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1.
Rev. Méd. Clín. Condes ; 32(1): 20-29, ene.-feb. 2021. ilus
Artículo en Español | LILACS | ID: biblio-1412893

RESUMEN

El Coronavirus SARS-CoV-2 produce la enfermedad COVID-19, cuya manifestación más grave y potencialmente letal es la neumonía. En este artículo revisaremos las manifestaciones clínicas del COVID-19, la fisiopatología de la neumonía, el manejo intrahospitalario previo al ingreso a Unidades de Cuidados Intensivos, la embolia pulmonar que es una complicación muy frecuente de esta enfermedad y el seguimiento de los pacientes posterior al alta. Para esta publicación nos hemos basado en publicaciones médicas y en estudios que hemos hecho durante esta pandemia en nuestro Centro de Enfermedades Respiratorias. i:es


The SARS-CoV-2 Coronavirus causes the COVID-19 disease, the most severe and potentially fatal manifestation of which is pneumonia. In this article, we will review the clinical manifestations of COVID-19, the pathophysiology of pneumonia, in-hospital management prior to admission to Intensive Care Units, pulmonary embolism, which is a very frequent complication of this disease, and the follow-up of patients after hospitalization. For this publication we have relied on medical publications and studies that we have done during this pandemic at our Center for Respiratory Diseases. i:en


Asunto(s)
Humanos , Neumonía/fisiopatología , Neumonía/terapia , COVID-19/fisiopatología , COVID-19/terapia , Terapia por Inhalación de Oxígeno , Neumonía/etiología , Embolia Pulmonar , Factores de Riesgo , Corticoesteroides/uso terapéutico , Ventilación no Invasiva , SARS-CoV-2/patogenicidad , COVID-19/complicaciones , COVID-19/diagnóstico
2.
Rev. méd. Chile ; 147(11): 1458-1467, nov. 2019. tab
Artículo en Español | LILACS | ID: biblio-1094176

RESUMEN

Interstitial lung diseases are a broad, diverse, challenging group of diseases, most of them chronic whose prognosis is not good. In the last two decades there have been considerable advances in the knowledge of the epidemiology, pathological and genetic bases and treatment of several of these diseases. This article summarizes and presents updated information about their classification, new knowledge on genetics and treatments in idiopathic pulmonary fibrosis, advances in the diagnosis and management of hypersensitivity pneumonitis and a review of the broad spectrum of interstitial diseases associated with connective tissue diseases. Several clinical trials are currently underway whose results will be available in the coming years and will provide more information and tools to improve the treatment of these patients.


Asunto(s)
Enfermedades Pulmonares Intersticiales/clasificación , Enfermedades Pulmonares Intersticiales/diagnóstico , Pronóstico , Enfermedades del Tejido Conjuntivo/diagnóstico , Diagnóstico Diferencial , Fibrosis Pulmonar Idiopática/diagnóstico , Alveolitis Alérgica Extrínseca/diagnóstico
3.
Rev. méd. Chile ; 146(7): 938-941, jul. 2018. tab, graf
Artículo en Español | LILACS | ID: biblio-961482

RESUMEN

Paraquat, a non-selective bipyridyl pesticide, is one of the leading causes of death from intoxication in many parts of Asia and America. It is the second most sold herbicide worldwide, being widely used in Chile. Its ingestion generates toxicity due to the release of superoxide radicals, mainly affecting kidneys, lungs and liver. There is no antidote available. We report a 31 years old male who ingested Paraquat for suicidal purposes. He developed an acute renal and hepatic failure and a rapidly progressive severe respiratory failure with images compatible with acute pulmonary fibrosis. No response to immunosuppressive treatment was observed. He died eight days after admission. The use of cyclophosphamide associated with glucocorticoids could lower risk of death the in these patients, although the pathophysiology of respiratory failure is still under study.


Asunto(s)
Humanos , Masculino , Adulto , Paraquat/envenenamiento , Fibrosis Pulmonar/inducido químicamente , Herbicidas/envenenamiento , Fibrosis Pulmonar/tratamiento farmacológico , Fibrosis Pulmonar/diagnóstico por imagen , Suicidio , Metilprednisolona/uso terapéutico , Chile , Resultado Fatal , Ciclofosfamida/uso terapéutico , Glucocorticoides/uso terapéutico , Inmunosupresores/uso terapéutico
4.
Rev. chil. infectol ; 34(5): 518-519, oct. 2017. graf
Artículo en Español | LILACS | ID: biblio-1042641

RESUMEN

There are no evidence-based guidelines about prophylaxis against Pneumocystis jiroveci pneumonia in inflammatory bowel disease. We report a case of P. jiroveci pneumonia in patient with Crohn's disease receiving infliximab and methotrexate. This case emphasizes the importance of considering the possibility of this infection in inflammatory bowel disease patients treated on biological therapy.


Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Neumonía por Pneumocystis/inducido químicamente , Fármacos Gastrointestinales/efectos adversos , Enfermedad de Crohn/tratamiento farmacológico , Infliximab/efectos adversos , Neumonía por Pneumocystis/diagnóstico por imagen , Radiografía , Tomografía Computarizada por Rayos X , Factores de Riesgo , Inmunosupresores/efectos adversos
5.
Rev. méd. Chile ; 142(1): 9-15, ene. 2014. ilus, graf, tab
Artículo en Español | LILACS | ID: lil-708844

RESUMEN

Background: Idiopathic Pulmonary Fibrosis (IPF) is the most prevalent of all interstitial lung diseases. The usual underlying pathological picture is an interstitial pneumonia (UIP). Aim: To describe the evolution of a Chilean cohort of patients with IPF. Material and Methods: Patients with the disease were identified at the pathology registry of National Institute of Thoracic Diseases, Santiago, Chile. Patients were included if they had surgical biopsy of UIP and compatible clinical and radiological characteristics. The medical records of included patients were reviewed, recording clinical information and lung function test results. Survival was analyzed obtaining death records from the Chilean National Identification Service. Results: Data from 142 patients with a mean age of 58 years (42% men), were analyzed. Mean initial lung function showed a forced vital capacity (FVC) of 73%, carbon monoxide diffusing capacity (DLCO) of 57% and a distance covered in 6-minute walk (6MWT) of 95% of expected normal values. The median survival was 80 months. Predictors of survival were a DLCO of less than 40% and an oxygen saturation at the end of the 6MWT of less than 89%. Conclusions: Survival in this group of patients was higher than the figures reported elsewhere. DLCO and the fall of oxygen saturation after walking were predictors of mortality, as previously described in other populations.


Asunto(s)
Femenino , Humanos , Masculino , Persona de Mediana Edad , Fibrosis Pulmonar Idiopática/mortalidad , Biopsia , Estudios de Cohortes , Fibrosis Pulmonar Idiopática/patología , Pulmón/patología , Pruebas de Función Respiratoria , Estudios Retrospectivos , Análisis de Supervivencia
6.
Rev. méd. Chile ; 137(10): 1363-1366, oct. 2009. ilus, tab, graf
Artículo en Español | LILACS | ID: lil-534045

RESUMEN

Devices such as Novalung® can be used as a bridge to lung transplantation while waiting for a suitable donor. We report a 50 year-old male with a terminal pulmonary fibrosis and candidate for lung transplantation. He was admitted to the hospital due to a severe deterioration of his respiratory condition, with the presence of severe respiratory acidosis despite conventional invasive respiratory support. Respiratory support with Novalung® was started, resulting in a progressive reduction ofpCOz that became normal ten hours after the installation of the device. Five days later a successful lung transplantation wasperformed.


Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Acidosis Respiratoria/terapia , Oxigenación por Membrana Extracorpórea/instrumentación , Trasplante de Pulmón , Cuidados Preoperatorios/instrumentación , Listas de Espera
7.
Rev. psiquiatr. (Santiago de Chile) ; 15(1): 10-22, ene.-mar. 1998. ilus, tab
Artículo en Español | LILACS | ID: lil-255314

RESUMEN

Este estudio examina la influencia relativa de diversos factores psicosociales en el uso de substancias químicas en una muestra de adolescentes de Santiago de Chile. Estos incluyen variables de tipo sociodemográfico, del grupo de pares, de la familia destrezas aprendidas y de personalidad. Todas éstas se incorporaron en un modelo predictivo de la aparición de conductas de riesgo especificas. Entre los resultados dignos de mención están que la edad, los modelos de rol de los pares y de la familia tuvieron el papel más importante. Además, hicieron contribuciones importantes destrezas aprendidas tales como rechazo de drogas y empatía. Finalmente, el autoconcepto y la ansiedad fueron variables de personalidad que predijeron significativamente tanto el uso de marihuana como de alcohol. Es interesante constatar que hay características psicosociales similares en Chile y en los Estados Unidos tendientes a predecir el uso adolescente de substancias. Investigaciones futuras debieran determinar hasta que grado factores psicosociales como los examinados aquí predicen universalmente el consumo de substancias


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Trastornos Relacionados con Sustancias/epidemiología , Ansiedad , Autoimagen , Familia , Abuso de Marihuana/epidemiología , Factores de Riesgo , Alcoholismo/epidemiología , Encuestas Epidemiológicas , Factores Socioeconómicos , Predicción
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