Revista médica de Chile
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In the last decades, there has been an increase in life expectancy in the world, with the consequent modification in the proportion of adults over 60 years. This is accompanied by an increase in pathologies for which aging is the main risk factor, such as dementia and hearing loss, which profoundly affect the quality of life of individuals and their family and impact health system costs. Given the lack of disease-modifying treatments for dementia, the study of mechanisms to prevent its occurrence has become a world priority. ⋯ This result undoubtedly has important consequences for the understanding the multifactorial nature of dementia, our daily clinical practice and public policies aimed at its prevention and treatment. In this article, we review the current evidence supporting the association between dementia and hearing loss, discussing the available strategies for prevention, detection and treatment of hearing loss and its possible impact on the natural course of dementia. A flow chart for the clinical management of different subgroups of patients is proposed.
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Revista médica de Chile · Aug 2020
[Determinants of door to needle time for intravenous thrombolysis in acute ischemic stroke].
Intravenous thrombolysis (IT) in acute ischemic stroke (AIS) is time dependent. The time elapsed from hospital admission to the thrombolytic bolus is named door to needle time (DNT) and is recommend to be of less than 60 min. ⋯ The individual elements that correlated with a DNT longer than 60 min were the failure to detect the AIS during triage and doubts about its diagnosis.
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Revista médica de Chile · Aug 2020
Case Reports[Anaplastic large cell lymphoma associated with breast implants, diagnosed by fine needle aspiration. Report of one case].
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare type of non-Hodgkin T-cell lymphoma, recently defined in the 2016 World Health Organization (WHO) classification of lymphoid neoplasms. It occurs more commonly when textured implants are used and appears clinically as a late seroma. Cytologically, these lesions are composed of large atypical cells with pleomorphic nucleus and an immunophenotype positive for T cell markers and CD30, and negative for ALK1. ⋯ Excisional biopsy of the capsule was performed, observing that the neoplastic cells were confined to the inner surface of the capsule. Imaging studies did not find evidence of disseminated disease. The present case demonstrates the importance of the study of any late periprosthetic effusion, which can be performed using fine needle aspiration.
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Revista médica de Chile · Aug 2020
[COVID-19 and psychological behavior: a systematic review of the psychological effects of 21st century pandemics].
The aim of this work was to conduct a systematic review on psychological behavior in the context of pandemic scenarios during the twenty-first century. We focused on empirical works and brief case reports of H1N1 flu and COVID-19. Our review included 32 papers published both in English or Spanish. ⋯ In addition, we found that certain social groups experienced a critical psychosocial impact likely due to the pandemic. Psychosocial factors affecting adherence were also identified, which allow us to better understand how health strategies are followed by the population. Different psychosocial suggestions, which emerged from the papers reviewed, were systematized and should be considered as possible pandemic strategies to be implemented.
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Revista médica de Chile · Aug 2020
Case Reports[Management of chylous ascites and chylothorax. Report of one case].
Chylous Ascites (CA) and chylothorax (CTx) are associated with obstruction, disruption or insufficiency of the lymphatic system. We report a 68-year-old male, with a history of alcoholic cirrhosis, who had recurrent events of CTx and CA. ⋯ A transjugular intrahepatic portosystemic shunt (TIPS) was successfully placed and pleural effusion subsided. This case shows that CA and CTx can be caused by portal hypertension and they may subside employing a multimodal management strategy.