Revista médica de Chile
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Revista médica de Chile · Feb 2021
[Comparison of different methods to estimate glomerular filtration rate in older adults].
Glomerular filtration rate (GFR) estimation in older adults using a creatinine clearance/24-hour (CrCl) or an equation based on serum creatinine, are often considered equivalent by clinicians. ⋯ The practice of considering equivalent the GFR estimation using the creatinine-based equations with measured creatinine clearance in older adults should be reconsidered, because their results differ markedly.
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Even though the mechanisms that mediate essential hypertension (HT) are not fully understood, an immunological-inflammatory mechanism could be the common pathway for diverse pathophysiological mechanisms. We analyze in a simplified way the participation of the immune system in HT. T lymphocytes (TL) and antigen presenting cells (APCs) are components of the immune system capable of generating proinflammatory cytokines. ⋯ Additionally, a immunomodulation decrease by regulatory TL, worsens endothelial dysfunction and reduces vasodilation in experimental HT. Results of recent studies indicate that lymphocyte activation would be mediated by antigens captured by antigen APCs for subsequent presentation to "naive" TL. On the other hand, proinflammatory states such as obesity, the change of the intestinal microbiota and the increase in salt intake favors TL and APC activation, contributing to HT development.
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Revista médica de Chile · Feb 2021
[In defense of the biomedical model in psychiatry. the case of depression].
Defining what is meant by "mental illness" has three dimensions: (i) the ontological dimension, which attempts to answer the question of what is a mental illness in itself, (ii) the scientific dimension, which attempts to identify its causes, and (iii) the practical dimension, which will seek a treatment. This article uses depression to examine how various conceptual alternatives in contemporary literature attempted to tackle the problem of what is a mental illness. After evaluating the scope of their proposals in the three dimensions mentioned above, it is concluded that the biomedical model could become a good candidate for developing a useful framework for understanding, having a scientific explanation and treating depression.