Revista médica de Chile
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Revista médica de Chile · Feb 2024
Review[What we know today about solitary rectal ulcer syndrome].
Solitary Rectal Ulcer Syndrome (SRUS) is a rare defecation disorder with varied clinical manifestations and often presents challenges in diagnosis. To date, there is no definitive treatment for SRUS. ⋯ Surgery is reserved for correcting anatomical problems. This review provides an update on available data regarding the pathophysiology, presentation, clinical evaluation, and various treatment alternatives.
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Revista médica de Chile · Feb 2024
Review Case Reports[Catatonia as a presentation of major depressive disorder in the eldery and differential diagnosis of consciousness impairment: A case report and literature review].
We report the case of an older female patient suffering from a subacute qualitative and quantitative alteration in the state of consciousness secondary to a major depressive disorder with catatonic features. We discuss and review the clinical presentation, diagnosis, etiology, and treatment of catatonia in older adults from the internist's point of view.
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Revista médica de Chile · Feb 2024
Review[What do we know about craniopharyngioma? Updated review of the main advances and local experience.].
Craniopharyngioma is a tumor of benign histology, although it can cause serious sequelae due to its location and growth in the sellar and suprasellar region. It is characterized by being aggressive due to its ability to invade locally, and by its high recurrence rate. Histologically, two distinct tumors have been acknowledged, which were previously considered subtypes. ⋯ The symptoms of both of these tumor types are secondary to hormonal deficits, hydrocephalus or visual disturbances. Treatment should be performed in centers with experience in them, achieving a balance between a wide resection and protection of hypothalamic function. Radiotherapy has proven to reduce tumor recurrence, with a current focus on the development of medical treatments based on molecular targets.
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Revista médica de Chile · Feb 2024
Practice Guideline[Multidisciplinary consensus on the use of SGLT-2 inhibitors in chilean clinical practice using the GRADE methodology].
The Chilean consensus on the use of SGLT-2 inhibitors (iSGLT-2) in clinical practice, jointly developed by the societies of Cardiology, Diabetes, Family Medicine, and Nephrology, strongly recommends the use of these drugs in people with heart failure with reduced ejection fraction, type 2 diabetes mellitus for prevention of cardiovascular events, and chronic kidney disease. In heart failure with preserved or mildly reduced ejection fraction, and chronic kidney disease without diabetes, the consensus suggests the use of iSGLT-2. ⋯ Safety and cost-effectiveness considerations for prioritized implementation according to evidence are discussed. The document highlights the importance of multidisciplinary collaboration and the generation of local evidence to maximize the potential of these drugs in the management of complex cardiometabolic conditions in Chile.
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Revista médica de Chile · Feb 2024
Case Reports[Extracorporeal membrane oxygenation (ECMO) in severe acute respiratory distress syndrome due to blunt chest trauma: A case report].
We report a case of a patient with chest trauma (TT) complicated with severe acute respiratory distress syndrome (ARDS) who required extracorporeal membrane oxygenation (ECMO) as ventilatory support. Clinical case: A 48-year-old man, with no relevant history, after a high-energy vehicle collision admitted with severe TT. He evolved with respiratory failure that required intubation and connection to mechanical ventilation (MV). ⋯ Discussion: ECMO support is complex, expensive, and is performed in high-risk patients. The use of this resource requires trained health workers. Its use must be highly selective, constituting a valuable support tool in some patients with severe ARDS secondary to TT.