Revista médica de Chile
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Revista médica de Chile · Jun 2023
Review[Understanding Bipolar Disorder: Risk Factors & Protective Measures].
Bipolar Affective Disorder (BD) is a severe mental pathology characterized by recurrent mood episodes that usually cycle between two opposite poles: mania or hypomania and depression. It has a high level of morbidity/mortality (i.e., cardiovascular disease, cognitive impairment, altered functionality, and absenteeism from work) and associated substantial socioeconomic costs. The most dramatic outcome is death by suicide, which occurs in 5% to 15% of patients. ⋯ It is essential to determine the disease's risk and specific protective factors to prevent its occurrence, delay its appearance, and reduce its deterioration effects. Characteristics such as genetic profile, cognitive reserve (partially explained by educational level and premorbid intelligence), chronotype (particularly morning chronotype), personality aspects (including resilience and hyperthymic temperament), the absence of substance use and childhood maltreatment, in addition to an adequate support network, have been associated with a lower impact in the onset and course of the disease. Once present, interventions -both in the early and late stages (i.e., specific pharmacotherapy and psychotherapy, dietary factors, physical activity, and judicious use of antipsychotics)-can play a protective role against the appearance of the disease and the severity of its mood episodes.
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Revista médica de Chile · Jun 2023
Review[Pulmonary hypertension: calcium channel-mediated signaling, present and future pharmacological targets].
Pulmonary arterial hypertension is characterized by increased mean pulmonary arterial pressure, resistance, and pathological remodeling of pulmonary arteries. Calcium entry from the extracellular to the intracellular space through voltage-dependent and -independent channels play a major role in the increase of contractility of pulmonary arteries and in the loss of regulation of the proliferative behavior of the cells from the different layers of the pulmonary arterial wall. In doing so, these channels contribute to enhanced vasoconstriction of pulmonary arteries and their pathological remodeling. This review aims to summarize the evidence obtained from animal and cellular models regarding the involvement of the main plasma membrane calcium channels in these key pathophysiological processes for pulmonary arterial hypertension, discussing the potential value as pharmacological targets for therapies in the present and the future.
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Revista médica de Chile · Jun 2023
Multicenter Study[Assessing Convalescent Plasma Efficacy in Moderate COVID-19 Hospitalizations: A Bicentric Retrospective Study].
COVID-19 claimed millions of lives, mainly in the pre-vaccine era. Preliminary studies showed promising efficacy of convalescent plasma against SARS-CoV-2 (CP). ⋯ The use of CP in patients hospitalized for moderately severe COVID-19 was not associated with lower mortality, hospital stay, or the need for IMV.
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Revista médica de Chile · Jun 2023
Audiological follow-up in transplant patients treated with calcineurin immunosuppressants "Calcineurin inhibitors and Ototoxicity".
Ototoxicity is a side effect of drugs and medications that usually leads to bilateral and symmetric sensorineural hearing loss that commonly affects the high-frequency range initially, with or preceded by tinnitus. Possible ototoxic side effects of calcineurin inhibitor immunosuppressants have been suggested, but this remains unclear. Therefore, this study aims to evaluate audiological changes in patients undergoing transplantation receiving immunosuppressive treatment with calcineurin inhibitors. ⋯ It appears that tacrolimus does not cause hearing loss when levels are within the therapeutic range for a follow-up period of six months post-transplantation.
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Revista médica de Chile · Jun 2023
Comparative Study[Stage at diagnosis of prostate cancer in an institutional hospital. Review and comparison of national and international data].
Prostate cancer (PCa) is a disease with a high prevalence and incidence worldwide. Screening has pursued the early diagnosis of this disease to provide early treatment. We sought to characterize patients from a local hospital with respect to diagnosis and staging and to compare these results with previously reported data. ⋯ The stage at diagnosis in our series is somewhat higher than that reported by developed countries but considerably lower than that published by other Latin American countries and even from other hospitals in our country. It is of great national relevance to have clear protocols for screening and access to PSA to reduce the cases diagnosed in advanced stages.