Revista médica de Chile
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Revista médica de Chile · Dec 2019
[Extracellular vesicle concentration in maternal plasma as an early marker of gestational diabetes].
Background During pregnancy, there is an increase in the amount of extracellular vesicles, especially placental exosomes, in maternal plasma. Aim To isolate and characterize extracellular vesicles from blood during the three trimesters of pregnancy and to evaluate their capacity to identify patients at risk of developing gestational diabetes. Material and Methods A case-control study was conducted in a cohort of 50 pregnant women with plasma samples taken in each trimester. ⋯ The size of the extracellular vesicles obtained in the first trimester of pregnancy was very similar between groups (144 ± 37 nm for controls and 143 ± 34 nm for patients with gestational diabetes mellitus). Moreover, the concentration of extracellular vesicles collected in the first trimester, was significantly higher in patients who developed gestational diabetes mellitus later in pregnancy compared to normoglycemic pregnant women (7.94 x 10 8 and 5.15 x 10 8 , p = 0.03). Conclusions Our results provide an insight into the potential capacity of first trimester plasma extracellular vesicles as early biomarkers for the prediction of gestational diabetes mellitus.
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Revista médica de Chile · Dec 2019
[Hospital mortality and long-term survival of 103 patients with infective endocarditis requiring surgery].
Background Infective endocarditis (IE) is a serious disease with high mortality, especially among the most severe cases undergoing surgery. Aim To analyze the clinical features, perioperative mortality and long-term survival of patients with infective endocarditis requiring surgery. Material and Methods Review of medical records of patients who underwent heart valve surgery for active infective endocarditis in a public hospital between 1995 and 2008. ⋯ The most common causative microorganisms were S. aureus in 12%, coagulase-negative Staphylococcus in 11%, S. viridans in 10% and Enterococcus in 7%. Hospital mortality was 20.4% and ten-year survival was 65%. Conclusions Patients with severe IE requiring surgical treatment still have high perioperative and late mortality.
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Revista médica de Chile · Dec 2019
[Prolonged disorders of consciousness after an acute brain injury].
Only a fraction of patients in coma secondary to a primary acute brain injury develop a vegetative state (VS). At least 20% of patients show late transitions to a minimally conscious states (MCS). ⋯ Specific therapies are of limited effectiveness. This population is vulnerable to misdiagnosis and limited access to medical care and rehabilitation, thus generating ethical problems.
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Revista médica de Chile · Dec 2019
[Arteria coronaria única y cardiopatía coronaria: origen anómalo de la arteria coronaria derecha desde la descendente anterior. Casos clínicosAnomalous origin of the right coronary artery in the middle third of the anterior descending artery. Report of two cases].
The anomalous origin of the coronary arteries is uncommon and the origin of the right coronary artery from the middle third of the anterior descending artery is a finding of extreme rarity. We report two patients with coronary atherosclerotic disease and with an acute coronary syndrome, in whom a single left coronary artery was found. The clinical and angiographic characteristics and the treatment of these patients are described.
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Revista médica de Chile · Dec 2019
[Reserva cognitiva y demencias: Limitaciones del efecto protector en el envejecimiento y el deterioro cognitivoLimited protective effects of cognitive reserve on the progression of cognitive impairment].
Aging constitutes a series of physical, physiological and cognitive changes, affecting independence in the activities of daily living. During this stage, neurodegenerative diseases and cognitive impairment are common. ⋯ The objective of this systematic review is to identify evidence where high cognitive reserve does not limit the effects of cognitive impairment. Results indicate that the protective effect of cognitive reserve occurs only in the presence of minimal cognitive impairment, but not at later stages.