Revista Hospital Clínico Universidad de Chile

Enfermedades por superantígenos en Dermatología Pediátrica: una serie de casos

Claudia Schroder Huaquín, Ligia Aranibar Durán — Tue, 12 Dec 2023 00:00:00 +0000

Superantigen diseases (SAg) are part of a series of pathologies triggered or exacerbated by antigens, such as bacteria or viruses, which non-specifically stimulates a large population of T-lymphocytes. Their clonal proliferation often leads into a cytokine storm, which is responsible for the clinical manifestations. These diseases differ in their severity and in their clinical expression, ranging from exclusively cutaneous involvement to the presence of potentially lethal multi-organ dysfunction. In recent times, the presentation of these diseases has increased considerably, especially in the pediatric population, thanks to the contribution of the COVID-19 virus in its role as superantigen. We present 6 clinical cases in the pediatric population that presented symptoms attributable to disease due to superantigens.

Angiografía coronaria normal. Una forma de evaluar el uso apropiado de la indicación de este estudio.

Héctor Ugalde P., Raimundo Morris C., Ángela Pino L., Hernán Prat M. — Tue, 12 Dec 2023 00:00:00 +0000

Coronary angiography remains the gold standard when studying coronary artery disease. Currently, there are guidelines on how to do this diagnostic procedure and the diseases that require its application, however, a significant proportion of inappropriate exams are reported, with increased risk to patients and overall healthcare costs. This has not been evaluated in our country. In this study the last 500 normal consecutive coronary artery angiographies on patients with suspected coronary artery disease and 50 with severe 3 vessel disease. Three cardiologist with different experience, blinded to the coronariography results, were asked to review the clinical data of the 550 patients and decide if they would perform or not a coronary angiography. Then data were analyzed to identify potential causes for normal coronary angiographies. The results showed that in 100% of severe three vessel disease patients, cardiologist would perform coronary angiography and in normal exams, 60% would be performed, with 40% of them would have been inappropriate, similar to literature. We can conclude that normal coronary angiographies with a good indication exist and a significant proportion of exams should not have been done, suggesting a more careful application of guidelines and improved non invasive testing before invasive exams.

Caracterización clínica de pacientes con pseudoexfoliación en estudio multicéntrico y asociación a ancestría mapuche-huilliche

Pablo Tomás Romero C., Eguzki Mena A., Danilo Olguín O., Luisa Herrera C. — Tue, 12 Dec 2023 00:00:00 +0000

Introduction: Pseudoexfoliation Syndrome (PEX) is a multisystemic disease. It is the most common cause of secondary glaucoma, which has a faster progression and worse prognosis. Objective: Description of epidemiological and ophthalmological clinical characteristics in patients with PEX at Universidad de Chile Clinical Hospital, San José Hospital, and Félix Bulnes Hospital. Methods: Multicenter descriptive study. Clinical records of patients with pseudoexfoliation glaucoma from the past 5 years were reviewed in 3 centers located in the Metropolitan Region. Epidemiological, clinical, treatment, and documented complication characteristics were analyzed. Furthermore, to analize a possible association between pseudoexfoliation glaucoma and Mapuche-Huilliche ethnicity we used a control group that included patients with primary open-angle glaucoma and no PEX. Results: Of 190 eyes from 95 patients, 172 with PEX-related glaucoma (GPEX) were included in the study, 56 were males and 39 females, with an average age of 76,7 years (range 58-92 years). 34,% had a family history of glaucoma. 15,8% (15 patients) had at least one surname of Mapuche origin and 11,6% had two last names. An association was found between the Mapuche-Huilliche ethnicity and the diagnosis of GPEX compared to the control group (Fisher’s exact test p = 0.007). In the 172 analyzed eyes, the average intraocular pressure was 17,9 (range 7-52). 92 eyes had a visual acuity (VA) <0.05, of which 29,9% had no light perception, and 80 eyes had VA ≥0.05. The average cup-to-disc ratio was 0.76. Mixed cataract was the predominant type, accounting for 56,8% of the total of cataracts, and 19,8% had hypermature/mature cataract. 24 eyes in the total sample had ocular complications, with central retinal vein thrombosis being the most common (5,2%), followed by phacodonesis or lens subluxation (3,5%). The modal number of medications used was 2, and in terms of surgical management 10,5% underwent trabeculectomy, 1,7% received drainage implant, and 23,3% had selective laser trabeculoplasty. Conclusion: PEX-related glaucoma in the studied population is a disease that occurs at an older age, leading to severe visual impairment due to the severity of glaucoma. Our findings indicate an association of GPEX and Mapuche-Huilliche ethnicity. Lastly, the importance of early diagnosis and treatment of this condition is emphasized given its high rate of blindness and complications in the studied sample.

Test radiológico

Tue, 12 Dec 2023 00:00:00 +0000

No abastract available

Resultado test radiológico

Benjamín Pizarro-Galleguillos, Camila Fabres B. — Tue, 12 Dec 2023 00:00:00 +0000

No abstract available

Fármacos de repropósito para combatir la quimiorresistencia en el cáncer ovárico epitelial

Maritza Garrido P., Carmen Romero O. — Tue, 12 Dec 2023 00:00:00 +0000

Epithelial ovarian cancer (EOC) is one of the most lethal gynecological cancers both in Chile and worldwide. Treatment in advanced stages is cytoreductive surgery followed by chemotherapy, based on platinum and taxanes. Unfortunately, resistance to chemotherapy is a frequent phenomenon in patients with EOC, worsening their prognosis. Therefore, the study of new drugs or complementary therapies to existing ones is essential to benefit EOC patients. Drug repurposing, or the use of old drugs that are commonly used for other purposes, may be key in the development of new therapies for EOC. This strategy, unlike de novo drug development, can be much cheaper, safer, and faster to implement. In this context, widely used drugs such as metformin and nonsteroidal anti-inflammatory drugs (NSAIDs) have shown promising antitumor effects in the context of cancer, including in different EOC models. In this work, we review the current evidence related to the antitumor effects of metformin and NSAIDs in tumor cells, with an emphasis on ovarian cancer cells and their projections for use in the context of EOC.

Resúmes V Jornadas de Investigación HCUCH “Vinculación territorial desde la investigación y la innovación en la salud pública”

Tue, 12 Dec 2023 00:00:00 +0000

El encuentro se realizó entre el 11 al 13 de octubre 2023 y contó con la participación de académicos, académicas y estudiantes de nuestro Hospital Clínico, de la Escuela de Salud Pública, Facultad de Medicina, FACSO, Facultad de Odontología y de la FAU. El propósito común fue conversar en torno a la investigación e innovación en el territorio y en relación a la nueva ley que fortalecerá el vínculo del HCUCH con el sistema de salud público. Investigadores provenientes de universidades chilenas y extranjeras, hospitales, clínicas y de servicios de salud del país participaron con entusiasmo en estas jornadas a través de los más de 70 pósteres expuestos durante su desarrollo y que corresponden al material que a continuación presentamos.

Editorial. Desafíos de la Ley Hospital Clínico Universidad de Chile

Eduardo Tobar A., Paul Délano R. — Tue, 12 Dec 2023 00:00:00 +0000

No abstract available