Revista médica de Chile
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Revista médica de Chile · Dec 2020
Case Reports[COVID-19 infection presenting as a myocardial infarction. Report of one case].
Isolated cardiac involvement of COVID-19 is an infrequent presentation, and myocardial infarction is even less common. We report a 30-year-old man presenting with retrosternal pain of insidious onset whose intensity increases suddenly. On admission, the patient had tachycardia and an EKG showed a 1 mm ST-elevation and diffuse PQ segment depression. ⋯ A coronary angiography showed a distal occlusion of the circumflex artery. Consequently, anticoagulation and double platelet anti-aggregation were started. The patient evolved favorably, with a decreasing troponin curve (last at discharge 0.49 ng/ml) and a control EKG with pathological Q in DIII and AvF, and symmetrically inverted T in DII, DIII, AvF, V4, V5, and V6.
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Revista médica de Chile · Dec 2020
[Factors associated with low quality of life in Chilean adults during the COVID-19 quarantine].
The quarantine and social distancing implemented during COVID 19 pandemic may hamper the quality of life of the population. ⋯ There are factors associated with a low quality of life during the quarantine of the COVID-19 pandemic in the Chilean population. Their identification could reinforce remedial actions at the government level to benefit the health of the population during this health emergency.
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The prevalence of inflammatory bowel disease (IBD) increased in the last decades. Thus, the number of pregnant women with the condition is also increasing. ⋯ Patients can undergo vaginal delivery in most forms of IBD. However, cesarean delivery is still preferable in women with a history of ileal pouch-anal anastomoses (IPAA) or active perianal disease.
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Hypopituitarism after moderate or severe traumatic brain injury (TBI) is usually underdiagnosed and therefore undertreated. Its course can be divided in an acute phase during the first 14 days after TBI with 50 to 80% risk of hypopituitarism, and a chronic phase, beginning three months after the event, with a prevalence of hypopituitarism that ranges from 2 to 70%. Its pathophysiology has been addressed in several studies, suggesting that a vascular injury to the pituitary tissue is the most important mechanism during the acute phase, and an autoimmune one during chronic stages. ⋯ Hence, we propose a simple and cost-effective algorithm to detect and treat a potential hypothalamic-pituitary-adrenal axis impairment and alterations of sodium homeostasis, both of which can be life-threatening. In the chronic phase, post-concussion syndrome is the most important differential diagnosis. Given the high prevalence of hypopituitarism, we suggest that all pituitary axes should be assessed in all patients with moderate to severe TBI, between 3 to 6 months after the event, and then repeated at 12 months after trauma by a specialized team in pituitary disease.
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Revista médica de Chile · Dec 2020
[Mortality in survivors of torture ad prison during the chilean dictatorship between 1973 and 1990].
Studies on the long-term consequences of torture in survivors in Chile have only addressed the consequences for mental health, leaving aside the physical consequences. ⋯ These results can inform prevention and treatment strategies for victims of the Chilean dictatorship.