Publisher: SciELO   (Total: 887 journals)

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Showing 601 - 800 of 887 Journals sorted alphabetically
Revista Colombiana de Anestesiología     Open Access   (Followers: 1, SJR: 0.154, CiteScore: 0)
Revista Colombiana de Antropologia     Open Access   (Followers: 2, SJR: 0.232, CiteScore: 0)
Revista Colombiana de Biotecnología     Open Access   (Followers: 1)
Revista Colombiana de Cancerología     Open Access   (SJR: 0.106, CiteScore: 0)
Revista Colombiana de Cardiologia     Open Access   (SJR: 0.113, CiteScore: 0)
Revista Colombiana de Ciencias Químico-Farmacéuticas     Open Access  
Revista Colombiana de Educación     Open Access  
Revista Colombiana de Entomología     Open Access   (Followers: 1, SJR: 0.184, CiteScore: 0)
Revista Colombiana de Estadística     Open Access   (SJR: 0.361, CiteScore: 1)
Revista Colombiana de Matemáticas     Open Access   (Followers: 1, SJR: 0.136, CiteScore: 0)
Revista Colombiana de Psicología     Open Access   (SJR: 0.151, CiteScore: 0)
Revista Colombiana de Química     Open Access   (Followers: 1, SJR: 0.115, CiteScore: 0)
Revista Contabilidade & Finanças     Open Access   (SJR: 0.145, CiteScore: 0)
Revista Costarricense de Cardiología     Open Access  
Revista Costarricense de Psicología     Open Access  
Revista Cubana de Anestesiología y Reanimación     Open Access   (Followers: 1)
Revista Cubana de Angiología y Cirugía Vascular     Open Access  
Revista Cubana de Cirugía     Open Access  
Revista Cubana de Endocrinología     Open Access  
Revista Cubana de Enfermería     Open Access   (Followers: 2, SJR: 0.102, CiteScore: 0)
Revista Cubana de Estomatologí­a     Open Access   (SJR: 0.128, CiteScore: 0)
Revista Cubana de Hematología, Inmunología y Hemoterapia     Open Access   (SJR: 0.196, CiteScore: 0)
Revista Cubana de Información en Ciencias de la Salud     Open Access   (SJR: 0.229, CiteScore: 0)
Revista Cubana de Informática Médica     Open Access  
Revista Cubana de Investigaciones Biomédicas     Open Access   (Followers: 1, SJR: 0.13, CiteScore: 0)
Revista Cubana de Medicina     Open Access   (Followers: 2)
Revista Cubana de Medicina General Integral     Open Access   (Followers: 1, SJR: 0.263, CiteScore: 0)
Revista Cubana de Medicina Militar     Open Access   (Followers: 1, SJR: 0.202, CiteScore: 0)
Revista Cubana de Medicina Tropical     Open Access   (SJR: 0.143, CiteScore: 0)
Revista Cubana de Obstetricia y Ginecología     Open Access   (SJR: 0.191, CiteScore: 0)
Revista Cubana de Oftalmología     Open Access   (Followers: 1)
Revista Cubana de Ortopedia y Traumatologí­a     Open Access   (SJR: 0.101, CiteScore: 0)
Revista Cubana de Plantas Medicinales     Open Access   (Followers: 1, SJR: 0.127, CiteScore: 0)
Revista Cubana de Salud Pública     Open Access   (SJR: 0.262, CiteScore: 0)
Revista da Educação Física : UEM     Open Access   (Followers: 1)
Revista da Escola de Enfermagem da USP     Open Access   (Followers: 2, SJR: 0.279, CiteScore: 1)
Revista da Faculdade de Educação     Open Access  
Revista da Sociedade Brasileira de Fonoaudiologia     Open Access  
Revista da Sociedade Brasileira de Medicina Tropical     Open Access   (SJR: 0.658, CiteScore: 1)
Revista de Administração Contemporânea     Open Access  
Revista de Administração de Empresas     Open Access   (Followers: 1, SJR: 0.16, CiteScore: 0)
Revista de Administração Pública     Open Access   (SJR: 0.294, CiteScore: 0)
Revista de Análisis Económico     Open Access   (SJR: 0.112, CiteScore: 0)
Revista de Antropologia     Open Access   (Followers: 4, SJR: 0.102, CiteScore: 0)
Revista de Bioética y Derecho     Open Access  
Revista de Biología Marina y Oceanografía     Open Access   (SJR: 0.23, CiteScore: 0)
Revista de Biología Tropical     Open Access   (Followers: 1, SJR: 0.326, CiteScore: 1)
Revista de Ciencia Politica     Open Access   (Followers: 2, SJR: 0.368, CiteScore: 1)
Revista de Ciencia y Tecnología     Open Access  
Revista de Ciências Agrárias     Open Access  
Revista de Ciencias Médicas de Pinar del Río     Open Access  
Revista de Ciencias Sociales     Open Access   (Followers: 1)
Revista de Cirugía     Open Access   (SJR: 0.121, CiteScore: 0)
Revista de Derecho     Open Access   (SJR: 0.364, CiteScore: 0)
Revista de Derecho (Concepción)     Open Access  
Revista de Derecho (Coquimbo)     Open Access  
Revista de Economía     Open Access  
Revista de Economia Contemporânea     Open Access   (SJR: 0.121, CiteScore: 0)
Revista de Economía del Caribe     Open Access  
Revista de Economia e Sociologia Rural     Open Access   (Followers: 2, SJR: 0.265, CiteScore: 0)
Revista de Economía Institucional     Open Access   (SJR: 0.141, CiteScore: 0)
Revista de Economia Poli­tíca     Open Access   (Followers: 1, SJR: 0.282, CiteScore: 0)
Revista de Enfermagem Referência     Open Access   (Followers: 2)
Revista de Estudios Historico-Juridicos     Open Access   (Followers: 1, SJR: 0.123, CiteScore: 0)
Revista de Estudios Sociales     Open Access   (Followers: 2, SJR: 0.166, CiteScore: 0)
Revista de Filosofia     Open Access   (SJR: 0.102, CiteScore: 0)
Revista de Geografía Norte Grande     Open Access   (Followers: 1, SJR: 0.296, CiteScore: 1)
Revista de Gestão Costeira Integrada     Open Access   (SJR: 0.251, CiteScore: 1)
Revista de Historia (Concepción)     Open Access  
Revista de Historia Americana y Argentina     Open Access  
Revista de Historia del Derecho     Open Access   (Followers: 1)
Revista de Ingeniería     Open Access  
Revista de Investigacion Psicologica     Open Access  
Revista de la Academia Colombiana de Ciencias Exactas, Físicas y Naturales     Open Access  
Revista de la Asociación Española de Neuropsiquiatría     Open Access  
Revista de la Ciencia del Suelo y Nutricion Vegetal     Open Access   (SJR: 0.224, CiteScore: 0)
Revista de la Construcción     Open Access   (SJR: 0.234, CiteScore: 1)
Revista de la Facultad de Agronomía     Open Access  
Revista de la Facultad de Ciencias Veterinarias, UCV     Open Access  
Revista de la Facultad de Derecho     Open Access  
Revista de la Facultad de Derecho y Ciencias Políticas     Open Access  
Revista de la Facultad de Medicina (México)     Open Access  
Revista de la Sociedad Boliviana de Pediatría     Open Access  
Revista de la Sociedad Española de Enfermería Nefrológica     Open Access  
Revista de la Sociedad Química del Perú     Open Access  
Revista de la Universidad Industrial de Santander. Salud     Open Access  
Revista de Medicina Veterinaria     Open Access  
Revista de Microbiologia     Open Access   (Followers: 1)
Revista de Nutrição     Open Access   (SJR: 0.282, CiteScore: 0)
Revista de Odontologia da UNESP     Open Access  
Revista de Odontologia da Universidade de São Paulo     Open Access  
Revista de Osteoporosis y Metabolismo Mineral     Open Access   (Followers: 2, SJR: 0.121, CiteScore: 0)
Revista de Otorrinolaringología y Cirugía de Cabeza y Cuello     Open Access  
Revista de Protección Vegetal     Open Access  
Revista de Psicología del Trabajo y de las Organizaciones     Open Access   (SJR: 0.418, CiteScore: 1)
Revista de Psiquiatria Clínica     Open Access   (Followers: 1, SJR: 0.271, CiteScore: 1)
Revista de Psiquiatria do Rio Grande do Sul     Open Access   (Followers: 1)
Revista de Salud Animal     Open Access  
Revista de Salud Pública     Open Access   (Followers: 1, SJR: 0.171, CiteScore: 0)
Revista de Saúde Pública     Open Access   (Followers: 1, SJR: 0.807, CiteScore: 2)
Revista de Sociologia e Polí­tica     Open Access   (Followers: 2, SJR: 0.482, CiteScore: 0)
Revista del Instituto de Medicina Tropical     Open Access  
Revista del Nacional     Open Access  
Revista Dental Press de Ortodontia e Ortopedia Facial     Open Access   (Followers: 1)
Revista Diacrítica     Open Access  
Revista Direito GV     Open Access   (Followers: 1)
Revista do Colégio Brasileiro de Cirurgiões     Open Access   (SJR: 0.221, CiteScore: 1)
Revista do Departamento de Psicologia. UFF     Open Access  
Revista do Hospital das Clinicas     Open Access  
Revista do Instituto de Estudos Brasileiros     Open Access   (Followers: 1)
Revista do Instituto de Medicina Tropical de São Paulo     Open Access   (SJR: 0.669, CiteScore: 1)
Revista Dor     Open Access  
Revista Ecuatoriana de Neurología     Open Access  
Revista EIA     Open Access   (Followers: 1)
Revista electrónica de investigación educativa     Open Access   (Followers: 1, SJR: 0.187, CiteScore: 0)
Revista Electronica Educare     Open Access   (Followers: 2)
Revista Española de Cirugía Oral y Maxilofacial     Open Access   (Followers: 1, SJR: 0.117, CiteScore: 0)
Revista Española de Enfermedades Digestivas     Open Access   (SJR: 0.417, CiteScore: 1)
Revista Española de Salud Pública     Open Access   (SJR: 0.249, CiteScore: 1)
Revista Española de Sanidad Penitenciaria     Open Access   (SJR: 0.135, CiteScore: 0)
Revista Estudos Feministas     Open Access   (SJR: 0.208, CiteScore: 0)
Revista Facultad de Ciencias Económicas: Investigación y Reflexión     Open Access  
Revista Facultad de Ingenieria - Universidad de Tarapaca     Open Access   (Followers: 1)
Revista Facultad de Ingeniería Universidad de Antioquia     Open Access   (Followers: 1, SJR: 0.172, CiteScore: 0)
Revista Facultad de Medicina de la Universidad Nacional de Colombia     Open Access   (SJR: 0.125, CiteScore: 0)
Revista Facultad Nacional de Agronomía, Medellín     Open Access   (SJR: 0.138, CiteScore: 0)
Revista Facultad Nacional de Salud Pública     Open Access  
Revista Gaúcha de Enfermagem     Open Access   (SJR: 0.225, CiteScore: 1)
Revista Geológica de América Central     Open Access  
Revista Geológica de Chile     Open Access   (Followers: 1)
Revista Gerencia y Políticas de Salud     Open Access   (SJR: 0.136, CiteScore: 0)
Revista Habanera de Ciencias Médicas     Open Access   (SJR: 0.211, CiteScore: 0)
Revista Historia y Sociedad     Open Access  
Revista IBRACON de Estruturas e Materiais     Open Access   (Followers: 1)
Revista Ingeniería Biomédica     Open Access  
Revista Ingenieria de Construcción     Open Access   (Followers: 1, SJR: 0.204, CiteScore: 0)
Revista Ingenierías Universidad de Medellín     Open Access  
Revista Integra Educativa     Open Access  
Revista Interamericana de Bibliotecología     Open Access   (Followers: 7)
Revista Internacional de Contaminación Ambiental     Open Access   (SJR: 0.152, CiteScore: 0)
Revista ION     Open Access  
Revista IUS     Open Access  
Revista Katálysis     Open Access  
Revista Lasallista de Investigación     Open Access   (SJR: 0.146, CiteScore: 0)
Revista Latino-Americana de Enfermagem     Open Access   (SJR: 0.339, CiteScore: 1)
Revista Latinoamericana de Bioética     Open Access  
Revista Latinoamericana de Derecho Social     Open Access   (Followers: 1, SJR: 0.101, CiteScore: 0)
Revista Latinoamericana de Desarrollo Económico     Open Access  
Revista Latinoamericana de Educación Inclusiva     Open Access  
Revista Latinoamericana de Filosofía     Open Access   (Followers: 1)
Revista Latinoamericana de Hipertension     Open Access   (SJR: 0.158, CiteScore: 0)
Revista Latinoamericana de Investigación en Matemática Educativa     Open Access   (SJR: 0.171, CiteScore: 0)
Revista Latinoamericana de Psicopatologia Fundamental     Open Access   (SJR: 0.201, CiteScore: 0)
Revista Medica de Chile     Open Access   (SJR: 0.259, CiteScore: 1)
Revista Médica del Hospital Nacional de Niños Dr. Carlos Sáenz Herrera     Open Access   (Followers: 1)
Revista Médica del Uruguay     Open Access  
Revista Médica Electrónica     Open Access  
Revista Médica La Paz     Open Access  
Revista Médico-Científica : Luz y Vida     Open Access  
Revista Mexicana de Análisis de la Conducta     Open Access   (SJR: 0.405, CiteScore: 1)
Revista Mexicana de Astronomía y Astrofísica     Open Access   (Followers: 2, SJR: 0.596, CiteScore: 1)
Revista Mexicana de Biodiversidad     Open Access   (SJR: 0.421, CiteScore: 1)
Revista Mexicana de Ciencias Agrícolas     Open Access   (Followers: 1)
Revista Mexicana de Ciencias Farmaceuticas     Open Access   (Followers: 1)
Revista Mexicana de Ciencias Geológicas     Open Access   (SJR: 0.308, CiteScore: 1)
Revista Mexicana de Ciencias Pecuarias     Open Access   (Followers: 1, SJR: 0.17, CiteScore: 0)
Revista Mexicana de Economía y Finanzas     Open Access  
Revista Mexicana de Física     Open Access   (SJR: 0.203, CiteScore: 0)
Revista mexicana de física E     Open Access  
Revista Mexicana de Fitopatología     Open Access  
Revista Mexicana de Ingeniería Biomédica     Open Access  
Revista Mexicana de Ingeniería Química     Open Access   (SJR: 0.328, CiteScore: 1)
Revista Mexicana de Investigación Educativa     Open Access   (Followers: 3, SJR: 0.291, CiteScore: 0)
Revista Mexicana de Micologí­a     Open Access  
Revista Mexicana de Sociologí­a     Open Access   (Followers: 9, SJR: 0.142, CiteScore: 0)
Revista Musical Chilena     Open Access   (SJR: 0.1, CiteScore: 0)
Revista MVZ Córdoba     Open Access   (SJR: 0.173, CiteScore: 0)
Revista Nutrícias     Open Access  
Revista Odonto Ciência     Open Access   (SJR: 0.101, CiteScore: 0)
Revista Opinión Jurídica     Open Access  
Revista Panamericana de Salud Pública     Open Access   (SJR: 0.452, CiteScore: 1)
Revista Paulista de Pediatria     Open Access   (SJR: 0.472, CiteScore: 1)
Revista Perspectivas     Open Access  
Revista Pilquen : Sección Ciencias Sociales     Open Access  
Revista Politécnica     Open Access  
Revista Portuguesa de Cirurgia     Open Access   (Followers: 1)
Revista Portuguesa de Enfermagem de Saúde Mental     Open Access  
Revista Portuguesa de Imunoalergologia     Open Access   (Followers: 2, SJR: 0.141, CiteScore: 0)
Revista Portuguesa de Ortopedia e Traumatologia     Open Access  
Revista Portuguesa de Saúde Pública     Open Access   (SJR: 0.155, CiteScore: 0)
Revista Portuguesa e Brasileira de Gestão     Open Access  
Revista Republicana     Open Access  
Revista Signos     Open Access   (SJR: 0.174, CiteScore: 0)
Revista Universitaria de Geografía     Open Access  
Revista Uruguaya de Cardiologia     Open Access  
Revista Vectores de Investigación     Open Access  
Revista Veterinaria     Open Access   (SJR: 0.105, CiteScore: 0)
RGO : Revista Gaúcha de Odontologia     Open Access   (SJR: 0.104, CiteScore: 0)
RIDE : Revista Iberoamericana para la Investigación y el Desarrollo Educativo     Open Access  
RIIIT : Internacional de Investigación e Innovación Tecnológica     Open Access  

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Revista Medica de Chile
Journal Prestige (SJR): 0.259
Citation Impact (citeScore): 1
Number of Followers: 0  

  This is an Open Access Journal Open Access journal
ISSN (Print) 0034-9887 - ISSN (Online) 0717-6163
Published by SciELO Homepage  [887 journals]
  • Use of sodium-glucose cotrasporter 2 inhibitors in type 2 diabetics.
           Experience in 77 patients

    • Abstract: Background: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are a new pharmacological alternative for the treatment of diabetes. Aim: To report our experience with the use of this type of drugs in type 2 diabetics treated in an outpatient clinic. Material and Methods: We selected 77 type 2 diabetic patients aged 59 ± 11 years (45 men) who started SGLT2i, based on the advice of their treating physician. We registered their demographic characteristics and changes in metabolic parameters, weight, blood pressure, albuminuria and adverse effects, during a follow-up of at least three months. Results: We observed a decrease of glycosylated hemoglobin A1c of 0.8 ± 1.14% (p < 0.01) and a weight decrease of 2.5 ± 2.24 kg (p < 0.01). The proportion of patients with a glycosylated hemoglobin A1c of less than 7% increased from 7.2% to 30.9% (p = 0.002). In addition, a relative decrease in albuminuria of 39.9% was observed (p = 0.07). The treatment was well tolerated with a rate of adverse effects of 21%, all of them being categorized as mild. Of these, most of them corresponded to genital mycotic infections. Conclusions: The effects observed in this study are comparable and of similar magnitude to randomized studies of SGLT2i reported in the international literature.
       
  • Surgical complications in cirrhotic patients. Analysis of 102 cases

    • Abstract: Background: Cirrhotic patients have an increased surgical risk due to potential intra and postoperative complications. Aim: To describe the clinical characteristics and surgical complications of cirrhotic patients undergoing surgery in a Chilean university hospital. Patients and Methods: Review of medical records of 102 cirrhotic patients aged 60 ± 11 years (52% males) who underwent elective or urgency surgery at an university hospital between 2010 and 2016. General, pre-surgical, and post-surgical complications were recorded. Results: The main etiologies of cirrhosis were non-alcoholic steatohepatitis (31%), and alcoholic cirrhosis (28%). Child-Pugh scores were A, B and C in 50, 28 and 22% of cases respectively. Median MELD (Model for End-stage Liver Disease) score was 11 (interquartile range: 10-15). The surgical procedure was elective in 71% of cases, with predominance of abdominal surgery (86%). The American Society of Anesthesiologists (ASA) score was three or more in 52% of patients. The frequency of any adverse outcome was 62%. The frequency increased along with the severity of cirrhosis and when surgery was urgent. The most common complications were acute renal failure (24%), increased ascites (23%) and encephalopathy (22%). Admission to intensive care unit occurred on 26% of patients, with six hospital deaths. Conclusions: In these patients, surgical complications were common, although with low mortality.
       
  • Telestroke in Chile: 1 year experience at 7 hospitals

    • Abstract: Background: Acute ischemic stroke (AIS) is one of the leading causes of death in Chile. Intravenous thrombolysis (IVT) is an effective treatment. Geographical barriers and lack of specialists limit its application. Telemedicine can overcome some of these pitfalls. Aim: To describe the implementation and results of AIS treatment by telemedicine at the TeleStroke Unit (TeleACV) of the Southern Metropolitan Health Service, connected with seven hospitals in Chile. Material and Methods: Descriptive analysis of a prospective tele-thrombolysis data-base that covers from 2016 to 2018, with an emphasis in the last year. Results: During the analyzed period, seven remote telemedicine centers were activated as far as 830 kilometers on a continental level from the reference center and up to 3,700 kilometers on an island level. There were 1,024 telemedicine consultations, 144 (14%) of them resulted in an IVT treatment. During 2018, 597 tele-consultations were made, thrombolysis was done in 115 (19%) patients aged 66+-13 years; 54 (46.6%) being female. The median admission National Institute of Health Stroke Scale was 8 (interquartile range (IQR) 5-14). The median door-to-needle time was 56.5 (IQR 44.8-73.3) minutes; 60% of patients were treated within 60 minutes. Eight patients (7%) were referred for a subsequent mechanical thrombectomy to a center of greater complexity. Symptomatic intra-cranial hemorrhages occurred in four treated patients (4%). One patient had a systemic bleeding. Conclusions: The Telestroke Unit achieved a high rate of IVT and good door-to-needle times. This may help to overcome some of the geographic barriers and the specialist availability gap in our country.
       
  • Increasing frequency of obesity in Chile

    • Abstract: Background: An explosive increase in overweight and obesity occurred in Chile since the 90's, without an integrative national policy. Aim: To describe the current obesity situation in Chile and its consequences. Material and Methods: Analysis of the available anthropometric data obtained by an annual census of anthropometry for students (Nutritional Map) collected by the Ministry of Education, and three National Health Surveys (2003, 2009-2010 y 2016-2017) performed by the Ministry of Health in adults. Results: According to the Nutritional Map the prevalence of obesity in 1987 was 7.5% among children of six years of age and increased to 24% in 2018 (8% with severe obesity). At 14 years of age, the frequency of obesity increased from 8 to 15% from 2011 to 2018. In children older than 15 years, overweight and obesity increased from 61 to 74% from 2003 to 2016. In the same period, total obesity increased from 23 to 34% and the frequency of diabetes duplicated from 6 to 12%. The frequency of hypertension did not change, but its prevalence is 45 and 73% after 45 and 65 years of age, respectively. Conclusions: The frequency of obesity will continue to increase, producing severe health risks for the population. Public policies addressing both structural and individual aspects are recommended.
       
  • Spontaneous dissection of visceral arteries. A series of cases

    • Abstract: Background: Spontaneous dissections of visceral arteries are rare and usually secondary to other disease. There is paucity of information about their natural course. Aim: To describe the imaging, clinical characteristics and follow-up of spontaneous visceral artery dissections diagnosed at our institution. Material and Methods: We report a series of 14 patients in whom a spontaneous dissection of a visceral artery was diagnosed on abdominal angio-CT between 2010 and 2018. Clinical features and evolution were recorded. Results: Isolated lesions of the celiac axis were the most common finding. Multiple territories were involved in 14% of cases. A dissection flap was observed in four cases, a hematoma-dissection complex in seven and an aneurysmal dilatation associated with the dissection in three. Of the 10 patients who were followed at our institution, 90% had stabilization or partial regression of the imaging findings. In the remaining case, new dissection events were observed. All cases were managed conservatively, and no death was reported. Conclusions: In this series of patients, spontaneous dissection of visceral arteries had a benign, favorable course, requiring only conservative management.
       
  • Risk of late appearance of acute myocardial infartion after carbon
           monoxide (CO) intoxication

    • Abstract: ABSTRACT Background: After acute carbon monoxide intoxication, there may be a higher risk for late adverse cardiac events. However, these patients are usually not followed to monitor the appearance of these effects. Aim: To follow patients seen at an emergency department for carbon monoxide intoxication, monitoring the appearance of myocardial infarction. To assess the predictive value for such complication of serum troponin, carboxyhemoglobin, and procalcitonin levels at the moment of intoxication. Material and Methods: We followed 237 patients receiving emergency care for carbon monoxide intoxication, with a serum carboxyhemoglobin of 5% or more, between 2010 and 2012. Levels of procalcitonin and troponin I were measured. Patients were followed for five years after the intoxication. Results: During the follow up period, 35 patients had a myocardial infarction. These patients had significantly higher carboxyhemoglobin, procalcitonin and troponin I levels at the moment of the intoxication than their counterparts who did not had a myocardial infarction in the follow up. A logistic regression analysis showed that age, carboxyhemoglobin levels, procalcitonin, troponin 1 and length of CO exposure were associated with a higher risk of myocardial infarction. Procalcitonin, troponin and carboxyhemoglobin levels had a high sensitivity and specificity to predict the appearance of myocardial infarction, with high areas under the receiver operating characteristic (ROC) curves. Conclusions: In patients with CO intoxication, carboxyhemoglobin, troponin and procalcitonin levels at the moment of the intoxication are significant predictors of the late appearance of myocardial infarction. Antecedentes: Después de una intoxicación con monóxido de carbono, hay un mayor riesgo de desarrollar problemas cardiovasculares a largo plazo. Sin embargo, estos pacientes no son seguidos habitualmente para evaluar la aparición de estos eventos. Objetivo: Efectuar un seguimiento de pacientes que han sufrido una intoxicación con CO, evaluando la aparición de infarto del miocardio. Evaluar el valor de los niveles de troponina, carboxihemoglobina y procalcitonina para predecir la aparición de estos eventos. Material y Métodos: Seguimos 237 pacientes que fueron atendidos de urgencia por una intoxicación con CO, con niveles de carboxihemoglobina de 5% o más, entre 2010 y 2012. Se midieron los niveles de procalcitonina, troponina 1 y carboxihemoglobina y los pacientes fueron seguidos por cinco años después de la intoxicación. Resultados: Durante el seguimiento, 35 pacientes tuvieron un infarto al miocardio. Estos pacientes tenían niveles significativamente más altos de procalcitonina, troponina 1 y carboxihemoglobina al momento de la intoxicación, que los pacientes que no tuvieron un infarto durante el seguimiento. Una regresión logística mostró que la edad, carboxihemoglobina, procalcitonina, troponina y la duración de exposición a CO se asociaron a un mayor riesgo de infarto. Procalcitonina, troponina 1 y carboxihemoglobina tuvieron una alta sensibilidad y especificidad para predecir la aparición de infarto, con áreas bajo la curva ROC (receiver operating characteristic) elevadas. Conclusiones: En pacientes con intoxicación por CO, la carboxihemoglobina, procalcitonina y troponina son predictores significativos de la aparición de infarto agudo de miocardio en el largo plazo.
       
  • Effect of a high-speed bodyweight resistance training on timed up and go
           and one leg stance in older women

    • Abstract: Background: High-speed resistance training programs aiming to increase muscle power have beneficial effects on balance. Aim: To compare the effect of high-speed bodyweight resistance training and normal-speed bodyweight resistance training on the static and dynamic balance in community-dwelling older women. Material and Methods: Thirty-five non-disabled community-dwelling women aged 65 to 80 years were trained for 12 weeks using a high-speed bodyweight resistance training (HS-BT) or a normal-speed bodyweight resistance training (NS-BT). At baseline and after the intervention, One Leg Stance (OLS) and Timed Up and Go (TUG) tests were measured. Participants with an attendance to training sessions of less than 70% were excluded from the final analysis. Results: Data from 26 participants were analyzed, 14 women aged 71 ± 4 years who received HS-BT and 12 women aged 73 ± 4 years who received NS-BT. After 12 weeks of training, a significant improvement in TUG was observed in women receiving HS-BT (ΔTUG −1.07 sec, p < 0.01), but without changes in the OLS test. No significant changes were observed in any of the tests in the NS-BT group. Conclusions: High-speed bodyweight resistance training for 12 weeks improved TUG in these women.
       
  • Lifestyles of Chilean housewives. Analysis of the 2009-2010 Chilean Health
           Survey

    • Abstract: Background: Housewives represent a important proportion of the Chilean population. However, there is limited evidence about their lifestyles. Aim: To characterize lifestyles and determine the level of compliance with healthy lifestyles guidelines of housewives in Chile. Material and Methods: Housewives from the 2009-2010 National Health Survey were included. The variables studied included levels of physical activity (PA), sedentary behavior, diet, hours of sleep and smoking. Compliance with healthy lifestyle behaviors was evaluated through logistic regression, granting a value of 1 for compliance and 0 for non-compliance. A healthy lifestyle was defined as meeting at least four healthy behaviors. Results: Housewives aged > 55 years had a higher BMI and waist circumference compared to those aged < 40 years. Housewives were also more likely to report moderate alcohol consumption and were more likely to meet a healthier lifestyle score (Odds ratio = 1.52 [95% confidence intervals: 1.09 to 2.11], p = 0.013). No significant age trends were observed for other lifestyle behaviors. Conclusions: Housewives had high levels of central obesity, excess body weight and high levels of salt intake but low alcohol intake. Their healthy lifestyles behaviors increased along with increasing age.
       
  • Arrival times of patients with stroke to a public hospital

    • Abstract: Background: Stroke is a time-dependent emergency. Most patients with acute ischemic stroke are excluded from reperfusion therapies due to late consultation. Aims: To estimate the arrival times of patients with stroke to the Emergency Room (ER) of a public hospital. To identify factors associated with early consultation. Material and Methods: A convenience sample, 583 patients aged 71 ± 13 years (55% males) consulting for stroke at an emergency room was analyzed in terms of delay between onset of symptoms and arrival to the ER, demographics and etiology of stroke. Results: The admission diagnoses were ischemic stroke in 76%, intracerebral hemorrhage in 12%, transient ischemic attack in 9% and subarachnoid hemorrhage in 3%. The median time of arrival was 8 hours and 11 minutes after the onset of symptoms. Nineteen percent of consultations for ischemic stroke occurred within 3 hours of symptom onset, and 38% within 6 hours. In the logistic regression analysis, having an address near the hospital and the severity of stroke were associated with early consultation with a combined odds ratio of 5.97 (95% confidence intervals 3.23-11.04). Conclusions: There were significant differences in the arrival times of patients with stroke. Only a low proportion of patients with ischemic stroke consulted within the window for reperfusion therapies. Severe strokes and living near the hospital were associated with early consultation.
       
  • Prostate cancer in african american immigrants in Chile

    • Abstract: In 2017, migrants were 4.35% of the Chilean population, mainly from Peru and Colombia. From 2015, the amount of migrants from Central America, particularly from Haiti increased notably. This process changed the phenotype of the male population, increasing the proportion of black men, mainly between 20 and 50 years. Afro-descendant men have a higher risk for prostate cancer, and the tumor can appear as early as 40 years of age among them. This increase will have future repercussions on the public health system, since part of these men have low income and poor living conditions. Therefore, it is necessary to discuss early detection strategies focused on this population, including education for both patients and health professionals. This review includes data on the reality of migration in Chile and its impact on the health system. The higher incidence and mortality of prostate cancer in the migrant population is reviewed and risk-adjusted screening strategies are proposed.
       
  • Fermentable oligosaccharides, disaccharides, monosaccharides and polyols
           (FODMAPS)

    • Abstract: An increasing number of children and adults are currently suffering symptoms due to FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols) consumption. These carbohydrates are poorly digested in the human gastrointestinal tract, exerting an osmotic effect in the small intestine. In the colon, they become substrates to the microbiota. Microbial fermentation explains symptoms such as abdominal distention (postprandial fullness), bloating and flatulence, abdominal pain and loose feces or diarrhea. There are no standardized methods to measure them in daily clinical work. Daily tolerance and the no-effect doses are unclear. How to diagnose and treat FODMAP associated symptoms is also controversial. In this review, we aim to define FODMAP, their associated symptoms and the current techniques for assessing them. The low-FODMAP diet is described and how to implement it.
       
  • Prion induced spongiform encephalopathy of Creutzfeldt-Jakob disease

    • Abstract: The infectious protein or prion (PrPSC) is a transmissible and replicable polypeptide, which arises from an abnormal folding of the PrP protein, by unknown mechanisms and without changes in the primary sequence of its amino acids. Its new spatial disposition arises from the substitution of its alpha helices by beta bands, which increase its structural stability, avoiding its complete proteolysis, resulting in a residual accumulation of prions. These prions induce the misfolding of normal PrP protein, generating their exponential increase, leading to a disturbance of neuronal homeostasis which results in the development of the fatal spongiform encephalopathy of the Creutzfeldt-Jakob disease (CJD). This is the most prevalent human prion disease, and 90% of cases are sporadic, suggesting the endogenous genesis of prions. There are different types of prions, identified based on the genetic variance of codon 129 amino acids of the prion protein. Meteonin (M) and Valine (V)), associated with the result of their enzymatic proteolysis, define prions type 1 (21 kDa) and type 2 (19 kDa). The Classical form of CJD produced by MM1 prion occurs in 70% of the cases. The Cerebellar form originated by the VV2 prion occurs in 15% of cases, the form with Kuru plates, associated with the prion MV2 occurs in 5%, and the Vacuolar, related to the MM2 prion occurs in 4%. CJD is always characterized by behavioral, motor, cognitive, and vision alterations and by findings in magnetic resonance imaging, electroencephalogram and cerebrospinal fluid that define each clinical and neuropathological form.
       
  • The presence of women in Chilean medicine: from the times of Eloísa
           Díaz to this day

    • Abstract: Though the presence of many women in medicine goes unnoticed today, their incorporation to the field was slow and difficult. It took until the end of the nineteenth century for women to be finally allowed to study at the University in Chile, being Eloísa Díaz the first woman to become a medical doctor in 1887. In that century, only six women became medical doctors. However, throughout the twentieth century, this small proportion of women in medicine increased at a similar rate as tuition did in the schools of medicine, especially from the 1960's when limited quotas for women were abolished. At present, women doctors constitute 40% of the total pool of medical doctors in Chile, being present in all specialties, though preferably found as general practitioners, family doctors and pediatricians. While many women have stood out in academia and in politics, they have also successfully reached high positions in scientific societies (and other offices such in the Health Ministry, and even the country's presidency) their participation is still limited in these areas. It is only fair to conclude that the outstanding participation that women in Chilean medicine enjoy today is not solely due to their long-lasting efforts, but more importantly, to their tireless struggle to overcome prejudice, discrimination and misunderstanding; the latter being especially represented by pioneer women of medicine.
       
  • Julio Escámez Contreras and his masterful mural History of the
           Medicine and Pharmacy in Chile

    • Abstract: Julio Escámez Contreras was a highly creative, skilled and versatile Chilean painter who painted in Chile from 1940 to 1974 when he went into exile to Costa Rica and died there in 2015. In 1953-54, Escámez painted a large mural in a private pharmacy in the city of Concepcion, Chile, The History of Medicine and Pharmacy in Chile. This mural describes the origins and development of medicine and pharmacy in Chile, placing that origin in the medicinal activities of the mapuche indigenous population. The mural consists of three sections, each painted on the upper segment of three adjacent walls in the pharmacy, with each section focused on one period in the evolution of medicine and pharmacy in Chile. The first section is devoted to indigenous medical practices including its pharmacopeia and religious practices, the second describes medical approaches during colonial times, still with strong indigenous components but also with indigenous and Catholic hybrid religious elements, while the third depicts modern medicine, including chemistry, anatomical, physical and pharmacological activities complemented with public health components such as nursing, vaccination and health education. Read from left to right, the mural provides a highly lively, accurate and valid depiction of the evolution of medicine and pharmacy in Chile. Escámez' artistry and skill in the use of perspective, color, landscape, architecture and Chilean subjects, including real life individuals, produces a typical Chilean mural. However, his originality and consummate use of a non-verbal visual language delivers a more universal message, one that helps to explain the repeated efforts, of the government responsible for his exile, to destroy some of the works produced by him.
       
  • Spirituality in medicine. An analysis of Christina Puchalki's writings

    • Abstract: The relationship between spirituality and medicine is present from the very origins of Medicine. Its relevance has been rediscovered during the past decades. Numerous publications report positive health results when spiritual needs of patients are addressed.
      Authors like Edmund Pellegrino and Christina Puchalski have gained an acknowledged leadership in this field. The purpose of the article is to study Christina Puchalkis' contributions to the field, specifically through the identification and analysis of the ethical reasons that - according to Puchalski – justify the medical duty to provide spiritual care. As a result of our investigations, we propose to systematize the ethical reasons identified in Puchalski's writings in seven categories, that presuppose a broad definition of spirituality and a conception of “whole patient care”. Our analysis shows that Puchalski's arguments are ultimately grounded on an ethics of virtue and a realist anthropology, more than in mere positive effects or in patient's wishes. Indeed, Puchaslki's anthropological conception recognized human dignity as an intrinsic value that must be always acknowledged, especially in the context of disease, where questions about the meaning of life, suffering, connection and transcendence inevitable arise. We conclude that Puchalski's ethical arguments are solid and suggest the challenge of including the spiritual dimension in the formation of health care professionals.
       
  • Adventitial cystic disease of the popliteal artery as a cause of
           intermittent claudication: not your usual suspect. Report of one case

    • Abstract: Adventitial cystic disease of the popliteal artery is a rare condition of uncertain etiology, which presents as intermittent claudication of the lower extremity in middle-age patients. We report a 44-year-old man presenting with intermittent claudication of his left leg. MR angiography showed cystic parietal lesions that caused compression with partial occlusion of the left popliteal artery. Surgical resection of the affected segment was performed, with venous graft interposition. The histopathological analysis of the surgical specimen was consistent with cystic adventitial disease.
       
  • Continuous intra arterial nimodipine for vasospasm secondary to
           subarachnoid hemorrhage. Report of one case

    • Abstract: We report a 39-year-old male with an aneurysmal subarachnoid hemorrhage without hydrocephalus, in whom a right choroidal aneurysm was early excluded by endovascular coil insertion. Intracranial pressure (PIC) and cerebral oxygenation (PtiO2) sensors for neuromonitoring were installed due to a persistent comatose state. From the 3rd day, neuromonitoring became altered. CT angiography and cerebral angiography showed severe proximal and distal vasospasm (VE) of the middle (ACM) and anterior (ACA) right cerebral arteries. VE was treated with angioplasty and intravenous nimodipine. Forty eight hours later, despite hemodynamic maximization, neuromonitoring became altered again, mainly explained by a decrease in PtiO2 below 15 mmHg. A severe VE in ACM and right ACA was confirmed by angiography. Given the presence of an early and recurrent VE, which was associated with a decrease in cerebral oxygenation, internal carotid micro-catheters for continuous nimodipine infusion were installed. This therapy maintained a normal neuromonitoring for 15 days. During this period, attempts were done to decrease or discontinue the infusion, but the patient presented parallel falls of cerebral oxygenation or decreased cerebral perfusion observed with perfusion CT, interpreted as persistent VE. Finally, the infusion was stopped at day 15 without significant complication. We conclude that intra-arterial nimodipine continuous infusion in refractory VE can be useful and safe in selected patients. Multimodal neuromonitoring is essential.
       
  • Comments to the article “Association of physical activity with quality
           of life in patients with chronic kidney disease”

    • Abstract: We report a 39-year-old male with an aneurysmal subarachnoid hemorrhage without hydrocephalus, in whom a right choroidal aneurysm was early excluded by endovascular coil insertion. Intracranial pressure (PIC) and cerebral oxygenation (PtiO2) sensors for neuromonitoring were installed due to a persistent comatose state. From the 3rd day, neuromonitoring became altered. CT angiography and cerebral angiography showed severe proximal and distal vasospasm (VE) of the middle (ACM) and anterior (ACA) right cerebral arteries. VE was treated with angioplasty and intravenous nimodipine. Forty eight hours later, despite hemodynamic maximization, neuromonitoring became altered again, mainly explained by a decrease in PtiO2 below 15 mmHg. A severe VE in ACM and right ACA was confirmed by angiography. Given the presence of an early and recurrent VE, which was associated with a decrease in cerebral oxygenation, internal carotid micro-catheters for continuous nimodipine infusion were installed. This therapy maintained a normal neuromonitoring for 15 days. During this period, attempts were done to decrease or discontinue the infusion, but the patient presented parallel falls of cerebral oxygenation or decreased cerebral perfusion observed with perfusion CT, interpreted as persistent VE. Finally, the infusion was stopped at day 15 without significant complication. We conclude that intra-arterial nimodipine continuous infusion in refractory VE can be useful and safe in selected patients. Multimodal neuromonitoring is essential.
       
  • Seventy years of existence of the Tulahuen strain of Trypanosoma cruzi

    • Abstract: We report a 39-year-old male with an aneurysmal subarachnoid hemorrhage without hydrocephalus, in whom a right choroidal aneurysm was early excluded by endovascular coil insertion. Intracranial pressure (PIC) and cerebral oxygenation (PtiO2) sensors for neuromonitoring were installed due to a persistent comatose state. From the 3rd day, neuromonitoring became altered. CT angiography and cerebral angiography showed severe proximal and distal vasospasm (VE) of the middle (ACM) and anterior (ACA) right cerebral arteries. VE was treated with angioplasty and intravenous nimodipine. Forty eight hours later, despite hemodynamic maximization, neuromonitoring became altered again, mainly explained by a decrease in PtiO2 below 15 mmHg. A severe VE in ACM and right ACA was confirmed by angiography. Given the presence of an early and recurrent VE, which was associated with a decrease in cerebral oxygenation, internal carotid micro-catheters for continuous nimodipine infusion were installed. This therapy maintained a normal neuromonitoring for 15 days. During this period, attempts were done to decrease or discontinue the infusion, but the patient presented parallel falls of cerebral oxygenation or decreased cerebral perfusion observed with perfusion CT, interpreted as persistent VE. Finally, the infusion was stopped at day 15 without significant complication. We conclude that intra-arterial nimodipine continuous infusion in refractory VE can be useful and safe in selected patients. Multimodal neuromonitoring is essential.
       
  • Effectiveness of group versus individual interventions in the management
           of chronic patients. Challenge for primary care teams

    • Abstract: We report a 39-year-old male with an aneurysmal subarachnoid hemorrhage without hydrocephalus, in whom a right choroidal aneurysm was early excluded by endovascular coil insertion. Intracranial pressure (PIC) and cerebral oxygenation (PtiO2) sensors for neuromonitoring were installed due to a persistent comatose state. From the 3rd day, neuromonitoring became altered. CT angiography and cerebral angiography showed severe proximal and distal vasospasm (VE) of the middle (ACM) and anterior (ACA) right cerebral arteries. VE was treated with angioplasty and intravenous nimodipine. Forty eight hours later, despite hemodynamic maximization, neuromonitoring became altered again, mainly explained by a decrease in PtiO2 below 15 mmHg. A severe VE in ACM and right ACA was confirmed by angiography. Given the presence of an early and recurrent VE, which was associated with a decrease in cerebral oxygenation, internal carotid micro-catheters for continuous nimodipine infusion were installed. This therapy maintained a normal neuromonitoring for 15 days. During this period, attempts were done to decrease or discontinue the infusion, but the patient presented parallel falls of cerebral oxygenation or decreased cerebral perfusion observed with perfusion CT, interpreted as persistent VE. Finally, the infusion was stopped at day 15 without significant complication. We conclude that intra-arterial nimodipine continuous infusion in refractory VE can be useful and safe in selected patients. Multimodal neuromonitoring is essential.
       
 
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