Síndrome de Brugada asociado a pericarditis aguda / Brugada syndrome associated to acute pericarditis

Resumen Comunicamos el caso de un hombre de 56 años que ingresó por pericarditis aguda febril, probablemente de causa viral, que durante su evolución presentó una fibrilación auricular paroxística y taquicardia ventricular polimorfa recurrente. El análisis de la historia clínica y serie electrocardiográfica permitió el diagnóstico retrospectivo asociado de un síndrome de Brugada. Hubo buena respuesta inicial al tratamiento antiinflamatorio asociado a colchicina y se implantó un desfibrilador automático intracavitario para prevención de muerte súbita. Se discuten aspectos clínicos del síndrome de Brugada, la importancia de la fiebre y de la pericarditis como cuadro clínico asociado.

Abstract A 56-year-old patient was admitted for acute febrile pericarditis, probably viral, who presented with paroxysmal atrial fibrillation and recurrent polymorphic ventricular tachycardia during his clinical course. Analysis of the clinical and electrocardiographic findings allowed the retrospective diagnosis of Brugada syndrome in the context of pericarditis. An initial response to anti-inflammatory treatment associated with colchicine was good. An internal cardioverter defibrillator was implanted to prevent sudden death. Clinical aspects of the Brugada syndrome, the importance of fever and pericarditis as an associated clinical condition are discussed.

Schizophrenia and COVID-19 delirium.

Since its outbreak, coronavirus disease 2019 has been producing atypical manifestations aside from fever, coughing and dysnea. One of the most common is delirium, which, however, is highly overlooked. This has consequences in the treatment of patients and also may lead to underdiagnosing the infection. In this work, we present the case of a man diagnosed with schizophrenia, who had been stable for more than 20 years and that presented with an atypical picture of psychotic and confusional symptoms related to COVID-19 infection.

Association between electroencephalographic modulation, psychotic-like experiences and cognitive performance in the general population.

AIM: An association between deficit of electroencephalographic (EEG) modulation during an odd-ball task and psychotic symptoms has been described in clinical samples, in agreement with the proposed role for altered salience in psychosis. To discard the possible influence of medication, the relationship between psychotic-like experiences and EEG modulation in the general population was explored. METHODS: EEG and psychotic-like experiences were assessed in 194 healthy subjects during a P300 paradigm. EEG modulation was assessed as changes from pre-stimulus to response windows in spectral entropy (SE, a measurement of signal irregularity), median frequency (MF, a quantifier of the frequency distribution of oscillatory activity) and theta, alpha, beta-1, beta-2 and gamma relative power (RP, a summary of the distribution of spectral components). RESULTS: A significant widespread decrease in SE and MF from baseline to response was found, with a significant increase in RP for theta and a decrease for higher frequency bands, supporting an increase in EEG regularity and a slowing of brain oscillations during the response. Furthermore, a significant association was found between SE modulation and distress of negative psychotic-like experiences, as well as between verbal memory and RP modulation for beta-1. Performance in verbal fluency was associated with the increase in theta RP during the response. CONCLUSION: EEG irregularity of healthy subjects decreased at the expense of a larger contribution of theta RP and a decreased contribution of fast frequency bands. Subjects with smaller modulation showed poorer cognitive scores and greater distress of negative psychotic-like experiences.

[Relationship between subclinical psychotic symptoms and cognitive performance in the general population]. / Relaciones entre síntomas psicóticos subclínicos y rendimiento cognitivo en la población general.

INTRODUCTION: Subclinical psychotic symptoms are associated to negative life outcomes in the general population, but their relationship with cognitive performance is still not well understood. Assessing the relationship between performance in cognitive domains and subclinical psychotic symptoms in the general population may also help understand the handicap attributed to clinical psychosis, in which these alterations are present. METHODS: Subclinical and cognitive assessments were obtained in 203 participants from the general population by means of the Community Assessment of Psychic Experiences, the Brief Assessment of Cognition in Schizophrenia, the Wechsler Adults Intelligence Scale and the Wisconsin Card Sorting Test. The positive and negative subclinical symptoms and their relationship with age and cognition were examined, followed by assessing the influence of subclinical depression scores on the possible relationships between those subclinical psychotic symptoms and cognitive deficits. RESULTS: Inverse relationships were found between frequency in the Community Assessment of Psychic Experiences positive dimension and motor speed, and frequency and distress in the Community Assessment of Psychic Experiences negative dimension and motor speed. A direct relationship was also found between distress scores of the positive dimension and executive functions. Both positive and negative subclinical symptoms were related to depression scores. CONCLUSIONS: Psychotic symptoms, similar to those in the clinical population, may be associated with cognitive deficits in the general population.

[Lingual treatment of an anterior open bite case]. / Traitement en technique linguale d'un cas de béance antérieure.

One of the benefits of the orthodontic lingual technique is the complete discretion it provides, preserving acceptable facial esthetics throughout treatment. Nevertheless, it is a fact that the treatment of open bites with this technique inevitably poses a challenge for the practitioner. The patient we present in this article displayed a skeletal and dental Class II with anterior open bite. The difficulty with this case was to control the incisal torque during open bite closure, given that this constitutes a critical factor in the lingual technique. Consequently, we will emphasize above all our diagnostic procedures as well as our treatment strategies designed to achieve our objectives while controlling the incisal torque.

A case of myopericarditis associated to Campylobacter jejuni infection in the southern hemisphere.

Myopericarditis is an infrequent complication of acute diarrheal illness due to Campylobacter jejuni, and it has been mainly reported in developed nations. The first case detected in Chile--an upper-middle income country--that is coincidental with the increasing importance of acute gastroenteritis associated to this pathogen, is described. Recognition of this agent in stools requires special laboratory techniques not widely available, and it was suspected when a young patient presented with acute diarrhea, fever, and chest pain combined with electrocardiogram (EKG) abnormalities and elevated myocardial enzymes. C. jejuni myopericarditis can easily be suspected but its detection requires dedicated laboratory techniques.

A case of myopericarditis associated to Campylobacter jejuni infection in the southern hemisphere

Myopericarditis is an infrequent complication of acute diarrheal illness due to Campylobacter jejuni, and it has been mainly reported in developed nations. The first case detected in Chile - an upper-middle income country -, that is coincidental with the increasing importance of acute gastroenteritis associated to this pathogen, is described. Recognition of this agent in stools requires special laboratory techniques not widely available, and it was suspected when a young patient presented with acute diarrhea, fever, and chest pain combined with electrocardiogram (EKG) abnormalities and elevated myocardial enzymes. C. jejuni myopericarditis can easily be suspected but its detection requires dedicated laboratory techniques.

Análisis comparativo de las características clínico-angiográficasy de los resultados inmediatos y tardíos de stents liberadores de drogas vs. no liberadores / Immediate and late clinical an angiographic results of coronary stent implantation: comparison of drug eluting versus bare metal stents

Introducción: La reducción de la reestenosis intrastent ha permitido una gran aceptación de los stents liberadores de drogas (DES). El objetivo de este trabajo ha sido evaluar nuestra experiencia clínica inicial con DES y compararla con aquellos que sólo recibieron BMS (stents no liberadores de drogas). Materiales y Métodos: Se compararon 71 pacientes tratados con DES (Cypher® = 32 o Taxus® = 39) con 903 pacientes tratados sólo con BMS. Además del análisis clínico y angiográfico detallado, se efectuó seguimiento clínico de a lo menos 6 meses. Resultados: Los pacientes tratados con DES con mayor frecuencia eran más complejos y tenían características clínicas y angiográficas desfavorables. Sin embargo, no hubo diferencias en la tasa de éxito angiográfico (100 vs. 99,2 por ciento) ni en las complicaciones isquémicas intrahospitalarias (1,3 vs. 0 por ciento). En el seguimiento los tratados con DES tuvieron menor recurrencia de la angina (8,7 vs. 19,0 por ciento), revascularización del vaso tratado (0 vs. 7,5 por ciento) y menos eventos isquémicos (4,4 por ciento vs. 14,6 por ciento). Conclusiones: A pesar de su empleo en pacientes con características clínicas y angiográficas desfavorables, los DES lograron un mejor resultado a largo plazo en comparación con los BMS.

Background: There has been considerable enthusiasm for drug eluting stents (DES) in coronary angioplasty due to the lower restenosis rate associated to their use. Aim: To compare clinical and angiographic results of DES implantation, compared to traditional bare metal stents (BMS) Methods: 71 patients who received DES (Cypher® = 32; Taxus® = 39) were compared to 903 patients who had received BMS. Detailed clinical and angiographic evaluation and 6 month follow up data were analyzed. T test and X2 analysis were used for comparisons. Results: Compared to the BMS group, the DES group had complex clinical (diabetes mellitus, family history, active smokers) and agiographic findings (lower ejection fraction, longer lesions) in a greater proportion of cases (p < 0.05 vs BMS). The immediate angiographic success rate did not differ between groups (100 percent vs 99.2 percent, respectively). Acute ischemic complications occurred in 1.3 percent in DES patients compared to 0 percent in BMS (pNS). At follow-up, angina recurrence (8.7 percent vs 19 percent, p < 0.043), need for revascularization (0 percent vs 7.5 percent, p < 0.02) and new ischemic events (4.4 percent vs 14.6 percent, p < 0.02) were lower in DES as compared to BMS patients. Conclusion: In spite of the greater clinical and angiographic complexity, patients with DES had better long term clinical results than patients who received BMS.

Acupuntura y ginecología / Acupunture and gynecology

Se presenta el análisis de una muestra de 255 pacientes afectadas por distintas enfermedades ginecológicas como: mioma uterino, quiste ovárico, displasia de mama y enfermedad pélvica crónica (EPC). Como resultado del tratamiento aplicado según las distintas afecciones, se comprobó una mayor frecuencia de mejoría total sintomática en los miomas uterinos con el 42,9 porciento, le siguen en frecuencia la EPC con el 34,8 porciento, las displasias de mamas mostraron una mejoría total del 29,2 porciento y por último, los quistes de ovario con el 14,3 porciento. La mejoría parcial sintomática mostró su mayor frecuencia en los quistes de ovario con 84,7 porciento, las displasias de mamas con el 70,8 porciento, del 52,8 porciento en la EPC y en los miomas uterinos el 49 porciento. En las displasias de mamas y en los quistes de ovario se redujo la tumoración en el 66,7 porciento de los casos y en los miomas uterinos en el 49 porciento. En las EPC y los miomas uterinos no se observó mejoría en el 12,4 y 8,2 porciento respectivamente

Quiste folicular inflamatorio: una patología odontopediátrica / Follicular inflammatory cyst: a pedodontic pathology

Se presenta un niño de 8 años con un aumento de volumen marcado en la región posteroizquierda mandibular, esta anormalidad se relaciona con una infección consecutiva a gangrena pulpar del segundo molar inferior izquierdo temporal. Previa a su derivación, se efectuó la exodoncia de la pieza gangrenada, y se trató la lesión mediante antibióticos y antiinflamatorios en forma prolongada sin resultados. El caso es tratado en el Pabellón de Cirugía Dental Infantil, Area Odontopediatría de la Facultad de Odontología Universidad de Chile. Estudios clínicos y radiográficos estiman la enucleación total de la lesión, cuyo diagnóstico histopatológico fue quiste folicular inflamatorio. Al cabo de 1 año de controles periódicos, el aumento de volumen prácticamente ha desaparecido y la regeneración ósea analizada radiográficamente evidencia una gran recuperación

Reubicación quirúrgica de incisivos con fracturas corono-radiculares por medio de rotaciones intraalveolares / Surgical reimplantation of incisors with crown-root fractures through intralveolar movements

En este artículo se presentan los resultados obtenidos al tratar un niño que presentaba una fractura corono-radicular, mediante la utilización de un tratamiento alternativo, que logra a través de pequeños movimientos intraalveolares la reubicación quirúrgica de estas piezas dentarias, muchas veces destinadas a perderse