Revista médica de Chile
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Revista médica de Chile · Jun 2009
[Professionalism of physicians from the point of view of physicians and students].
Professionalism should be included as a fundamental component in the curriculum of undergraduate as well as graduate students of Medicine. Future physicians should be aware of the attributes that a professional should possess. ⋯ The attributes that physicians and medical students evaluate as essential in professionalism were identified using the LAM approach. At the beginning of the career, students have a definite humanistic approach to their future profession.
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Revista médica de Chile · Mar 2009
[Use of intravenous immunoglobulin for the treatment of toxic epidermal necrolysis and Stevens-Johnson/toxic epidermal necrolysis overlap syndrome. Review of 15 cases].
Toxic epidemial necrolysis (TEN) is an acute adverse drug reaction, that has an unpredictableprogression and a 30% mortality. The incidence of TEN in the general population is approximately 0.4 to 1.2 cases/million/year. It is characterized pathologically by keratinocyte apoptosis which leads to epidemial detachment. Keratinocyte apoptosis is triggered by activation of the Fas-FasL, pathway and could be prevented by the use of intravenous immunoglobulin (IVIG). ⋯ Despite the lack of blind, multicentric and randomized triáis, we agree with some international studies that TVIG is beneficial as a treatment for SSJ/NETand TEN .
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Aging generates four important changes in the structure and function of the respiratory system. There is a reduction in the elastic recoil of the lung causing "senile emphysema", a condition characterized by reduction in the alveolar surface area without alveolar destruction, which is associated with hyperinflation, increased lung compliance and reduction in alveolar-capillary diffusing capacity. There is a decrease in the compliance of the chest watt, due to calcification of its articulations, dorsal kyphosis and "barrel chest". ⋯ The increased static lung compliance combined with the decreased chest watt compliance leads to an increase in the functional residual capacity with aging. On the other hand, the loss of alveolar and airways elastic recoil combined with the reduction in the strength of the expiratory muscles, leads to an increase in residual volume and decreased maximal expiratory airflow rates and vital capacity. Despite these changes, the respiratory system maintains an adequate gas exchange at rest and during exercise during the whole life span, showing a normal PaCO2 and a slight decline in PaO2 (-0,3 mmHg per year) which is attenuated to become almost undetectable over the age of 70.
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Revista médica de Chile · Mar 2009
[Detection and genotyping of human papillomavirus in biopsies of uterine cervical adenocarcinoma].
The genotyping of Human Papillomavirus (HPV) will improve knowledge about the local epidemiological association of this virus with adenocarcinoma. ⋯ In this sample of biopsies, there was a high prevelence of HPV 16 and a low prevalence of HPV 18, which historically has been related to adenocarcinoma. The genotypes found correspond to those described in South America.
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Revista médica de Chile · Jan 2009
Case Reports[Acute type A aortic dissection in pregnant patient with Marfan syndrome. Report of one case].
Aortic dissection is a life-threatening disease that requires immediate surgical intervention. Marfan syndrome is a hereditary disease with an autosomal dominant transmission, which affects the connective tissue, with skeletal, cardiovascular and ocular involvement. It is one of the most prevalent connective tissue disorders, presenting a risk of aortic dissection of approximately 1% even without dilatation of the aorta. ⋯ The patient underwent a cesarean section and delivered a healthy baby. Afterwards, aortic valve repair and ascending aortic replacement was successfully performed under circulatory arrest with deep hypothermia. Additionally mitral valve repair for degenerative disease with posterior, autologous pericardium mitral valve ring was performed.