Revista médica de Chile
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Revista médica de Chile · Nov 2024
Review[Coronary Angiography in Clinical Practice: Update on Indications, Complications, and Contraindications].
Coronary angiography (CA) is the gold standard for identifying the presence and extent of atherosclerotic coronary artery disease or dynamic stenosis of the arteries. ⋯ Since the first CA, performed by Mason Sones in 1958, there has been an exponential growth in interventional cardiology, where CA has improved its technique generating more evidence in its indications.
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Revista médica de Chile · Sep 2024
Review[β-Lactam Hypersensitivity: Narrative Review and an Inpatient Management Algorithm Proposal].
β-Lactam hypersensitivity is the most frequently self-reported drug hypersensitivity reaction. However, most of these patients are not truly allergic. The label of B. Lactam allergy is associated with multiple adverse outcomes, including mortality, increased costs, and hospital stay; therefore, healthcare practitioners should try to eliminate this label, when possible, in addition to knowing what safe antibiotic alternatives exist depending on the degree of risk, if the allergy is confirmed. ⋯ According to the literature review results, we propose a management algorithm for hospitalized patients.
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Revista médica de Chile · Sep 2024
Review[Utility of CT Cardiac Angiography in the Evaluation of Infective Endocarditis and Its Complications].
Infective endocarditis (IE) is an infection that affects the heart valves, endocardium, and great vessels. It has a mortality rate of approximately 30% per year, so early diagnosis is essential to reduce morbidity and mortality. Cardiac angio-CT triggered by electrocardiogram (ECG) has been considered in IE management guidelines in recent years, given its high spatial resolution, contributing to the diagnosis and evaluation of valvular complications (vegetations, perforations, dysfunctions), perivalvular (abscesses, pseudoaneurysms, prosthesis dehiscence, fistulas) and compromised coronary arteries (embolism), allowing early diagnosis and treatment.
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Revista médica de Chile · Sep 2024
Review Case ReportsHypophosphatemic Rickets as a Key Sign for the Diagnosis of Hereditary Tyrosinemia Type 1: Case Reports and Narrative Review of the Literature.
Hereditary tyrosinemia type 1 (HT-1) is an inborn error of metabolism caused by a defect in tyrosine (tyr) degradation. This defect results in the accumulation of succinylacetone (SA), causing liver failure with a high risk of hepatocarcinoma and kidney injury, leading in turn to Fanconi syndrome with urine loss of phosphate and secondary hypophosphatemic rickets (HR). HT-1 diagnosis is usually made in infants with acute or chronic liver failure or by neonatal screening programs. ⋯ After diagnosis, all started treatment with a specific diet and nitisinone with prompt recovery and a quick remission of clinical signs of HR, being able to discontinue their conventional rickets therapy successfully. Conclusion: We present three patients with HT-1 whose main complaint was HR. It is important to know the main features of this metabolic disorder and have a high index of suspicion when we follow-up children with HR, especially if they are not responding to conventional therapy or develop liver dysfunction.
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Revista médica de Chile · Jul 2024
Review Case Reports[Acute Myocardial Infarction as a Presentation of Takayasu Arteritis in a Patient with Ulcerative Colitis: Case Report and Review of the Topic].
A 36-year-old woman with ulcerative colitis presented with progressive chest pain and neurovegetative symptoms. The electrocardiogram showed ST segment elevation in the inferior wall. The patient had a previous history of fatigue and night sweats. ⋯ Aortitis was suspected, which led to additional studies, among which a slight elevation of inflammatory activity indices stood out, and a computed tomography angiography showed periaortic fibrotic thickening and significant stenosis in multiple arteries, suggesting Takayasu vasculitis. She was treated with prednisone and methotrexate and underwent delayed myocardial revascularization surgery with good results. This case highlights the complexity of Takayasu arteritis, its possible association with ulcerative colitis, and the importance of early diagnosis for adequate management.