Revista médica de Chile
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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
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
[Sociodemographic Patterning of Cardiorespiratory Fitness Derived by Equation in the Chilean Population: Findings from the Chilean Health Survey 2016-2017].
Cardiorespiratory fitness is a strong predictor of mortality and chronic diseases. However, its estimation is costly and time consuming which may limit it broad use in population-based studies. ⋯ This study reports fitness levels in a nationally representative sample of Chile. Fitness levels were higher in men than women however, its decline with age was more pronounce in men than women.
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Revista médica de Chile · Dec 2020
Observational Study[Features of 50 patients with SARS-CoV2 admitted to an intensive care unit and requiring mechanical ventilation].
Since March, Chile experienced an exponential increase in SARS-CoV2 cases, which led to an almost full occupancy of the intensive care units (ICU). ⋯ The information obtained in this study provides characteristics and early outcomes of hospitalized patients with confirmed COVID-19 and IMV, admitted to the ICU of our center.
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Revista médica de Chile · Dec 2020
Association between fitness, anthropometric indices and laboratory parameters in elderly women.
Aging causes an involution of anthropometric and health indices that can affect physical fitness. ⋯ Anthropometric variables, serum lipid levels and blood glucose were predictors of different physical fitness parameters in these women.