Revista médica de Chile
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Revista médica de Chile · Sep 2009
Review[Leptin-melanocortin system, body weight regulation and obesity].
Obesity is a multifactorial disease that is rarely associated to single gene defects. However, due to their direct cause-effect relationships, those genetic defects that cause some forms of monogenic obesity are relevant in the study of mechanisms that contribute to increased energy intake and body fat accumulation. Most of the genes that have been shown to cause monogenic obesity are related to the leptin-melanocortin system. ⋯ Mutations related to human monogenic obesity have been described in leptin, leptin receptor, proopiomelanocortin, prohormone convertase 1 or melanocortin receptor 4 genes. Therapy with human recombinant leptin in patients with genetic deficiency of the hormone is an effective medical treatment of obesity, although only applicable to very few families. The use of leptin-melanocortin agonists, drugs to avoid leptin resistance or combinations of treatments with leptin and other satiating peptides are currently being investigated for multifacotiral human obesity.
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Revista médica de Chile · Aug 2009
Review[Current diagnosis of polycystic ovary syndrome: expanding the phenotype but generating new questions].
Polycystic ovarian syndrome (PCOS), includes a wide spectrum of clinical symptoms and signs. Three different diagnostic classifications have been proposed to define this disease. ⋯ Finally, the Androgen Excess Society, published in 2006 new diagnostic criteria which required the presence of clinical or biochemical hyperandrogenism, with either PCOM or menstrual dysfunction to diagnose PCOS. We review the different classifications employed in the diagnosis of PCOS, the diverse phenotypes that may lead to the diagnosis of PCOS and their association with cardiovascular and metabolic complications.
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The mode of transmission and epidemiological approach for hepatitis A and B are different. However, both are preventable with vaccines whose efficacy and long lasting protection has been demonstrated. ⋯ Although the vaccine for hepatitis B was incorporated to the immunization program in 2005, the vaccine for hepatitis A persists in the list of interventions that must be assumed with priority by the Ministry of Health. If Chilean health authorities pretend to reach the enteric disease indicators of developed countries, they must accelerate the epidemiological transition towards the elimination of hepatitis A.
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Revista médica de Chile · Jun 2009
[Professionalism of physicians from the point of view of physicians and students].
Professionalism should be included as a fundamental component in the curriculum of undergraduate as well as graduate students of Medicine. Future physicians should be aware of the attributes that a professional should possess. ⋯ The attributes that physicians and medical students evaluate as essential in professionalism were identified using the LAM approach. At the beginning of the career, students have a definite humanistic approach to their future profession.
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Revista médica de Chile · Jun 2009
Case Reports[Intravascular hypothermia for the management of Intracranial hypertension in acute liver failure: case report].
Acute liver failure has a mortality rate in excess of 80%. Most deaths are attributed to brain edema with intracranial hypertension and herniation of structures, where ammonium plays a major role in its generation. We report an 18 year-old female with a fulminant hepatic failure caused by virus A infection. ⋯ Seventy two hours later, a liver transplantation was performed. After testing graft perfusion, rewarming was started, completing 122 hours of hypothermia at 33 degrees C. The patient was discharged in good conditions after 69 days of hospitalization.