Revista médica de Chile
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Revista médica de Chile · Nov 2020
Case Reports[Cushing syndrome caused by a giant adrenal carcinoma. Report of one case].
We report a previously healthy 34-year-old woman, presenting with a seven-month history of arterial hypertension, amenorrhea, weight gain, facial edema, acne, hirsutism and low back pain. A CT scan showed a right adrenal mass of 18 × 13 × 12.5 cm, and multiple vertebral and rib fractures. The hormonal study confirmed Cushing's Syndrome. ⋯ Study of vertebral fractures with magnetic resonance (MRI) showed crush fractures, without images of metastatic bone lesions. One year after surgery, a CT scan showed no signs of tumor recurrence. The patient was lost from follow-up thereafter.
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Revista médica de Chile · Nov 2020
Review[Anti-inflammatory therapies for SARS-COV2 infection from a hematological perspective].
The pathophysiology of the inflammatory profile induced by SARS-COV2 infection has similarities with conditions of immune system activation with cytokine release such as hemophagocytic syndrome and some cases of acute graft-versus-host disease. There are encouraging results of clinical studies, performed with increasingly better methodological quality, supporting the use of targeted and specific anti-inflammatory therapy in selected groups of patients with COVID-19 with severe inflammation. In this review we describe the inflammatory pathophysiology of the disease and the recent findings about its treatment.
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Revista médica de Chile · Nov 2020
Review[Excess mortality during the COVID-19 pandemic, a narrative review].
Capturing all the deaths caused by COVID-19 through epidemiologic surveillance based on individual case notification is difficult, therefore, all-cause excess mortality (EM) is an appropriate measure for geographic comparisons and monitoring of the application of non-pharmacological sanitary measures. This is a narrative review of the literature about the observed EM during the COVID-19 pandemic. A research was made on scientific databases (Google Scholar, Pubmed, Virtual Health Library) using the terms "excess mortality", "excess deaths", "COVID-19", "coronavirus", "SARS-CoV-2". ⋯ They confirm EM in the locations studied, with higher proportion of men and older people and with remarkable spatial heterogeneity. The need to optimize the standardization and updating of mortality registration and reporting mechanisms is highlighted. At a local level, data about EM that will allow these analyses is incipiently becoming available.
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Revista médica de Chile · Nov 2020
Case ReportsTrametinib and dabrafenib induced rhabdomyolysis, renal failure, and visual loss. Report of one case.
MEK- and BRAF-inhibitors trametinib and dabrafenib are successfully used for BRAF-mutated, metastasizing melanoma, but these compounds may induce side effects. We report a 50 years old female with BRAF-mutated metastasizing melanoma who received trametinib (2 mg/d) and dabrafenib (200 mg/d) after using interferon without benefit. Shortly after starting trametinib/dabrafenib, she experienced an inability to abduct the left eye. ⋯ She could not eat or drink during four days prior to admission. The patient suspected an adverse effect of trametinib/dabrafenib and discontinued it 2 days prior to admission. Thereafter, she experienced an almost complete remission of the deficits except for ocular muscle weakness and visual impairment.