","PeriodicalId":287456,"journal":{"name":"Revista Hospital Clínico Universidad de Chile","volume":"52 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":"122573832","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: 10.5354/2735-7996.2021.69657
Nicolás Faúndes G, Karen Genskowsky V, V. Palma P.
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":"Inmunodeficiencias en contexto de infección por SARS-CoV-2","authors":"Nicolás Faúndes G, Karen Genskowsky V, V. Palma P.","doi":"10.5354/2735-7996.2021.69657","DOIUrl":"https://doi.org/10.5354/2735-7996.2021.69657","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":"25 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":"124706126","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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