Revista médica de Chile
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Revista médica de Chile · Dec 2019
Review[Popular names and classification of illicit drugs commonly used in Chile].
Background The consumption of illicit drugs in Chile has increased over the years generating abuse and dependence problems and becoming a public health problem. Aim To build and disseminate a figure in which health personnel can quickly visualize illicit drugs and their common names, and thus be able to associate them with the effects and risks that are expected in the patient. Material and Methods A bibliographic review and compilation of information obtained from dealers and drug abusers. ⋯ Conclusions Illicit drugs have several popular names and various mechanisms of action. When confronting drug consumption this information is crucial to provide an adequate treatment and withdrawal management. However, it is important to keep in mind that this work only represents a management guide and that treatment should always focus on the condition and clinical manifestations of the patient.
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Revista médica de Chile · Dec 2019
ReviewIntoxicación por etilenglicol, fisiopatología y enfrentamiento clínico.
Toxic alcohols can produce severe poisoning with multiple organic involvement and even death. The most common form is ethylene glycol. The diagnosis can be extremely difficult if there is no history of its consumption. ⋯ The clinical manifestations are diffuse neurological involvement initially, followed by hemodynamic alterations due to myocardial damage associated with hypocalcemia and acidemia. Subsequently, severe tubular renal damage appears, which may require renal replacement therapy, and finally, focal neurological alterations. To treat this poisoning, it is necessary to inhibit the transformation of alcohol into acids, increase the metabolism of the latter or withdraw them directly with hemodialysis.
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Revista médica de Chile · Dec 2019
Absolute monocyte count as a prognostic parameter in diffuse large B cell lymphoma.
Background Prognosis of patients with Diffuse Large B Cell Lymphoma (DLBCL) is highly variable, and despite the use of modern immunochemotherapy regimens, almost 50% of patients will eventually relapse. Standard risk models, like the International Prognostic Index or the Revised International Prognostic Index (R_IPI) incorporate patient and tumor characteristics but do not consider variables related to host adaptive immunity which have been shown to be of significant prognostic value in non-Hodgkin lymphomas. Aim To analyze the prognostic significance of the absolute monocyte count at diagnosis in diffuse large-B-cell lymphoma in a retrospective setting. ⋯ Results The absolute monocyte count, analyzed as a dichotomized variable predicted progression-free and overall survival in low risk patients according to the R-IPI score. Worse outcomes were observed in those with high monocyte count al diagnosis. Conclusions Absolute monocyte count could help in the identification of high-risk patients otherwise expected to have a good prognosis according to traditional scores.
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Revista médica de Chile · Dec 2019
Observational Study[Clinicopathological correlation among proliferative classes and subclasses of lupus nephritis in renal biopsies].
Background Lupus nephritis (LN) is a complication of systemic lupus erythematosus that requires renal biopsy (RB). Proliferative classes III, IV-S, IV-G have especial clinical and pathological characteristics. Aim To determine the association between pathological features in RB with serum creatinine and urine protein levels. ⋯ Proteinuria is a variable that differentiates classes III from IV-G, being significantly higher in the second. Severe arteriosclerosis is a constant and significant finding that differentiates LN III from LN IV. Thus, we propose its usefulness for distinguishing LN classes, and eventually, to be considered in the chronicity index.
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Revista médica de Chile · Dec 2019
[Hospital mortality and long-term survival of 103 patients with infective endocarditis requiring surgery].
Background Infective endocarditis (IE) is a serious disease with high mortality, especially among the most severe cases undergoing surgery. Aim To analyze the clinical features, perioperative mortality and long-term survival of patients with infective endocarditis requiring surgery. Material and Methods Review of medical records of patients who underwent heart valve surgery for active infective endocarditis in a public hospital between 1995 and 2008. ⋯ The most common causative microorganisms were S. aureus in 12%, coagulase-negative Staphylococcus in 11%, S. viridans in 10% and Enterococcus in 7%. Hospital mortality was 20.4% and ten-year survival was 65%. Conclusions Patients with severe IE requiring surgical treatment still have high perioperative and late mortality.