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Rusia-Ucrania: la nociva combinación que explica la guerra
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Olmedo González, Hernán

Relaciones internacionales

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Jun 2023, Volume 32 Nº 64 Páginas 39 - 58

Resumo: Es En | Texto: Es En | PDF: Es | PDF: En

Resumen Este artículo tiene por finalidad aportar evidencia empírica sobre dos proposiciones con respecto a la guerra interestatal entre Rusia y Ucrania. La primera enuncia que al menos desde el año 2013 a la actualidad, la díada Rusia-Ucrania ha reunido todos los factores de riesgo asociados al inicio de guerras interestatales. La segunda enuncia que esta guerra es resultado de un proceso de mutación de una guerra intraestatal internacionalizada a una guerra interestatal. El argumento del estudio enuncia que tanto los factores de riesgo como así también la mutación se explican por una nociva combinación: asimetría de poder entre los Estados miembros participantes del conflicto en fase intraestatal internacionalizada con limitado poder político emergente en la díada interestatal.

Abstract The objective of this article is to present empirical evidence on two propositions about the inter-state war between Russia and Ukraine. The first postulate claims that, at the very least, from 2013 to the present the Russia-Ukraine inter-state dyad has shown all the risk factors associated with the start of interstate wars. The second postulate puts forward that this war is the result of a mutation process from an internationalized intra-state war to an inter-state war. This study argues that both the risk factors and the mutation may be explained by a noxious combination: asymmetry of power between the member States participating in the conflict in the internationalized intra-state phase, with limited political power emerging in the inter-state dyad.

https://doi.org/10.24215/23142766e162

Warthin-like and classic papillary thyroid cancer have similar clinical presentation and prognosis
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Olmos, Roberto

; Muñoz, Francisco

; Donoso, Francisca

; López, Jorge

; Bruera, María José

; Ruiz-Esquide, Magdalena

; Mosso, Lorena

; Lustig, Nicole

; Solar, Antonieta

; Droppelmann, Nicolás

; Montero, Pablo H.

; González, Hernán E.

; Domínguez, José Miguel

Archives of Endocrinology and Metabolism

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Out 2020, Volume 64 Nº 5 Páginas 542 - 547

Resumo: En | Texto: En | PDF: En

ABSTRACT Objective Warthin-like papillary thyroid cancer (WL-PTC) is an uncommon variant of PTC, usually associated with lymphocytic thyroiditis. Scarce evidence suggests that WL-PTC has similar clinical presentation to classic PTC (C-PTC), with no studies comparing risks of recurrence and response to treatment between both variants. Our objective was to describe the clinical presentation and prognosis of WL-PTC and compare it to C-PTC. Subjects and methods Retrospective analysis of a prospective cohort, including 370 (96%) patients with C-PTC and 17 (4%) with WL-PTC, consecutively treated with total thyroidectomy with or without RAI, followed for at least 6 months. We compared clinical presentation, risk of mortality and recurrence, as well as response to treatment between both variants. Results Of the total cohort: 317 (82%) female, 38 ± 13.5 years, median follow-up 4 years (0.5-28.5); most of them stage I and low/intermediate risk of recurrence. We found no differences regarding clinical-pathological data and risk of recurrence. WL-PTC was associated with a higher rate of anti-thyroglobulin antibodies (TgAb) (65% vs. 36%, p = 0.016) and lymphocytic thyroiditis (59% vs. 34%, p = 0.03). The rates of biochemical and structural incomplete responses were similar in both variants. WL-PTC had a lower rate of excellent response (23% vs. 54%, p = 0.01), which became non-significant when performing analysis by TgAb presence (50% vs. 67%, p = NS). Conclusions WL-CPT and C-CPT have similar clinical presentation and rate of recurrence. The lower rate of excellent response to treatment in WL-PTC is due to a higher frequency of TgAb. WL-PCT should not be considered an aggressive variant of PTC.

https://doi.org/10.20945/2359-3997000000270 436 downloads

Conflictividad y órdenes mundiales: el inicio de los equilibrios sistémicos y el primer intento de un multilateralismo universal
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Fernández Luzuriaga, Wilson

; Olmedo González, Hernán

Revista de Relaciones Internacionales, Estrategia y Seguridad

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Jun 2020, Volume 15 Nº 1 Páginas 13 - 30

Resumo: Es En Pt | Texto: Es En Pt | PDF: Es | PDF: En | PDF: Pt

Resumen: Este artículo se inserta en el marco de un proyecto de investigación de mayor alcance que avanza en el estudio de posibles relaciones entre estructura de poder, conflictividad y construcción de órdenes internacionales, a partir de cumbres multilaterales de gran relevancia: la Paz de Westfalia de 1648, el Congreso de Viena de 1815, la Conferencia de Paz de París de 1919 y la Conferencia de San Francisco de 1945. Analiza específicamente la Paz de París de 1919 y sus tratados derivados. En una primera instancia, reitera una exposición sistematizada de datos cuantitativos referentes a la estructura del sistema internacional según número de grandes potencias y nivel de conflictividad; este último derivado de tres indicadores específicos: número de grandes potencias en conflicto, duración de conflictos entre grandes potencias y severidad de los conflictos. Sobre este punto, el trabajo presenta cuatro resultados para el periodo 1500-2000: el predominio de una estructura de poder de tipo multipolar elevada o alta en el sistema internacional; la ausencia de unipolaridad; la inexistencia de diferencias significativas en los niveles de conflictividad según el tipo de estructura, y el registro de los niveles de conflictividad más elevados con identificación previa a la celebración de las cumbres abordadas. En una segunda instancia, analiza las consecuencias de la Conferencia, teniendo en cuenta la ecuación normativa establecida en Westfalia: igualdad jurídica-soberanía-equilibrio de poder. El principio de igualdad jurídica es revalorizado a partir del reconocimiento de las nacionalidades y de la libre determinación de los pueblos, a pesar de algunas contradicciones que reposicionan a los Estados poderosos. El principio de la soberanía comenzará a leerse desde dos tensiones: las potestades asignadas a una organización internacional como la Liga de las Naciones con los intereses soberanos de los Estados, y un diseño sistémico basado en los principios liberales y democráticos con el derecho a la autodeterminación de los pueblos. El equilibrio de poder trasciende el espacio europeo y occidental, supone el debilitamiento definitivo de las aristocracias nacionales y, liderado por Estados Unidos de América, comienza a gestarse un nuevo paradigma de equilibrio sobre bases idealistas y liberales para dar sustento a una seguridad colectiva.

Abstract: This article is inserted in the framework of a much larger research project that advances in the study of potential relations among power structure, conflict, and construction of international orders, based on highly relevant multilateral summits: the Peace of Westphalia of 1648, the Congress of Vienna of 1815, the Paris Peace Conference of 1919, and the San Francisco Conference of 1945. It specifically analyzes the Paris Peace of 1919 and its derivative treaties. Firstly, it reiterates a systematic presentation of quantitative data referring to the structure of the international system according to number of great powers and level of conflict. The latter derives from three specific indicators: number of great powers in conflict, duration of conflicts among major powers, and severity of conflicts. In this regard, the paper presents four results for the 1500-2000 period: predominance of a highly multipolar power structure in the international system; absence of unipolarity; no significant differences in the levels of conflict per type of structure, and report of the highest levels of conflict identified prior to the summits addressed. Secondly, it discusses the Conference's consequences, considering the regulatory equation established in Westphalia: equality before the law-sovereignty-balance of power. The principle of equality before the law is revalued from the recognition of nationalities and self-determination of peoples, despite some contradictions that reposition powerful states. The principle of sovereignty will begin to be read from two tensions: the powers assigned to an international organization such as the League of Nations vs. the sovereign interests of states, and a systemic design based on liberal and democratic principles vs. the right to self-determination of peoples. Balance of power transcends the European and Western area, entails the definitive weakening of national aristocracies and, led by the United States of America, gives rise to a new idealistic and liberal paradigm of balance to support collective security.

Resumo: Este artigo se encontra no âmbito de um projeto de pesquisa de maior alcance que estuda as possíveis re -lações entre estrutura de poder, conflito e construção de ordens internacionais, a partir de cúpulas multilaterais de grande relevância: a Paz de Westfalia de 1648, o Congresso de Viena de 1815, a Conferência de Paz de Paris de 1919 e a Conferência de San Francisco de 1945. Analisa, em especial, a Paz de Paris de 1919 e seus tratados derivados. Em um primeiro momento, reitera uma exposição sistematizada de dados quantitativos referentes à estrutura do sistema internacional segundo o número de grandes potências e o nível de conflitos; este último derivado de três indicadores específicos: número de grandes potências em conflito, duração de conflitos entre grandes potências e gravidade dos conflitos. Sobre este ponto, este trabalho apresenta quatro resultados para o período entre 1500 e 2000: o predomínio de uma estrutura de poder de tipo multipolar elevada ou alta no sistema internacional; a ausên -cia de unipolaridade; a inexistência de diferenças significativas nos níveis de conflito segundo o tipo de estrutura e o registro dos níveis de conflito mais elevados com identificação prévia à celebração das cúpulas abordadas. Em um segundo momento, analisa as consequências da Conferência, considerando a equação normativa estabelecida em Westfalia: igualdade jurídica-soberania-equilíbrio de poder. O princípio de igualde jurídica é revalorizado a partir do reconhecimento das nacionalidades e da livre determinação dos povos, apesar de algumas contradições que reposicionam os Estados poderosos. O princípio da soberania começará a ser lido a partir de duas tensões: as potestades designadas a uma organização internacional como a Liga das Nações com os interesses soberanos dos Estados, e um desenho sistêmico baseado nos princípios liberais e democráticos com o direito à autodeterminação dos povos. O equilíbrio de poder transcende o espaço europeu e ocidental, supõe o enfraquecimento definitivo das aristocracias nacionais e, liderado pelos Estados Unidos da América, começa a ser administrado um novo paradigma de equilíbrio sobre bases idealistas e liberais para dar apoio a uma segurança coletiva.

https://doi.org/10.18359/ries.4099 353 downloads

Water potential in cape gooseberry (Physalis peruviana L.) plants subjected to different irrigation treatments and doses of calcium
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Álvarez-Herrera, Javier

; González, Hernán

; Fischer, Gerhard

Agronomía Colombiana

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Dez 2019, Volume 37 Nº 3 Páginas 274 - 282

Resumo: Es En | Texto: Es En | PDF: Es | PDF: En

RESUMEN Con el objetivo de establecer si el manejo del riego y de la nutrición con calcio que se le da al cultivo de uchuva para disminuir el rajado de los frutos afecta el potencial hídrico de la planta, se llevó a cabo el presente trabajo, en donde se empleó un diseño en bloques al azar con 12 tratamientos en arreglo factorial de 4×3. Los bloques fueron las frecuencias de riego (4, 9 y 14 días distanciadas). El primer factor fue la lámina de riego (0.7; 0.9; 1.1 y 1.3 de la evaporación del tanque clase A) y el segundo la dosis de calcio (0, 50 y 100 kg ha-1), lo que representó 36 unidades experimentales. Las uchuvas propagadas por semilla se trasplantaron en materas de 20 L usando turba rubia como sustrato. Se determinó el potencial hídrico en hojas (ψ hoja ) y tallos (ψ tallo ), así como el consumo de agua y la eficiencia en el uso del agua de riego (EUAr) por parte de las plantas de uchuva. El ψ hoja y el ψ tallo en las plantas presentó una tendencia sinusoidal a lo largo del día. La frecuencia de riego de 4 días con una lámina de riego de 1.1 mostró los valores más altos de ψ hoja y ψ tallo . Los ψ hoja y ψ tallo alcanzaron los valores más altos al alba (4 a.m.) producto de los bajos niveles en el déficit de presión de vapor (DPV) existentes a esa hora, y llegaron a su punto más bajo en las horas del mediodía. La lámina de riego de 1.1 presentó la segunda mayor EUAr, y es la lámina de riego más adecuada para el cultivo de uchuva pues generó la mayor cantidad de frutos de tamaño grande y menores porcentajes de rajado de frutos.

ABSTRACT To determine whether the management of irrigation and nutrition in cape gooseberry crops with calcium to reduce the cracking of fruits affects the water potential of the plants, the present study was carried out using a randomized block design with 12 treatments in a 4×3 factorial arrangement. The blocks were the irrigation frequencies (4, 9 and 14 days apart). The first factor was the irrigation coefficient (0.7, 0.9, 1.1 and 1.3 of the evaporation tank of class A), and the second factor was the calcium dose (0, 50 and 100 kg ha-1), representing 36 experimental units. Seed propagated cape gooseberries were transplanted in 20 L pots using peat moss as substrate. The water potential in the leaves (ψ leaf ) and stems (ψ stem ) was measured as well as the water consumption and irrigation water-use efficiency (WUEi) of the plants. The ψ leaf and ψ stem of the cape gooseberry plants presented a sinusoidal trend throughout the day. The water frequency of 4 days with an irrigation coefficient of 1.1 showed the highest values of ψ leaf and ψ stem . The ψ stem and ψ leaf reached the highest values at predawn (4 am) as a result of the low vapor pressure deficit (VPD) levels that occurred at that time and reached their lowest point in the midday hours. The irrigation coefficient of 1.1 had the second largest WUEi and, thus, represented the water level most suitable for growing cape gooseberry since it generated the largest number of big fruits and the smallest percentage of cracked fruits.

https://doi.org/10.15446/agron.colomb.v37n3.79935 259 downloads

In properly selected patients with differentiated thyroid cancer, antithyroglobulin antibodies decline after thyroidectomy and their sole presence should not be an indication for radioiodine ablation
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Zavala, Luis Felipe

; Barra, María Inés

; Olmos, Roberto

; Tuttle, Michael

; González, Hernán

; Droppelmann, Nicolás

; Mosso, Lorena

; Domínguez, José M.

Archives of Endocrinology and Metabolism

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Jun 2019, Volume 63 Nº 3 Páginas 293 - 299

Resumo: En | Texto: En | PDF: En

ABSTRACT Objective Our objective was to evaluate the trend of antithyroglobulin antibodies (TgAb) during follow-up of patients with differentiated thyroid cancer (DTC) treated without RAI, as well as their role in the risk of recurrence. Subjects and methods This was a prospective, descriptive study. A total of 152 consecutive patients with DTC treated in a single institution undergoing total thyroidectomy without RAI and followed for a median of 2.3 years (0.5-10.3) were divided in two groups: TgAb(-) (n = 111) and TgAb(+) (n = 41). Patients were classified according to AJCC 7th and 8th editions, as well as to their risk of recurrence and response to treatment categories. Results Both groups, TgAb(-) and TgAb(+), were similar regarding patient and tumor characteristics. At the end of follow-up, 90 (59.2%), 57 (37.5%), 3 (2%) and 2 (1.3%) patients achieved excellent, indeterminate, biochemically incomplete and structurally incomplete response, respectively. The risk of structural recurrence was similar in both groups (TgAb[-] 0.9% vs. TgAb[+] 2.4%, p = 0.46). In the TgAb(+) group, TgAb became negative in 10 (24.4%), decreased ≥ 50% without negativization in 25 (60.9%), decreased < 50% in 4 (9.8%) and remained stable or increased in 2 (4.9%) cases. The only incomplete structural response had increasing TgAb during follow-up. Conclusions In properly selected patients with DTC, TgAb concentration immediately after total thyroidectomy should not mandate RAI ablation, and their trend during follow-up may impact the risk of recurrence.

https://doi.org/10.20945/2359-3997000000123 865 downloads

Riesgo de recurrencia en cáncer diferenciado de tiroides: escala MINSAL
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Domínguez, José Miguel

; Martínez, María Teresa

; Massardo, José Miguel

; Muñoz, Suelí

; Droppelmann, Nicolás

; González, Hernán E.

; Mosso, Lorena

Revista médica de Chile

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Mar 2018, Volume 146 Nº 3 Páginas 282 - 289

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Background: Differentiated thyroid cancer (DTC) is generally associated with a favorable prognosis. Its treatment requires surgery, selective use of radioiodine and levothyroxine, and its intensity must be adjusted to the initial risks of mortality and recurrence. Aim: To validate the risk of recurrence classification developed by the Chilean Ministry of Health in 2013 (MINSAL 2013), and compare it with the American Thyroid Association (ATA) 2009 and 2015 classifications. Material and Methods: Retrospective study of 362 patients with DTC aged 44.3 ± 13.4 years (84% women), treated with total thyroidectomy, selective radioiodine ablation and levothyroxine and followed for a median of 4.2 years (range 2.0-7.8). Risk of recurrence was estimated with MINSAL 2013, ATA 2009 and ATA 2015 classifications, and risk of mortality with 7th and 8th American Joint Committee on Cancer (AJCC)/TNM systems. Clinical data obtained during follow-up were used to detect structural and biochemical persistence/recurrence. Results: A mean dose of 104 ± 48 mCi radioiodine was received by 91% of patients. MINSAL 2013 classified 148 (41%), 144 (40%), 67 (19%) and 3 (1%) patients as very low, low, intermediate and high risk of recurrence, respectively. Forty-five (12.4%) patients had persistence or recurrence during follow-up: 33 structural and 12 biochemical. Rates of persistence/recurrence on each category of MINSAL 2013 were 4.1%, 7.6%, 37.3% and 100%, respectively (p < 0.01). Areas under Receiver Operating Characteristic curves for persistence or recurrence of MINSAL 2013, ATA 2009 and ATA 2015 were 0.77 vs 0.73 vs 0.72, respectively. Conclusions: MINSAL 2013 classifies appropriately DTC patients and estimates correctly their risk of persistence or recurrence.

https://doi.org/10.4067/s0034-98872018000300282 3702 downloads

Papillary thyroid microcarcinoma: characteristics at presentation, and evaluation of clinical and histological features associated with a worse prognosis in a Latin American cohort
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Domínguez, José M.

; Nilo, Flavia

; Martínez, María T.

; Massardo, José M.

; Muñoz, Sueli

; Contreras, Tania

; Carmona, Rocío

; Jerez, Joaquín

; González, Hernán

; Droppelmann, Nicolás

; León, Augusto

Archives of Endocrinology and Metabolism

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Fev 2018, Volume 62 Nº 1 Páginas 6 - 13

Resumo: En | Texto: En | PDF: En

ABSTRACT Objective We aimed to describe the presentation of papillary microcarcinoma (PTMC) and identify the clinical and histological features associated with persistence/recurrence in a Latin American cohort. Subjects and methods Retrospective study of PTMC patients who underwent total thyroidectomy, with or without radioactive iodine (RAI), and who were followed for at least 2 years. Risk of recurrence was estimated with ATA 2009 and 2015 classifications, and risk of mortality with 7th and 8th AJCC/TNM systems. Clinical data obtained during follow-up were used to detect structural and biochemical persistence/recurrence. Results We included 209 patients, predominantly female (90%), 44.5 ± 12.6 years old, 183 (88%) received RAI (90.4 ± 44.2 mCi), followed-up for a median of 4.4 years (range 2.0–7.8). The 7th and 8th AJCC/TNM system classified 89% and 95.2% of the patients as stage I, respectively. ATA 2009 and ATA 2015 classified 70.8% and 78.5% of the patients as low risk, respectively. Fifteen (7%) patients had persistence/recurrence during follow-up. In multivariate analysis, only lymph node metastasis was associated with persistence/recurrence (coefficient beta 4.0, p = 0.016; 95% CI 1.3-12.9). There were no PTMC related deaths. Conclusions Our series found no mortality and low rate of persistence/recurrence associated with PTMC. Lymph node metastasis was the only feature associated with recurrence in multivariate analysis. The updated ATA 2015 and 8th AJCC/TNM systems classified more PTMCs than previous classifications as low risk of recurrence and mortality, respectively.

https://doi.org/10.20945/2359-3997000000013 2090 downloads

Estudio y manejo de nódulos tiroideos por médicos no especialistas. Consenso SOCHED
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Tala, Hernán

; Díaz, René E.

; Domínguez Ruiz-Tagle, José Miguel

; Sapunar Zenteno, Jorge

; Pineda, Pedro

; Arroyo Albala, Patricia

; Barberán, Marcela

; Cabané, Patricio

; Cruz Olivos, Francisco

; Gac, Patricio E.

; Glasinovic Pizarro, Andrea

; González, Hernán E.

; Grob, Francisca

; Hidalgo Valle, Maria Soledad

; Jaimovich, Rodrigo

; Lanas, Alejandra

; Liberman, Claudio

; Lobo Guiñez, Maite

; Madrid, Arturo

; Moreno Seguel, Marcela

; Mosso, Lorena

; Munizaga, Fernando C.

; Ortiz Parada, Eugenia

; Osorio Gonnet, Fernando

; Slater Morales, Jeannie

; Solar, Antonieta

; Stehr, Carlos

; Vásquez Rodríguez, Félix

; Véliz, Jesús

; Villaseca Najarian, Roberto

; Wohllk, Nelson

Revista médica de Chile

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Ago 2017, Volume 145 Nº 8 Páginas 1028 - 1037

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

The thyroid nodule is a frequent cause of primary care consultation. The prevalence of a palpable thyroid nodule is approximately 4-7%, increasing up to 67% by the incidental detection of nodules on ultrasound. The vast majority are benign and asymptomatic, staying stable over time. The clinical importance of studying a thyroid nodule is to exclude thyroid cancer, which occurs in 5 to 10% of the nodules. The Board of SOCHED (Chilean Society of Endocrinology and Diabetes) asked the Thyroid Study Group to develop a consensus regarding the diagnostic management of the thyroid nodule in Chile, aimed at non-specialist physicians and adapted to the national reality. To this end, a multidisciplinary group of 31 experts was established among university academics, active researchers with publications on the subject and prominent members of scientific societies of endocrinology, head and neck surgery, pathology and radiology. A total of 14 questions were developed with key aspects for the diagnosis and subsequent referral of patients with thyroid nodules, which were addressed by the participants. In those areas where the evidence was insufficient or the national reality had to be considered, the consensus opinion of the experts was used through the Delphi methodology. The consensus was approved by the SOCHED board for publication.

https://doi.org/10.4067/s0034-98872017000801028 28478 downloads

Analysis of epibiont data in relation with the Debilitated Turtle Syndrome of sea turtles in Chelonia mydas and Lepidochelys olivacea from Concepción coast, Chile
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Fernández, Italo

; Retamal, Marco Antonio

; Mansilla, Miguel

; Yáñez, Francisco

; Campos, Víctor

; Smith, Carlos

; Puentes, Guillermo

; Valenzuela, Ariel

; González, Hernán

Latin american journal of aquatic research

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Nov 2015, Volume 43 Nº 5 Páginas 1024 - 1029

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Epibionts on the surface of the skin and shell of a specimen of Chelonia mydas and three Lepidochelys olivacea found floating on the coast of Concepción, Chile, between June 2010 and December 2012, were analyzed. These epibionts were analyzed during the clinical inspection and the tissue changes related to its settlement, with filamentous algae around, were observed. Subsequently, the epibionts were identified by morphological observation. The knowledge about theses epibionts in Chile is reviewed and the potential occurrence of Debilitated Turtle Syndrome (DTS) in these turtles is discussed. The presence of sea turtles in the Chilean coast is considered a casual event, so there is little information on this issue. We propose it is necessary to carry out more studies on the association between turtles and epibionts because their identification, colonizing reptiles’ surface may give relevant information to a better understanding of different diseases, including DTS, that affect these marine reptiles and facilitates the development of strategies intended to recover their populations.

Se presenta el hallazgo de epibiontes en la superficie de la piel y caparazón de un ejemplar de Chelonia mydas y tres de Lepidochelys olivacea encontrados flotando frente a la costa de Concepción, Chile, entre junio de 2010 y diciembre de 2012. Los epibiontes se visualizaron clínicamente y se observaron alteraciones tisulares relativas a su asentamiento junto con algas filamentosas a su alrededor. Los epibiontes se identificaron por observación morfológica. Se presenta una revisión respecto del conocimiento en Chile de los organismos encontrados y se discute la potencial ocurrencia del Síndrome de Debilitamiento de Tortugas (SDT) en los caparazones analizados. La presencia de tortugas marinas en el litoral chileno es un evento ocasional y existe escasa información respecto de esta problemática. Se recomienda realizar estudios sobre la asociación entre las tortugas y epibiontes porque su identificación, colonizando la superficie de estos reptiles, puede aportar datos relevantes para una mejor comprensión de las enfermedades que afectan a las tortugas marinas, incluyendo el SDT, y facilita el desarrollo de estrategias destinadas a recuperar sus poblaciones.

https://doi.org/10.3856/vol43-issue5-fulltext-23 1956 downloads

10.

Clinical utility of early amplitude integrated EEG in monitoring term newborns at risk of neurological injury ,
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Toso, Paulina A.

; González, Alvaro J.

; Pérez, María E.

; Kattan, Javier

; Fabres, Jorge G.

; Tapia, José L.

; González, Hernán S.

Jornal de Pediatria

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Abr 2014, Volume 90 Nº 2 Páginas 143 - 148

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

OBJETIVO: testar a utilidade clínica do aEEG precoce em recém-nascidos a termo com risco delesão neurológica, para prever resultados neurológicos de curto prazo.MÉTODOS: estudo prospectivo e descritivo. Os critérios de inclusão foram encefalopatia neonatal, distúrbios neurológicos e bebês com SARA grave. Sensibilidade, especificidade, valor preditivo positivo e negativo e razão de verossimilhança foram calculados. Dados clínicos edemográficos foram analisados. O resultado neurológico foi definido como a soma de conclusões clínicas, de eletro e de neuroimagem.RESULTADOS: dentre os 21 neonatos monitorados, dez (48%) apresentaram resultado neurológico de curto prazo alterado. O aEEG apresentou sensibilidade de 90%, especificidade de 82%, valor preditivo positivo de 82% e valor preditivo negativo de 90%. A VR positiva foi de 4,95, e a RV negativa de 0,12. Em três dos 12 (25%) neonatos com encefalopatia foi possível definir melhora gravidade de sua condição pelo aEEG. Foram detectadas convulsões em oito neonatos (38%), todas subclínicas no início do estudo, e nenhum apresentou um padrão histórico normal no aEEG. O estado de três neonatos (43%) evoluiu e exigiu dois ou mais medicamentos para tratamento.CONCLUSÕES: em neonatos com encefalopatia ou outra doença grave, os distúrbios no aEEGocorrem com mais frequência. O aEEG forneceu uma classificação melhor da gravidade da encefalopatia, detectou convulsões subclínicas precoces e permitiu que fosse feito o monitoramento da resposta ao tratamento. O aEEG é uma ferramenta útil para prever resultados neurológicos de curto prazo em todos os bebês doentes na UTIN.

OBJECTIVE:to test the clinical utility of an early amplitude-integrated electroencephalography (aEEG) to predict short-term neurological outcome in term newborns at risk of neurology injury.METHODS:this was a prospective, descriptive study. The inclusion criteria were neonatal encephalopathy, neurologic disturbances, and severe respiratory distress syndrome. Sensitivity, specificity, positive and negative predictive values, and likelihood ratio (LR) were calculated. Clinical and demographic data were analyzed. Neurological outcome was defined as the sum of clinical, electroimaging, and neuroimaging findings.RESULTS:ten of the 21 monitored infants (48%) presented altered short-term neurologic outcome. The aEEG had 90% sensitivity, 82% specificity, 82% positive predictive value, and 90% negative predictive value. The positive LR was 4.95, and the negative LR was 0.12. In three of 12 (25%) encephalopathic infants, the aEEG allowed for a better definition of the severity of their condition. Seizures were detected in eight infants (38%), all subclinical at baseline, and none had a normal aEEG background pattern. The status of three infants (43%) evolved and required two or more drugs for treatment.CONCLUSIONS:in infants with encephalopathy or other severe illness, aEEG disturbances occur frequently. aEEG provided a better classification of the severity of encephalopathy, detected early subclinical seizures, and allowed for monitoring of the response to treatment. aEEG was a useful tool at the neonatal intensive care unit for predicting poor short-term neurological outcomes for all sick newborn.

https://doi.org/10.1016/j.jped.2013.07.004 2778 downloads

11.

Concordancia de la citología por punción con aguja fina para la detección de cáncer de tiroides en pediatría
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Grob, Francisca

; Carrillo, Diego

; Martínez-Aguayo, Alejandro

; Zoroquain, Pablo

; Solar, Antonieta

; Nicolaides, Irini

; González, Hernán

Revista médica de Chile

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Mar 2014, Volume 142 Nº 3 Páginas 330 - 335

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Background: Despite the low frequency of thyroid nodules (TN) in children, one of every four is malignant. Fine-needle aspiration cytology (FNAC) has a high accuracy detecting thyroid cancer. Aim: To evaluate the performance of FNAC in TN in Chilean children to detect thyroid cancer. Patients and Methods: The pathological reports of 77 thyroidectomies and 103 FNAC carried out in patients aged less than 18 years, between 2002 and 2013 were reviewed. In 36 patients aged 15 ± 2 years (77% women), both the reports of the thyroidectomy and FNAC were available. The cytological specimens were reclassified based on Bethesda 2010. The histology was classified as benign (nodular hyperplasia and follicular adenoma, n = 18), or malignant (papillary, follicular and medullar carcinoma, n = 18). The concordance of the cytology with the final biopsy report was calculated. Results: FNAC classified 13 specimens as definitively benign and 13 as definitively malignant. Among these, these concordances with the pathological study of the biopsy was 100%. Of six cytology tests considered "suspicious for follicular neoplasm" by FNAC, four were benign (67%), and two malignant (33%). Of four cytology tests considered "suggestive of carcinoma" by FNAC, one was benign (25%), and three malignant (75%). Conclusions: Among the studied children, there was a good concordance between FNAC and surgical biopsies. Therefore a FNAC should be carried out when malignancy is suspected in pediatric patients with a TN.

7446 downloads Citado 1 vez em SciELO

12.

Del macro al microcarcinoma tiroideo: cambios en las características de presentación del cáncer de tiroides en un centro universitario chileno en 20 años
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Mosso, Lorena

; Campusano, Claudia

; González, Hernán

; Domínguez, José Miguel

; Salman, Patricio

; Suazo, Valeria

; Solar, Antonieta

; Cerda, Jaime

Revista médica de Chile

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Abr 2013, Volume 141 Nº 4 Páginas 442 - 448

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Background: The prevalence of thyroid cancer has increased, particularly in nodules smaller than 10 mm, probably due to the growing use of routine thyroid ultrasound. There is controversy about the biological behavior of micro carcinomas and the relevance of their early detection. Aim: To characterize the clinical presentation of thyroid cancer over 20 years in an University medical center and to evaluate the differences between macro and micro carcinomas. Patients and Methods: We reviewed 1547 surgical biopsy records of thyroid cancer in our institution obtained between 1991 and 2010. Results: We observed a sustained increase in the rate of thyroidectomies for thyroid cancer (per 1000 surgical procedures) in the study period. Papillary, follicular, mixed, medullary and anaplastic carcinomas were observed in 95, 3, 2, 0.5 and 0.1% of biopsies, respectively. The incidence of tumors of less than 10 mm (micro carcinoma) also increased. Those findings were associated with a significant decrease in tumor aggressiveness, determined by a low frequency of surgical margin involvement of thyroid capsule, perithyroid tissue invasion, vascular permeation and lymph node metastases. Conclusions: The increased prevalence of thyroid cancer, especially of micro carcinomas, may reflect the greater use of diagnostic ultrasound or represent a real change in the biological behavior of this disease and our data suggest that further studies are needed to know the impact of early treatment in the outcome of those patients because of the real less histologic agressiveness of micro carcinomas.

4518 downloads Citado 2 vezes em SciELO

13.

First pathological report of parasitic gastric ulceration in Humboldt penguin(Spheniscus humboldti)along the coast of south-central Chile
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Yáñez, Francisco

; Fernández, Ítalo

; Campos V, Víctor

; Mansilla, Miguel

; Valenzuela, Ariel

; González, Hernán

; Rodríguez, Cristhian

; Rivas, Meyling

; Alveal, Katherine

; Oyarzún, Ciro

Latin american journal of aquatic research

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Jul 2012, Volume 40 Nº 2 Páginas 448 - 452

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

This report offers a macroscopic and histological description of ulcerative gastric lesions in Humboldt penguins associated with the presence of Contracaecum pelagicum. Parasites of this genus have been isolated from different species of marine mammals and birds, including penguins, demonstrating its capacity to generate ulcerative lesions in the gastrointestinal tracts of many hosts. A bibliographic review revealed no publications on gastric ulceration by nematodes in Humboldt penguins. Studies carried out in Chile concerning gastrointestinal parasitism by nematodes of the Contracaecum genus in S. humboldti only established the parasite's taxonomy. This is the first pathological description of a parasitic ulcerative manifestation in the stomach of S. humboldti in the world. The Humboldt penguin is a vulnerable species. Therefore, this study is relevant as it offers a better understanding of the diseases that affect S. humboldti and facilitates the development of strategies intended to recover the population.

El presente trabajo ofrece una descripción macroscópica e histológica de lesiones gástricas de tipo ulcerativas en el pingüino de Humboldt asociadas a la presencia de Contracaecum pelagicum. Parásitos del género Contracaecum han sido aislados de diferentes especies de mamíferos y aves marinas, incluyendo pingüinos, en gran parte del mundo, demostrando una gran capacidad de generar lesiones ulcerativas en un número importante de hospederos. La revisión bibliográfica reveló la ausencia de publicaciones relativas a cuadros ulcerativos gástricos causados por nemátodos en el pingüino de Humboldt. Los estudios realizados en Chile concernientes a parasitismo gastrointestinal por nemátodos del género Contracaecum en S. humboldti sólo han abordado aspectos taxonómicos. Esta publicación constituye la primera descripción patológica de un cuadro de ulceraciones gástricas parasitarias en el pingüino de Humboldt. S. humboldti está catalogado como especie vulnerable por lo que este estudio es relevante en cuanto a incrementar el entendimiento de las patologías que afectan a la especie facilitando el desarrollo de estrategias tendientes a la recuperación de la población.

2879 downloads Citado 2 vezes em SciELO

14.

Armonización de la vigilancia sanitaria interfronteriza: una propuesta vinculante en salud internacional
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Quirós, Héctor Manuel

; Rodríguez González, Hernán

; Valderrama Vergara, José Fernando

Revista Panamericana de Salud Pública

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Ago 2011, Volume 30 Nº 2 Páginas 148 - 152

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

A quantitative and qualitative study to identify mechanisms and actions to help harmonize cross-border health surveillance and provide a timely and effective response to events that may threaten international health security. The capacities of Brazil, Colombia, and Peru were analyzed in three areas: (a) the legal and administrative framework; (b) the ability to detect, evaluate, and report risk situations and (c) the ability to investigate, intervene in, and communicate international health risk situations. Data were collected through a document review, workshops, group work, and semistructured interviews with key individuals in health surveillance in the three countries. The average national capacity for the trio of countries within "the legal and administrative framework" was 69.4%; 83.3% in "the ability to detect, evaluate and report"; and 78.7% in "the ability to investigate, intervene in, and communicate international health risk situations." More resources should be directed toward coordinated action among the three countries in order to strengthen surveillance and public health monitoring in their border areas.

Estudio cuantitativo y cualitativo dirigido a identificar mecanismos y acciones que contribuyan a armonizar la vigilancia de la salud interfronteriza para dar respuestas oportunas y efectivas a eventos que puedan amenazar la seguridad sanitaria internacional. Se analizaron las capacidades de Brasil, Colombia y Perú en tres áreas: a) marco legal y administrativo; b) capacidad para detectar, evaluar y notificar situaciones de riesgo y c) capacidad para investigar, intervenir y comunicar situaciones de riesgo sanitario internacional. La recolección de datos se hizo mediante revisión documental, talleres, trabajo grupal y entrevistas semiestructuradas a actores clave de la vigilancia sanitaria en los tres países. El promedio nacional de capacidades para el trío de países en "marco legal y administrativo" fue de 69,4%; en "capacidad para detectar, evaluar y notificar", 83,3%, y en "capacidad para investigar, intervenir y comunicar situaciones de riesgo", 78,7%. Se deben dirigir más recursos hacia acciones coordinadas entre los tres países para fortalecer la vigilancia y el control de la salud pública en sus zonas de frontera.

2868 downloads Citado 2 vezes em SciELO

15.

Utilidad de la PTH intraoperatoria como predictor de curación quirúrgica en hiperparatiroidismo primario
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Domínguez, José Miguel

; Velasco, Soledad

; Goñi, Ignacio

; León, Augusto

; González, Hernán

; Claure, Raúl

; Arteaga, Eugenio

; Campusano, Claudia

; Fardella, Carlos

; López, José Manuel

; Mosso, Lorena

; Rodríguez, José Adolfo

; González, Gilberto

Revista médica de Chile

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Dez 2009, Volume 137 Nº 12 Páginas 1591 - 1596

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Background: The aim of the surgical treatment of primary hyperparathyroidism (PHPT) is to achieve its complete cure, evidenced by normal serum calcium in the postoperative period. Measurement of intraoperative serum parathormone (PTH) can be useful to predict complete cure of the disease. Aim: To assess the usefulness of intraoperative PTH measurement to predict complete cure of PHPT Material and methods: Serum PTH was measured to all patients operated for PHPT between 2003 and 2008, before and five and ten minutes after the excision of the parathyroid gland causing the disease. The criteria for complete cure were normal serum calcium at 24 hours and 6 months after surgery and the pathological confirmation of parathyroid gland excision. Results: Eighty-eight operated patients, aged 58±15 years (72 females) were studied. Sixty four percent were asymptomatic and their preoperative serum calcium was 11.6± 1.2 mg/dl. A normal serum calcium was achieved in 86 patients (98%) at 24 hours and 50 of 52 patients followed for six months (96%). The pathological study disclosed an adenoma in 69 (78%), and multiglandular disease in 16 (18%), a parathyroid cancer in one and a normal gland in one patient. Intraoperative PTH predicted early and definitive cure in 97% and 100% of patients with a single adenoma, respectively. Among patients with multiglandular disease, the predictive figures were 94% and 100%, respectively. Conclusions: Intraoperative PTH measurement efficiently predicts early and definitive surgical cure of PHPT.

5737 downloads Citado 2 vezes em SciELO

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