Revista médica de Chile
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Revista médica de Chile · Apr 2023
[Outcomes of Laparoscopic Liver Resection for Hepatocellular Carcinoma: A Single-Center Experience].
Hepatocellular carcinoma (HCC) is the sixth most common cancer in the world. Surgery is the treatment of choice in stages 0 and A in the Barcelona Clinic Liver Cancer classification. A minimally invasive technique in this scenario has the advantage of reducing postoperative pain, blood loss, and hospital stay. We present our experience and outcomes in laparoscopic liver resection in HCC. ⋯ Laparoscopic liver resection for the treatment of HCC in our series is safe, with no 30-day mortality, low incidence of complications, no postoperative liver failure, and suitable medium- and long-term oncological results.
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Revista médica de Chile · Apr 2023
[Hyperferritinemia in a Chilean Academic Healthcare Network: A Retrospective Study].
The distribution of causes of hyperferritinemia in international series is heterogeneous. Also, the association between ferritin and prognosis is controversial. This study aims to describe the diagnosis associated with hyperferritinemia in a retrospective cohort at an academic healthcare network in Chile. ⋯ The most frequent categories were "inflammatory and autoimmune diseases" and "hematological malignancies", but ferritin level was similar in both. Further research could validate a prognostic role.
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Revista médica de Chile · Apr 2023
Case Reports[Post-obstructive polyuria. Pathophysiological analysis of a case].
The relief of the impediment to urinary flow is the treatment of acute kidney failure due to urinary tract obstruction. However, there is a risk of inducing massive polyuria, which can be self-limited or produce severe contraction of the intravascular volume with pre-renal acute kidney failure and alterations in the internal environment. Polyuria, urine output > 3 L/d or > 200 mL/min for more than 2 hours, can have multiple causes, and can be classified as osmotic, aqueous or mixed. ⋯ Finally, there may be tubular dysfunction and decreased solutes in the renal medullary interstitium, adding resistance to the action of vasopressin. The latter causes a loss of free water (mixed polyuria). We present the case of a patient with post-obstructive polyuria where, by analyzing the clinical symptoms and laboratory alterations, it was possible to interpret the mechanisms of polyuria and administer appropriate treatment for the pathogenic mechanism.
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Revista médica de Chile · Apr 2023
[Alarming signals: Worsening obesity, physical inactivity and high perception of stress in first-year medical and dental students in Chile].
The high prevalence of obesity, smoking, and physical inactivity in Chile despite government-sponsored measures and campaigns, along with others in the last 30 years, suggests additional reinforcement of these efforts at the primary care level. ⋯ The progressive obesity and physical inactivity, high-stress perception, and persistent smoking prevalence in the first year of academic life suggest considering measures in the curricular academic structure that facilitate adjustments in the student's lifestyles. Future follow-up of this cohort, increasing participants, and assessing students' mental health are planned.
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Revista médica de Chile · Apr 2023
[Clinical and regulatory challenges of forced hospitalization in Chile under the new Mental Health Law].
Forced hospitalization is a common practice in psychiatry. It involves limiting the patient's freedom of movement in a clinical context without expressing informed consent, causing stress to the family and support network. Thus, forced hospitalization may cause violations, disturbances, or threats to the human rights of a vulnerable population. ⋯ The new law No. 21,331 establishes a more demanding standard for the origin of forced internment, shortening the distance concerning the human rights guidelines regarding intellectual disability. The incoming development of the regulations mandated by the law could fill in the gaps in several situations that may arise and clarify fuzzy points. The key stakeholders' participation level will be critical in this matter.