Revista médica de Chile
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Revista médica de Chile · Jan 2020
[How to interpret systematic reviews with multiple comparisons or network meta-analysis].
Systematic reviews evaluating multiple interventions can be useful in different clinical situations. However, some concerns arise when more than two interventions are compared and there is a paucity of good quality randomized clinical trials. A novel statistical method based on indirect comparisons, called network meta-analysis (NMA), can be a useful approach to find a clinical answer when multiple interventions are evaluated for the same outcome or comparator. The aim of this review is to describe the main characteristics and provide a user guide for a critical analysis of NMA focusing on its three main domains, namely homogeneity, transitivity and consistency.
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Revista médica de Chile · Jan 2020
Case Reports[Bilateral renal papillary necrosis of spontaneous resolution as a cause of microscopic hematuria. Report of one case].
Renal papillary necrosis is an infrequent cause of hematuria characterized by ischemic necrosis of the renal medulla, especially the papilla. Its most common cause is analgesic abuse. ⋯ We report a 63-year-old female studied for an asymptomatic microscopic hematuria whose tomographic study showed a bilateral renal papillary necrosis. No etiology was found, and she evolved with a spontaneous complete remission.
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Revista médica de Chile · Jan 2020
[Association between high vitamin B12 levels and one year mortality in older people admitted to the hospital].
Supplementation of vitamin B12 in older adults is a common practice to avoid vitamin B12 insufficiency. However, there is a paucity of information about the effects of cobalamin excess. ⋯ There was a significant association between high levels of cobalamin and all-cause mortality in this group of patients aged ≥ 65 years-old.
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Revista médica de Chile · Jan 2020
[Frequency of malignancy in thyroid incidentalomas detected by whole body 18F-FDG PET/CT].
Thyroid incidentalomas detected by 18F-Fludeoxyglucose (FDG) PET/CT are defined as an incidental and unexpected thyroid focus present in a patient studied for a non-thyroid disease. ⋯ Half of nodular thyroid incidentalomas detected by 18F-FDG PETC/CT are malignant. A nodule with a SUVmax ≥ 5,0 is highly suggestive of malignancy, regardless of its size.
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Revista médica de Chile · Jan 2020
[Endoscopy after bariatric surgery: what the endoscopist must know].
Endoscopy is essential in the assessment and treatment of the bariatric patient, especially in the postoperative state. Since bariatric surgery is increasing exponentially, endoscopists should be familiar with the anatomy and how to manage possible complications. ⋯ Dreaded complications such as leaks, stenosis or weight regain can be successfully assessed and treated by endoscopy. Postoperative evaluation of symptoms requires the precise search of details that can change patient's management.