Artículos de Revistas
URI permanente para esta colección
Examinar
Envíos recientes
Ítem When Ethics Meet Socrates in Critical Care(Society of Critical Care Medicine and Wolters Kluwer Health, 2025-06) Pedreros, Cesar; Saenz, Angel; Ferre, Andrés; Giglio, AndrésThis process shows how structured philosophical dialogue can potentially transform confrontational scattered discussions into collaborative exploration of complex ethical issues in critical care maintaining mutual respect and potentially reducing the emotional burdenÍtem The role of cellular senescence in endothelial dysfunction and vascular remodelling in arteriovenous fistula maturation(Wiley, 2025-02-20) González, Ignacia; Maldonado-Agurto, RodrigoHaemodialysis (HD) is often required for patients with end-stage renal disease. Arteriovenous fistulas (AVFs), a surgical procedure connecting an artery to a vein, are the preferred vascular access for HD due to their durability and lower complication rates. The aim of AVFs is to promote vein remodelling to accommodate increased blood flow needed for dialysis. However, many AVFs fail to mature properly, making them unsuitable for dialysis. Successful maturation requires remodelling, resulting in an increased luminal diameter and thickened walls to support the increased blood flow. After AVF creation, haemodynamic changes due to increased blood flow on the venous side of the AVF initiate a cascade of events that, when successful, lead to the proper maturation of the AVF, making it suitable for cannulation. In this process, endothelial cells play a crucial role since they are in direct contact with the frictional forces exerted by the blood, known as shear stress. Patients requiring HD often have other conditions that increase the burden of senescent cells, such as ageing, diabetes and hypertension. These senescent cells are characterized by irreversible growth arrest and the secretion of pro-inflammatory and pro-thrombotic factors, collectively known as the senescence-associated secretory phenotype (SASP). This accumulation can impair vascular function by promoting inflammation, reducing vasodilatation, and increasing thrombosis risk, thus hindering proper AVF maturation and function. This review explores the contribution of senescent endothelial cells to AVF maturation and explores potential therapeutic strategies to alleviate the effects of senescent cell accumulation, aiming to improve AVF maturation rates.Ítem Transcriptional activation of genes associated with the matrisome is a common feature of senescent endothelial cells(Springer Nature, 2025-02-13) Gonzalez, Ignacia; Arredondo, Sebastián; Maldonado-Agurto, RodrigoCellular senescence is a stable cell cycle arrest that occurs in response to various stress stimuli and affects multiple cell types, including endothelial cells (ECs). Senescent cells accumulate with age, and their removal has been linked to reduced age-related diseases. However, some senescent cells are important for tissue homeostasis. Therefore, understanding the diversity of senescent cells in a cell-type-specific manner and their underlying molecular mechanisms is essential. Senescence impairs key ECs functions which are necessary for vascular homeostasis, leading to endothelial dysfunction and age-related vascular diseases. In order to gain insights into these mechanisms, we analyzed publicly available RNA-seq datasets to identify gene expression changes in senescent ECs induced by doxorubicin, irradiation, and replication exhaustion. While only a few genes were consistently differentially expressed across all conditions, some gene ontologies (GO) were shared. Among these, our analysis focused on validating the expression of genes associated with the matrisome, which includes genes encoding for extracellular matrix (ECM) structural components and ECM-associated proteins, in a doxorubicin-induced senescence model. Our results show that the matrisome transcriptome undergoes significant remodeling in senescent endothelial cells, regardless of the specific inducers of senescence, highlighting the importance of understanding how ECM alterations affect senescence.Ítem Seasonal transcriptome profile across three different tissues of the Andean Killifish Orestias ascotanensis(Springer Nature, 2025-06-10) Maldonado-Agurto, Rodrigo; Acevedo, Elvis; Maracaja-Coutinho, Vinicius; Montecino, MartinThe Andean killifish Orestias ascotanensis inhabits the high-altitude Ascotán Salt Pan, an environment with variable salinity, high UV exposure, low oxygen, and extreme daily temperature fluctuations. These conditions make it an excellent model for studying high-altitude fish biology. However, the transcriptomic responses of O. ascotanensis to seasonal acclimation remain unexplored. To investigate seasonal and tissue-specific transcriptomic profiles, RNA-seq was performed on 42 libraries from gills, skin, and muscle tissues of 14 individuals collected in summer (n = 7) and winter (n = 7). Each library had a median of 105 million reads. Principal component analysis revealed strong tissue-specific expression, and seasonal differential expression analyses identified significant transcriptomic changes within each tissue. Additionally, a bioinformatics pipeline identified 10,365 high-confidence long non-coding RNAs (lncRNAs), predicted by at least three computational tools. Compared to protein-coding genes, lncRNAs exhibited higher tissue specificity, with a predominance of monoexonic structures and shorter exon lengths. This dataset provides the first comprehensive view of seasonal mRNA and lncRNA expression in O. ascotanensis tissues.Ítem Infraorbital canal variants and its clinical and surgical implications: A systematic review(Springer Nature, 2024-04-29) Orellana-Donoso, Mathias; Romero Zucchino, Diego; Fuentes Abarca, Alonso; Aravena Ríos, Priscila; Sanchis Gimeno, Juan; Konschake, MarkoBackground: Recent literature highlights anomalous cranial nerves in the sinonasal region, notably in the sphenoid and maxillary sinuses, linked to anatomical factors. However, data on the suspended infraorbital canal (IOC) variant is scarce in cross-sectional imaging. Anatomical variations in the sphenoid sinuses, including optic, maxillary, and vidian nerves, raise interest among specialists involved in advanced sinonasal procedures. The infraorbital nerve's (ION) course along the orbital floor and its abnormal positioning within the orbital and maxillary sinus region pose risks of iatrogenic complications. A comprehensive radiological assessment is crucial before sinonasal surgeries. Cone-beam computed tomography (CBCT) is preferred for its spatial resolution and reduced radiation exposure. Objective: The aim of this study was to describe the prevalence of anatomical variants of the infraorbital canal (IOC) and report its association with clinical condition or surgical implication. Methods: We searched Medline, Scopus, Web of Science, Google Scholar, CINAHL, and LILACS databases from their inception up to June 2023. Two authors independently performed the search, study selection, data extraction, and assessed the methodological quality with assurance tool for anatomical studies (AQUA). Finally, the pooled prevalence was estimated using a random effects model. Results: Preliminary results show that three types are prevalent, type 1: the IOC does not bulge into the maxillary sinus (MS); therefore, the infraorbital foramen through the anterior wall of MS could be used for identification of the ION. Type 2: the IOC divided the orbital floor into medial and lateral aspects. Type 3: the IOC hangs in the MS and the entire orbital floor lying above the IOC. From which the clinical implications where mainly surgical, in type 1 the infraorbital foramen through the anterior wall of MS could be used for identification of the ION, while in type 2, since the lateral orbital floor could not be directly accessed an inferiorly transposition of ION is helpful to expose the lateral orbital wall directly with a 0 scope; or using angled endoscopes and instruments, however, the authors opinion is that direct exposure potentially facilitates the visualization and management in complex situations such as residual or recurrent mass, foreign body, and fracture located at the lateral aspect of the canal. Lastly, in type 3, the ION it's easily exposed with a 0° scope. Conclusions: This systematic review identified four IOC variants: Type 1, within or below the MS roof; Type 2, partially protruding into the sinus; Type 3, fully protruding into the sinus or suspended from the roof; and Type 4, in the orbital floor. Clinical recommendations aim to prevent nerve injuries and enhance preoperative assessments. However, the lack of consistent statistical methods limits robust associations between IOC variants and clinical outcomes. Data heterogeneity and the absence of standardized reporting impede meta-analysis. Future research should prioritize detailed reporting, objective measurements, and statistical approaches for a comprehensive understanding of IOC variants and their clinical implications. Open Science Framework (OSF): https://doi.org/10.17605/OSF.IO/UGYFZ .Ítem Morphological Characteristics of the Double Mental Foramen and Its Relevance in Clinical Practice: An Observational Study(MDPI, 2024-04-25) Bruna Mejias, Alejandro; Nova Baeza, Pablo; Torres Riquelme, Florencia; Delgado Retamal, María Fernanda; Orellana-Donoso, Mathias; Suazo Santibañez, Alejandra; Sepulveda Loyola, Walter; Valdés Orrego, Iván; Sabchis Gimeno, Juan; Valenzuela Fuenzalida, Juan JoséThe mental foramen (MF) is an opening found bilaterally on the anterolateral aspect of the mandible; it can be round or oval and have different diameters. One of the anatomical variants of the jaw is the presence of an accessory mental foramen (AMF). These are usually smaller than the MF and can be located above, below, or to the sides of the main MF. The objective of this study was to recognize the presence of AMF in dry jaws of the Chilean population and collect information about its clinical relevance reported in the literature. In this descriptive observational study, we have collected dried jaws obtained from three higher education institutions in Santiago de Chile, from the Department of Morphology of the Andrés Bello University, the Normal Human Anatomy Unit of the University of Santiago, and the Human Anatomy pavilion from the Faculty of Medicine of the Finis Terrae University. The samples for this research were obtained by convenience, and the observation of the jaws was carried out in the human anatomy laboratories of each institution by three evaluators independently, and a fourth evaluator was included to validate that each evaluation was correct. The sample for this research came from 260 dry jaws, showing the following findings from the total jaws studied, and to classify as an accessory MF, it will be examined and measured so that it complies with what is declared in the literature as the presence of AMF, which is between 0.74 mm. and 0.89 mm. There were 17 studies included with a sample that fluctuated between 1 and 4000, with a cumulative total of 7946 and an average number of jaws analyzed from the studies of 467.4, showing statistically significant differences between the means with the sample analyzed in this study; p = 0.095. For the cumulative prevalence of the presence of AMF, this was 3.07 in this study, and in the compared studies, the average of AMF was 8.01%, which did not present a statistically significant difference; p = 0.158. Regarding the presence of variants of unilateral AMF, this occurred in five jaws, which is equivalent to 1.84% in the sample of this study, while in previous studies, it was 7.5%, being higher on the left side than on the right. The presence of AMF is a variant with high prevalence if we compare it with other variants of the jaw. Knowledge of the anatomy and position of the AMF is crucial to analyze different scenarios in the face of surgical procedures or conservative treatments of the lower anterior dental region.Ítem Effectiveness of DASH Diet versus Other Diet Modalities in Patients with Metabolic Syndrome: A Systematic Review and Meta-Analysis(MDPI, 2024-08-03) Valenzuela Fuenzalida, Juan José; Silva Bravo, Vicente; Moyano Valarezo, Laura; Delgado Retamal, María Fernanda; Matta Leiva, Josefa; Bruna Mejias, Alejandro; Nova Baeza, Pablo; Orellana-Donoso, Mathias; Suazo Santibañez, Alejandra; Oyanedel Amaro, Gustavo; Gutierrez Espinoza, HéctorBackground: Metabolic syndrome refers to the coexistence of several known cardiovascular risk factors, including insulin resistance, obesity, atherogenic dyslipidemia, and hypertension. These conditions are interrelated and share underlying mediators, mechanisms, and pathways. Improvement in dietary habits has been shown to improve metabolic parameters in patients undergoing treatment with different diets. Methods: A systematic search in different databases was realized using the keywords "Metabolic syndrome", "X syndrome", "Dash dietary" and "Dash diet". Finally, six studies were included in this meta-analysis. Results: All articles comparing the DASH diet vs. other diet modalities reported significant differences in favor of the DASH diet on Systolic blood pressure (SBP) (standardized mean difference [SMD] = -8.06, confidence interval [CI] = -9.89 to -7.32, and p < 0.00001), Diastolic blood pressure (SMD = -6.38, CI = -7.62 to -5.14, and p < 0.00001), Cholesterol HDL (SMD = 0.70, CI = 0.53 to 0.88, and p < 0.00001) and Cholesterol LDL (SMD = -1.29, CI = -1.73 to -0.85, and p < 0.00001) scales. Conclusions: The DASH diet has been shown to be beneficial in altered parameters in patients with MS, and the resulting improvements can significantly affect the daily health of these patients. We therefore recommend that professionals who manage these pathologies promote the use of the DASH diet for the management of specific symptoms.Ítem Association between types of abdominopelvic cancer in patients with situs inversus total: Systematic review(Wolters Kluwer Health, Inc., 2024-02-23) Milos Brandenberg, Daniel; Koscina, Zmilovan; Avila Sepulveda, Roberto; Baez, Belén; Perez Jimenez, Daniela; Nova Baeza, Pablo; Orellana-Donoso, Mathias; Bruna Mejías, AlejandroBackground: Situs inversus is a rare congenital anatomical variant that involves a group of anomalies regarding the arrangement of intrathoracic and intraabdominal organs. Being able to find in the abdominal region the liver, gallbladder, inferior vena cava, and head of the pancreas and ascending colon on the left side of the abdomen, while on the right side there is the spleen, the stomach, the body of the pancreas, the ligament of Treitz, descending colon among others. In this same way, the thoracic organs, lungs and heart, are changed in their position in a mirror translocation. Methods: We systematically searched MEDLINE, Web of Science, Google Scholar, CINAHL, Scopus, and LILACS; the search strategy included a combination of the following terms: "Situs inversus," "Situs inversus totalis," "Cancer," "Neoplasm," "Abdominopelvic regions," and "clinical anatomy." Results: Within the 41 included studies, 46 patients with situs inversus who had cancer, in addition to being found in this organ and in these regions, we also found as a result that the majority of the studies in the research were in stage II; finally, no one study could assert the direct relationship between the situs inversus totalis and the cancer. Conclusion: If our hallmarks could make us think that more exhaustive follow-up of the stomach and other organs should be carried out in these patients, there could also be other predisposing factors for cancer, which is why more studies are suggested to give future diagnostic and treatment guidelines treatment.Ítem Pediatric fluid resuscitation: an oxymoron?(Frontiers Media S.A., 2025-06-01) Díaz, Franco; Riderelli, Jocelyn; Jabornisky, RobertoIn conclusion, fluid therapy is vital for caring for critically ill children, but the rationale for employing fluid boluses as a blind blanket treatment for hemodynamic instability requires thorough reassessment. A comprehensive understanding of fluids as a drug in critical care, including a dose, duration, and de-escalation (4D’s defined by Malbrain et al.), is essential, with specific indications and duration (25). A more rational, individualized approach may facilitate the adoption of alternative strategies aimed at minimizing excessive fluid administration and preventing fluid overload (26). As underscored by FernandezSarmiento et al. (13), it is imperative that clinicians systematically assess and clearly document, at least on a daily basis, the current phase of critical illness in each pediatric patient to ensure fluid management is appropriately tailored. Given the mounting evidence highlighting the potential harms and only transient benefits of fluid resuscitation, a precise, individualized, and context-driven approach to fluid therapy is no longer optional—it is essential. Such a strategy is crucial for optimizing outcomes and minimizing iatrogenic complications in critically ill children globallyÍtem Functional echocardiography identifies association between early ventricular dysfunction and outcome in pediatric sepsis(Frontiers Media S.A., 2025-06-01) Reveco, Sonia; Barbagelata, Stella; Cruces, Pablo; Díaz, Franco; Yohanessen, Karla; Larraín, Marcos; Guerra, Mario; Bataszew, AlexanderObjective: This feasibility study aimed to describe the relation between ventricular dysfunction and outcome in pediatric sepsis.Methods: This prospective observational multicenter study was conducted in two Pediatric Intensive Care Units (PICU). We enrolled 51 patients aged younger than 15 year-old diagnosed with sepsis or septic shock. Functional echocardiography was performed by a pediatric intensivist within the first 24 h of admission and blind validated by a pediatric cardiologist. Ventricular dysfunction was defined by the presence of left or right systolic and/or diastolic dysfunction. The absence of these findings was considered normal ventricular function. Outcome was assessed by septic shock diagnosis rate, pediatric adaptation of Sequential Organ Failure Assessment (pSOFA),cardiovascular component of pSOFA, PICU-free and ventilator-free days.Results: 29 patients had sepsis, and 22 had septic shock. The main sites of infection were pulmonary (58.8%) and abdominal (17.6%). One out of four had ventricular dysfunction, and this group presented higher frequency of septicshock (69.2% vs. 34.2%, p = 0.028), higher frequency of total pSOFA ≥3 at 24 h (92% vs. 64%, p = 0.04), cardiovascular component of pSOFA (69.2% vs.31.2%, p = 0.017), and fewer PICU-free days [18 [0–23] vs. 23 [18–25],p = 0.027], compared to normal ventricular function group. Additionally, therewere more abnormal tissue doppler measurements, lower ś wave Z-Score[−0.6 [−1.3;0.4] vs. 0.5 [−0.2;1.1], p = 0.01] and lower é wave Z-Score [1.5[−2;0,1] vs. −0.3 [−2;0.4], p = 0.03] in the ventricular dysfunction group.Conclusion: Ventricular dysfunction was associated with more sepsis severity at 24 hours, fewer PICU—free days. Tissue doppler parameters were related to ventricular dysfunction.Ítem Manchester oxford foot questionnaire in foot and ankle Spanish patients: Transcultural adaption and validation(Elsevier, 2025-04-15) Gines Cespedosa, Alberto; Gonzalez Lucena, Gema; Gamba, Carlo; Bailez, Alberto; Ruiz Riquelme, Pablo; Martinez Lozano, JanBackground: Manchester-Oxford Foot Questionnaire (MOXFQ) has shown the best psychometric properties to evaluate patient-related outcomes in foot and ankle(F&A) surgeries. The aim is adapting and validating the MOXFQ for European-Spanish population, while assessing its psychometric properties. Method: Translation and cross-cultural adaption (MOXFQ-EUROSpa) was performed from MOXFQ-English original test. Its psychometric properties (reliability, internal consistency, floor and ceiling effects, construct validity and responsiveness) were calculated in 102 patients operated of orthopaedic F&A surgery in a Spanish hospital between 2021 and 2022. It was applied MOXFQ-EUROSpa, VAS-pain and EURO-QoL questionnaires. Data analyzed with SPSS.13.0; p-value < 0.05 Results: MOXFQ-EUROSpa showed excellent reliability (ICC=0.94 MOXFQ-index) and strong internal consistency (Cronbach's alpha=0.95 MOXFQ-index). Strong correlation with EuroQoL and VAS-pain confirmed validity. Good to excellent responsiveness for all domains, except MOXFQ-social(moderate). Postoperative MOXFQ-social had a floor effect. Conclusion: MOXFQ-EUROSpa demonstrated good psychometric properties therefore it should be considered to evaluate elective foot and ankle procedures results. Level of evidence IIÍtem Hipofosfatemia en UCI: No todo es síndrome de realimentación(Sociedad Chilena de Pediatría, 2025-03) Gómez Lund, Oscar; Reyes, Marco; Díaz, FrancoHemos leído con sumo interés la investigación publicada por Martínez en Andes pediátrica, en el que reportan la presencia de síndrome de realimentación en 111 de 343 niños ingresados a una unidad de cuidados intensivos (UCIP) de un hospital de referencia, una frecuencia alta en en línea con otras cohortes internacionales. Tal como es comentado por los autores el síndrome de realimentación es una entidad compleja, frecuentemente subvalorada, con consecuencias graves y pobremente estudiada.Ítem Análisis de la epidemia estacional por virus respiratorios y virus respiratorio sincicial (VRS) del año 2023 comparado con cohorte prepandemia (2015-2019) en Chile(Sociedad Chilena de Pediatría, 2025) Díaz, Franco; Carvajal, CristóbalDurante la pandemia de COVID-19, las infecciones respiratorias pediátricas disminuyeron drásticamente a nivel mundial. Sin embargo, en el otoño-invierno de 2023, estas enfermedades resurgieron de manera inusual, causando estrés en el sistema de salud. Comparando los datos del 2023 con los del quinquenio prepandemia del Departamento de Estadísticas e Información de Salud (DEIS) de Chile, observamos que la magnitud y frecuencia de las enfermedades respiratorias pediátricas fueron similares. No obstante, el estrés en el sistema de salud se debió al inicio temprano de la demanda, la sincronicidad de grupos etarios, la heterogeneidad geográfica y la capacidad de respuesta global y local. En la Región Metropolitana (RM), los casos no aumentaron en número, pero se presentaron 4 semanas antes. En las regiones central, centro-sur y sur, los casos aparecieron más temprano y durante un periodo más corto, resultando en un pico de hasta 4 veces más en hospitalizaciones y consultas de urgencia. La eficacia de las políticas públicas, como los cambios en programas educacionales y la inmunización contra el virus respiratorio sincicial (VRS), requiere un análisis objetivo y multisectorial. Es necesario ajustar las políticas para evitar la sobrerrepresentación de la RM y fomentar la colaboración público-privada para perfeccionar la información de la carga del VRS, y así mejorar los estándares de atención, tratamientos y su disponibilidad a lo largo de Chile.Ítem Clinical implications of aberrant anatomy of the common hepatic duct in liver surgery: a systematic review and meta-analysis(Springer, 2024-09-27) Valenzuela Fuenzalida, Juan José; Avalos Díaz, Constanza; Droguett Utreras, Antonia; Guerra Loyola, Javier; Nova Baeza, Pablo; Orellana-Donoso, Mathias; Suazo Santibañez, Alejandra; Oyanedel Amaro, Gustavo; Sanchis Gimeno, Juan; Bruna Mejias, Alejandro; Gkionoul Nteli, ChatzioglouIntroduction: Knowledge of anatomical variants that affect the hepatic duct (HD) are of particular clinical relevance during hepatobiliary surgical procedures. More specifically, the aberrant anatomy of the common HD is the most common anatomical variation affecting the biliary tree. Below, we describe different classifications of anatomical variants that affect this canal. According to Huang's classification, variations are determined depending on the insertion of the right posterior hepatic duct (RPHD). Materials and methods: Medline, Scopus, Web of Science, Google Scholar, CINAHL, and LILACS databases were investigated until January 2024. The methodological quality was assessed with an anatomical studies assurance tool (AQUA). Pooled prevalence was estimated using a random effects model. For the subgroup analysis, Student's T-test was used. Results: The prevalence rate of aberrant hepatic duct (AHD) was 15% (confidence interval [CI] of 7-22%). The first subgroup had cadavers and images. For the cadavers, the prevalence was 15.83% (CI: 11.22-18.3%), while the images had a prevalence of 22.06% (CI: 18.12-25.33%). This subgroup analysis showed no statistically significant difference between these groups (p = 0.127). The second subgroup comprised the continents where the included studies were from. In this subgroup, no statistically significant differences were found (p = 0.613). Finally, regarding the right or left laterality of the HD variant, there were no statistically significant differences (p = 0.089). Conclusion: A AHD corresponds to a finding that can occur in a significant percentage of our society, which could be an accidental discovery during surgeries or present asymptomatically throughout life and be a cadaveric discovery later. We believe it is important for surgeons to have prior knowledge of the possible variants of HD to prevent possible complications during and after surgery.Ítem Hepatic hilum variations and their clinical considerations in the liver: a systematic review and meta-analysis(MDPI, 2024-05-18) Valenzuela Fuenzalida, Juan José; Pena Santibañez, Fernanda; Vergara Salinas, Ayline; Meneses Caroca, Trinidad; Rojo Gonzalez, Javiera; Orellana-Donoso, Mathias; Nova Baeza, Pablo; Suazo Santibañez, Alejandra; Suazo Santibañez, Juan; Gutierrez Espinoza, HéctorBackground: The liver has a region called the hepatic hilum (HH) where structures enter and exit: anteriorly, the left and right hepatic ducts; posteriorly, the portal vein; and between these, the left and right hepatic arteries. The objective of this review is to know how variants in structures of the hepatic hilum are associated with clinical alterations of the liver. Methods: The databases Medline, Scopus, Web of Science, Google Scholar, CINAHL, and LILACS were researched until January 2024. The methodological quality was evaluated with an assurance tool for anatomical studies (AQUA). The pooled prevalence was estimated using a random effects model. Results: A total of six studies met the selection criteria established in this study for meta-analysis. The prevalence of hepatic hilus variants was 9% (CI = 5% to 13%), and the heterogeneity was 83%. The other studies were analyzed descriptively and with their respective clinical considerations in the presence of the variant, such as the high incidence of the Michels type III variant; among the portal vein variants, the type III variant of the Cheng classification stands out and in biliary anatomy, and the IIIa variant stands out according to the Choi classification. Conclusions: This review allowed us to know in detail the anatomical variants of HH; the structure with which the greatest care should be taken is the hepatic artery because of the probability of metastatic processes due to increased blood distribution in the hepatic lobules. Finally, we believe that new anatomical and clinical studies are needed to improve our knowledge of the relationship between HH variants and liver alterations or surgeries.Ítem Partial agenesis of the pectoralis major and minor muscle: A cadaveric case report(Wolters Kluwer Health, Inc., 2024-09-13) Bruna Mejias, Alejandro; Orellana-Donoso, Mathias; Nova Baeza, Pablo; Suazo Santibañez, Alejandra; Oyanedel Amaro, Gustavo; Valenzuela Fuenzalida, Juan JoséRationale: The pectoralis major and minor muscles, located in the anterior chest wall, are crucial for upper limb movements. Patient concerns: Their nonsyndromic absence is rare but significant for surgical procedures involving the axillary and pectoral regions. Diagnoses: Ultrasound can confirm the diagnosis and delimit the extent of the muscular abnormality, detect abnormalities of the costal cartilages, among others. Interventions: This descriptive, cadaveric case report involves a formalin-fixed 57-year-old North American male, with no clinical or family history of similar conditions. The study was conducted at the Human Anatomy Laboratory of the School of Medicine of the universidad Finis Terrae in Santiago, Chile, in August 2022. Outcomes: We present a cadaveric case of bilateral partial agenesis of the pectoralis muscles discovered during routine dissection. The pectoralis major muscle exhibited only the clavicular portion, with the sternocostal and abdominal portions absent and replaced by a thin layer of connective tissue bilaterally. The pectoralis minor muscle showed partial muscle fibers only in the most distal and inferior portions bilaterally. Lessons: This case report is significant due to the rarity of this condition without accompanying anatomical variations. Understanding this variant is valuable for clinical situations involving the shoulder and thorax region, such as trauma to the proximal third of the humerus, clavicular region, suprascapular region, and anterior chest wall. It may complicate conservative and/or surgical treatments due to different functional and irrigation patterns in the area and is also important for educating future professionals.Ítem Anatomical variants of the origin of the coronary arteries: a systematic review and meta-analysis of prevalence(MDPI, 2024-06-24) Valenzuela Fuenzalida, Juan José; Becerra Rodriguez, Emelyn; Quivira Muñoz, Alonso; Baez Flores, Belén; Escalona Manzo , Catalina; Orellana-Donoso, Mathias; Nova Baeza, Pablo; Suazo Santibañez, Alejandra; Bruna Mejias, Alejandro; Sanchis Gimeno, Juan; Gutiérrez Espinoza, Héctor; Granite, GuiniverePurpose: The most common anomaly is an anomalous left coronary artery originating from the pulmonary artery. These variants can be different and depend on the location as well as how they present themselves in their anatomical distribution and their symptomatological relationship. For these reasons, this review aims to identify the variants of the coronary artery and how they are associated with different clinical conditions. Methods: The databases Medline, Scopus, Web of Science, Google Scholar, CINAHL, and LILACS were researched until January 2024. Two authors independently performed the search, study selection, and data extraction. Methodological quality was evaluated using an assurance tool for anatomical studies (AQUA). Pooled prevalence was estimated using a random effects model. Results: A total of 39 studies met the established selection criteria. In this study, 21 articles with a total of 578,868 subjects were included in the meta-analysis. The coronary artery origin variant was 1% (CI = 0.8-1.2%). For this third sample, the funnel plot graph showed an important asymmetry, with a p-value of 0.162, which is directly associated with this asymmetry. Conclusions: It is recommended that patients whose diagnosis was made incidentally and in the absence of symptoms undergo periodic controls to prevent future complications, including death. Finally, we believe that further studies could improve the anatomical, embryological, and physiological understanding of this variant in the heart.Ítem Use of ketamine in patients with multifactorial neuropathic pain: a systematic review and meta-analysis(MDPI, 2024-09-03) Bruna Mejias, Alejandro; Baeza-Garrido, Vicente; Gamboa, Javiera; Baez Flores, Belén; San Martin, Jessica; Astorga, Constanza; Leyton, Javiera; Nova Baeza, Pablo; Orellana-Donoso, Mathias; Suazo Santibañez, Alejandra; Becerra Farfán, Álvaro; Oyanedel Amaro, Gustavo; Valenzuela Fuenzalida, Juan JoséNeuropathic pain (NP) is a heterogeneous group of conditions characterized by the experience of a number of sensory disturbances including pain, burning sensations, paroxysms of stabbing pain, dysesthesias, allodynia, and hyperalgesia. The above-mentioned sensations may occur in a specific dermatome area or other delimited region of the body. The objective of this review was to analyze the evidence for ketamine in multifactorial neuropathic pain. The research group systematically searched the databases MEDLINE (via PubMed), EMBASE, SCOPUS, the Cochrane Central Register of Controlled Trials, the Cumulative Index to Nursing and Allied Health Literature (Cinahl), and the Web of Science. The findings of this review show that different forms of low doses of ketamine (LDK) do not present statistically significant changes for any of the scales included. In this study, the total symptom score [standardized mean difference (SMD) = -3.59, confidence interval (CI) = -4.16 to -3.02, and p < 0.00001], neuropathy impairment score (SMD = -1.42, CI = -3.68 to 0.84, and p = 0.22), and neuropathy symptom checklist (SMD = -0.09, CI = -0.15 to -0.02, and p = 0.01) were taken into account. For finality compared to the use of a placebo, the findings suggest that LDK does not exhibit significant differences in terms of pain reduction and functionality. Moreover, no specific dosages are identified to support the use of LDK in the reduction in NP.Ítem Effectiveness of duloxetine versus other therapeutic modalities in patients with diabetic neuropathic pain: a systematic review and meta-analysis(MDPI, 2024-06-05) Valenzuela Fuenzalida, Juan José; López Chaparro, Michelle; Barahona Vásquez, Marisol; Campos Valdes, Javiera; Cordero Gonzalez, Javiera; Nova Baeza, Pablo; Orellana-Donoso, Mathias; Suazo Santibañez, Alejandra; Oyanedel Amaro, Gustavo; Gutiérrez Espinoza, HéctorObjectives: Diabetic peripheral neuropathy (DPN) is a chronic complication of diabetes mellitus (DM) with symptoms like intense pain and impaired quality of life. This condition has no treatment; instead, the pain is managed with various antidepressants, including duloxetine. The aim of this study is to analyze the evidence on the efficacy of duloxetine in the management of DPN. Methods: A systematic search in different databases was conducted using the keywords "diabetic neuropathy", "duloxetine therapy", "neuropathic pain", and "Diabetes Mellitus". Finally, eight studies were included in this meta-analysis. Results: All articles comparing duloxetine at different doses vs. a placebo reported significant differences in favor of duloxetine on pain scales like 24 h Average Pain Severity (standardized mean difference [SMD] = -1.06, confidence interval [CI] = -1.09 to -1.03, and p < 0.00001) and BPI Severity (SMD = -0.70, CI = -0.72 to -0.68, and p < 0.00001), among others. A total of 75% of the meta-analyses of studies comparing duloxetine at different doses showed a tendency in favor of the 120 mg/d dose. There were significant differences in favor of duloxetine when compared to routine care on the Euro Quality of Life (SMD = -0.04, CI = -0.04 to -0.03, and p < 0.00001) and SF-36 Survey (SMD = -5.86, CI = -6.28 to -5.44, and p < 0.00001) scales. There were no significant differences on the visual analog scale (VAS) when comparing duloxetine and gabapentin. Conclusions: Duloxetine appears to be effective in the management of DPN in different pain, symptom improvement, and quality of life scales.Ítem Anatomical variants of the renal veins and their relationship with morphofunctional alterations of the kidney: a systematic review and meta-analysis of prevalence(MDPI, 2024-04-21) Valenzuela Fuenzalida, Juan José; Vera Tapia, Karla; Urzúa Márquez, Camila; Yáñez Castillo, Javiera; Trujillo Riveros, Martín; Koscina, Zmilovan; Orellana-Donoso, Mathias; Suazo-Santibañez, Alejandra; Sanchis Gimeno, Juan; Bruna Mejias, Alejandro; Gutiérrez Espinoza, HéctorBackground: Variations in renal veins are quite common, and most people do not experience issues due to them. However, these variations are important for healthcare professionals, especially in surgical procedures and imaging studies, as precise knowledge of vascular anatomy is essential to avoid complications during medical interventions. The purpose of this study was to expose the frequency of anatomical variations in the renal vein (RV) and detail their relationship with the retroperitoneal and renal regions. Methods: A systematic search was conducted in the Medline, Scopus, Web of Science, Google Scholar, CINAHL, and LILACS databases from their inception until January 2024. Two authors independently carried out the search, study selection, and data extraction and assessed methodological quality using a quality assurance tool for anatomical studies (AQUA). Ultimately, consolidated prevalence was estimated using a random effects model. Results: In total, 91 studies meeting the eligibility criteria were identified. This study included 91 investigations with a total of 46,664 subjects; the meta-analysis encompassed 64 studies. The overall prevalence of multiple renal veins was 5%, with a confidence interval (CI) of 4% to 5%. The prevalence of the renal vein trajectory was 5%, with a CI of 4% to 5%. The prevalence of renal vein branching was 3%, with a CI of 0% to 6%. Lastly, the prevalence of unusual renal vein origin was 2%, with a CI of 1% to 4%. Conclusions: The analysis of these variants is crucial for both surgical clinical management and the treatment of patients with renal transplant and hemodialysis.