A novel radiographic index for the diagnosis of posterior acromioclavicular joint dislocations.

Background: Posterior acromioclavicular (AC) joint dislocations are frequently misclassified because posterior translation of the clavicle is difficult to evaluate in Zanca radiograph views. A novel radiographic index was used in this study to accurately diagnose posterior dislocations of the AC joint.

Hypothesis: This novel index has a high degree of accuracy for the diagnosis of posterior AC joint dislocations.

High-dose intravenous methylprednisolone for hantavirus cardiopulmonary syndrome in Chile: a double-blind, randomized controlled clinical trial.

Background: Andes virus (ANDV)-related hantavirus cardiopulmonary syndrome (HCPS) has a 35% case fatality rate in Chile and no specific treatment. In an immunomodulatory approach, we evaluated the efficacy of intravenous methylprednisolone for HCPS treatment, through a parallel-group, placebo-controlled clinical trial.

Methods: Patients aged >2 years, with confirmed or suspected HCPS in cardiopulmonary stage, admitted to any of 13 study sites in Chile, were randomized by study center in blocks of 4 with a 1:1 allocation and assigned through sequentially numbered envelopes to receive placebo or methylprednisolone 16 mg/kg/day (≤1000 mg) for 3 days.

Medical genetics and genetic counseling in Chile.

In the South American Republic of Chile genetic counseling is not currently recognized as an independent clinical discipline, and in general is provided by physicians with training in clinical genetics. At present only one genetic counselor and 28 clinical geneticists practice in this country of over 16 million inhabitants. Pediatric dysmorphology constitutes the primary area of practice in clinical genetics.

Mice long-term high-fat diet feeding recapitulates human cardiovascular alterations: an animal model to study the early phases of diabetic cardiomyopathy.

Background/aim: Hypercaloric diet ingestion and sedentary lifestyle result in obesity. Metabolic syndrome is a cluster of clinical features secondary to obesity, considered as a pre-diabetic condition and recognized as an independent risk factor for cardiovascular diseases. To better understand the relationship between obesity, metabolic syndrome and cardiovascular disease as well as for the development of novel therapeutic strategies, animal models that reproduce the etiology, course and outcomes of these pathologies are required.

Respiratory and hemodynamic effects of a stepwise lung recruitment maneuver in pediatric ARDS: a feasibility study.

Background: Little is known about the efficacy and safety of recruitment maneuvers (RMs) in pediatric patients with acute respiratory distress syndrome (ARDS). We therefore assessed the effects on gas exchange and lung mechanics and the possible detrimental effects of a sequential lung RMs and decremental positive end-expiratory pressure (PEEP) titration in pediatric ARDS patients.

Methods: We enrolled patients <15 years of age with ARDS, progressive hypoxemia, <72 hr of mechanical ventilation, and hemodynamic stability.

Growth in Chilean infants with chromosome 22q11 microdeletion syndrome.

Chromosome 22q11 microdeletion syndrome has a wide range of clinical manifestations including congenital heart malformations, palatal defects, endocrine abnormalities, immunologic deficits, learning difficulties, and an increased predisposition to psychiatric disease. Short stature and poor weight gain in infancy are common findings and are usually seen in the absence of hormone deficiencies. An increased frequency of obesity has been observed in adolescents and adults.

Psychiatric disorders secondary to nonconvulsive status epilepticus of frontal origin. Two clinical case reports.

Nonconvulsive status epilepticus (NCSE) is common but often under-diagnosed. Due to the absence of specific symptoms, it is frequently misdiagnosed as a psychiatric disorder, which delays treatment. The cases of two patients who exhibited psychiatric symptoms and subtle cognitive disturbances (without confusion) as the sole manifestation of frontal lobe NCSE are reported.

[Daptomycin: pharmacological characteristics and its role in the treatment of gram positive infections].

Daptomycin recently made available in Chile, belongs to a new family of antimicrobials known as lypopeptides. Daptomycin has a unique mechanism of action and a potent bactericidal activity over susceptible agents. It is active against a number of clinically significant Gram positive cocci, including strains of Staphylococcus aureus and Enterococcus spp.

The antidiabetic effect of mesenchymal stem cells is unrelated to their transdifferentiation potential but to their capability to restore Th1/Th2 balance and to modify the pancreatic microenvironment.

Type 1 diabetes mellitus (T1DM) is a chronic metabolic disease that results from cell-mediated autoimmune destruction of insulin-producing cells. In T1DM animal models, it has been shown that the systemic administration of multipotent mesenchymal stromal cells, also referred as to mesenchymal stem cells (MSCs), results in the regeneration of pancreatic islets. Mechanisms underlying this effect are still poorly understood.

[Clinical-imaging-arthroscopic correlation in the diagnosis of meniscal lesions].

Objective: To assess the relation between location and intensity of pain in the articular interline as reported by the patient and proven objectively with the physical exam, and the type and location of the meniscal lesion found in the knee imaging study and arthroscopy.

Method: Prospective, observational, longitudinal study including 34 consecutive patients with a clinical and arthroscopic diagnosis of symptomatic meniscal tears. Pain location was reported, an MRI was taken and finally all patients were assessed with knee arthroscopy.

[Rotator cuff tear: correlation between ultrasound and arthroscopic findings].

Objective: To analyze the preoperative shoulder ultrasound (US) findings in patients with a diagnosis of rotator cuff (RC) tear and correlate them with the arthroscopic findings.

Methods: Retrospective analysis of a consecutive series of patients with a diagnosis of RC pathology in whom US was performed and who underwent surgery (shoulder arthroscopy). The US/arthroscopic findings were correlated with Fisher's and chi2 tests.

Nosema ceranae an emergent pathogen of Apis mellifera in Chile.

The microsporidian Nosema apis and Nosema ceranae have been associated with colony disorders of Apis mellifera and Apis cerana, respectively. N. apis is endemic in South America.

Mild hypothermia attenuates lung edema and plasma interleukin-1β in a rat mechanical ventilation-induced lung injury model.

Recent data suggest that deep hypothermia has protective effects on experimental induced lung injury. It is not well known if these effects persist with mild hypothermia. The authors hypothesized that mild hypothermia may attenuate lung injury and decrease local and systemic proinflammatory cytokines in a rat model of injurious mechanical ventilation (MV).

Intravenous administration of multipotent stromal cells prevents the onset of non-alcoholic steatohepatitis in obese mice with metabolic syndrome.

Background & Aims: Metabolic syndrome is secondary to obesity and characterized by dyslipidemia, insulin resistance, and hypertension. Non-alcoholic fatty liver disease is its hepatic manifestation, whose progression-limiting step is non-alcoholic steatohepatitis (NASH). The latter is characterized by lipid accumulation, hepatocyte damage, leukocyte infiltration, and fibrosis.

Cystic fibrosis in Chilean patients: Analysis of 36 common CFTR gene mutations.

Background: CFTR gene mutations have worldwide differences in prevalence and data on Chilean patients is scarce.

Methods: We studied 36 of the most common CFTR mutations in Chilean patients from the CF National Program [Programa Nacional de Fibrosis Quística (PNFQ)] of the Ministry of Health of Chile.

Results: Two hundred and eighty-nine patients were studied.

[Experience with capsule endoscopy diagnostic tool for the small intestine].

Background: Wireless capsule endoscopy (CE) is a relatively new method to evaluate the small intestine.

Aim: To evaluate the indications of CE in our center and assess whether specific indications are associated with best results during CE studies.

Material And Methods: Retrospective analysis of 69 patients aged 9 to 85 years (36 males) subjected to a CE at our institution between April 2004 and October 2007.

Endovenous administration of bone-marrow-derived multipotent mesenchymal stromal cells prevents renal failure in diabetic mice.

Twenty-five to 40% of diabetic patients develop diabetic nephropathy, a clinical syndrome that comprises renal failure and increased risk of cardiovascular disease. It represents the major cause of chronic kidney disease and is associated with premature morbimortality of diabetic patients. Multipotent mesenchymal stromal cells (MSC) contribute to the regeneration of several organs, including acutely injured kidney.

Accuracy of transcranial Doppler compared with CT angiography in diagnosing arterial obstructions in acute ischemic strokes.

Background And Purpose: Patients with acute ischemic stroke and intracranial arterial obstructions have a poor prognosis and a high probability of deteriorating at 24 hours. We aimed to evaluate the diagnostic accuracy of power motion mode Doppler (PMD-TCD) compared with CT angiography as standard in diagnosing intracranial arterial obstructions in patients presenting with ischemic stroke of <24 hours.

Methods: Consecutive patients presenting with acute ischemic stroke to the emergency department underwent high-resolution brain CT angiography and PMD-TCD within a 6-hour difference.

[Medicine in television. An ethical problem?].

Television programs where medical procedures are shown with progressive realism generate problems that physicians need to know and analyze. The authors analyze this issue, based on the respect to patient's dignity and the principles of bioethics. Medical programs on TV present specific problems to the different agents involved in them: TV media, physicians, health organization, public and patients or relatives that are exposed.