Revista médica de Chile
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Degenerative cervical myelopathy (DCM) is the most common cause of spinal cord dysfunction in adults. Its prevalence is increasing as a result of population aging. The diagnosis of DCM is often delayed or overlooked, resulting in secondary neurologic morbidity. ⋯ Surgery is not currently recommended for asymptomatic patients with evidence of spinal cord compression or cervical spinal stenosis on MRI, but they require a structured follow-up. Patients with moderate or severe DCM require surgical decompression to avoid further progression. The objective of this review is to raise awareness of degenerative cervical myelopathy and its increasing prevalence as well as to aid non-surgical healthcare workers for a timely diagnosis and management of this disabling condition.
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Revista médica de Chile · Mar 2022
Review[Delirium, catatonia and substance withdrawal syndrome manifested as psychomotor agitation in COVID-19: a pharmacological management approach for the general hospital setting].
Neuropsychiatric symptoms can be part of the clinical spectrum of COVID-19 infections. ⋯ Cooperation among different clinical units in the general hospital facilitated the implementation of a clinical algorithm for clinicians for the management of psychomotor agitation in COVID-19 patients.
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Revista médica de Chile · Mar 2022
Review[Methods to collect communities' values and preferences about health systems coverage].
Health systems do not have the capacity to finance all services. The impact of choosing one option or another is important in order to prioritize health resources. Citizen participation can help to set priorities or to select the interventions that will receive public funding. ⋯ The most commonly used mechanisms to gather information were interviews and surveys. We conclude that there is a limited number of articles with examples of tools to capture information about values and preferences in health decision processes. The main barrier observed was the lack of standardized processes to collect the values and preferences of the community.
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Revista médica de Chile · Jan 2022
Review[Immune checkpoint inhibitors. A breakthrough in cancer therapy].
Professors James P. Allison and Tasuku Honjo were awarded with the 2018 Nobel Prize in Medicine for their contributions in cancer immunotherapy. The latter is a breakthrough in cancer therapy, aimed to overcome tumor-induced immunosuppression, leading to the reactivation of the immune system against cancer cells. ⋯ This situation led to a biotechnological race focused on the development of effective antibodies able to "turn-on" the immune system cheated by the tumor. Anti-CTLA-4 and anti-PD-1 antibodies improve life-expectancy in cancer patients. In this review, we perform an historical overview of Professors Allison and Honjo contribution, as well as the immunological basis of this new and powerful therapeutic strategy, highlighting the clinical benefits of such intervention.
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Revista médica de Chile · Jan 2022
Review[Update on the management of intracranial hypertension syndrome].
Elevated intracranial pressure (ICP) is a devastating complication, with great impact on neurological status and high morbidity and mortality. Intracranial hypertension (ICH) has multiple etiologies. ⋯ Therefore, it must be managed as a neurological emergency. The objective of this review is to present in a friendly way the diagnostic approach and the management of ICH, focused on general practitioners.