Revista médica de Chile
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Revista médica de Chile · Dec 2019
Comparative Study[Association between cytochrome p4502c9 polymorphisms and losartan dosing in hypertensive patients].
Background Losartan is widely used in many clinicals settings. Its dosage is related to the genetic characteristics of CYP2C9 enzymatic activity, which metabolizes losartan to its active form E-3174, responsible for the antihypertensive effect. Aims To identify the frequency of allelic variants CYP2C9*2 and CYP2C9*3 in hypertensive patients and to compare genotypes with a healthy Chilean population. ⋯ The same tendency was observed with the need to use losartan twice a day, obtaining an OR of 5.88 (CI 0.54 -62.14). Conclusions There could be a relationship between the presence of CYP2C9 polymorphisms and the pathogenesis of hypertension. The presence of CYP2C9*3 is associated with the need for higher doses of losartan, possibly due to a decrease in the conversion of losartan to E-3174.
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Revista médica de Chile · Dec 2019
[Extracellular vesicle concentration in maternal plasma as an early marker of gestational diabetes].
Background During pregnancy, there is an increase in the amount of extracellular vesicles, especially placental exosomes, in maternal plasma. Aim To isolate and characterize extracellular vesicles from blood during the three trimesters of pregnancy and to evaluate their capacity to identify patients at risk of developing gestational diabetes. Material and Methods A case-control study was conducted in a cohort of 50 pregnant women with plasma samples taken in each trimester. ⋯ The size of the extracellular vesicles obtained in the first trimester of pregnancy was very similar between groups (144 ± 37 nm for controls and 143 ± 34 nm for patients with gestational diabetes mellitus). Moreover, the concentration of extracellular vesicles collected in the first trimester, was significantly higher in patients who developed gestational diabetes mellitus later in pregnancy compared to normoglycemic pregnant women (7.94 x 10 8 and 5.15 x 10 8 , p = 0.03). Conclusions Our results provide an insight into the potential capacity of first trimester plasma extracellular vesicles as early biomarkers for the prediction of gestational diabetes mellitus.
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Revista médica de Chile · Dec 2019
[Prolonged disorders of consciousness after an acute brain injury].
Only a fraction of patients in coma secondary to a primary acute brain injury develop a vegetative state (VS). At least 20% of patients show late transitions to a minimally conscious states (MCS). ⋯ Specific therapies are of limited effectiveness. This population is vulnerable to misdiagnosis and limited access to medical care and rehabilitation, thus generating ethical problems.
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Revista médica de Chile · Dec 2019
[Arteria coronaria única y cardiopatía coronaria: origen anómalo de la arteria coronaria derecha desde la descendente anterior. Casos clínicosAnomalous origin of the right coronary artery in the middle third of the anterior descending artery. Report of two cases].
The anomalous origin of the coronary arteries is uncommon and the origin of the right coronary artery from the middle third of the anterior descending artery is a finding of extreme rarity. We report two patients with coronary atherosclerotic disease and with an acute coronary syndrome, in whom a single left coronary artery was found. The clinical and angiographic characteristics and the treatment of these patients are described.