Tasa de mortalidad por síndrome de dependencia del alcohol 2016-2020 en Chile / Alcohol use disorder-related mortality rate 2016-2020 in Chile

Introducción: El consumo de alcohol es un problema a nivel mundial. En Chile es la droga más consumida, y en cantidades mayores que otros países de la región. Debido a la alta prevalencia y la gran cantidad de complicaciones asociadas, se describió la tasa de mortalidad por síndrome de dependencia del alcohol (SDA) entre los años 2016-2020 en Chile. Materiales y métodos: Estudio observacional, ecológico y descriptivo. La población correspondió a todos los fallecidos por SDA como causa básica en Chile entre 2016-2020 utilizando fuente Departamento de Estadísticas e Información de Salud. Se calculó la tasa de mortalidad según sexo, grupo etario y región con un total de 710 personas. Resultados: Durante el período 2016-2020 se observó un aumento de la tasa de mortalidad principalmente en 2020. Respecto al sexo, predominó la tasa de mortalidad en hombres. El grupo etario con mayor tasa de mortalidad fue el de 65-79. El promedio más alto de la tasa de mortalidad entre los años 2016 y 2020 es el de la región de Los Lagos (2,09) y una desviación estándar de (1,05). Discusión: Resulta interesante que la tasa de mortalidad promedio atribuible al alcohol es menor en Chile y Estados Unidos que en otros países de América. Tanto en Chile como en Argentina y Cuba la tasa de mortalidad es mayor en hombres, sin embargo, en relación al rango etario, el predominio de las tasas varía en la región.

Introduction: Alcohol consumption is a worldwide problem that has been steadily increasing. Chile is among the countries with the highest alcohol consumption per capita in Latin America. Due to the high prevalence and the large number of associated complications, we described the mortality rate due to alcohol dependence syndrome (ADS) between the years 2016-2020 in Chile. Material y methods: Observational, ecological and descriptive study. The population corresponded to all deaths due to ADS as a basic cause in Chile between 2016-2020 using source Department of Health Statistics and Information. The mortality rate was calculated according to sex, age group and region with a total of 710 people. Results: During the period 2016-2020, an increase in the mortality rate was observed mainly in 2020. Regarding sex, the mortality rate was predominantly in men. The age group with the highest mortality rate was 65-79. The highest average mortality rate between 2016 and 2020 is that of the Los Lagos region (2,09) and a standard deviation of (1,05). Discussion: Interestingly, the average alcohol-attributable mortality rate is lower in Chile and the United States than in other countries in the Americas. In Chile as well as in Argentina and Cuba, the mortality rate is higher in men, however in relation to age range, the predominance of rates varies across the region.

Tumores de glándula submandibular: experiencia clínica del Hospital Guillermo Grant Benavente / Submandibular gland tumors: clinical experience of Guillermo Grant Benavente Hospital

RESUMEN Introducción: Los tumores de la glándula submandibular son poco frecuentes. Representan menos del 1% de todos los tumores de cabeza y cuello. Corresponden al 10% de los tumores de las glándulas salivales. Aproximadamente el 50% son malignos. Objetivos: Analizar la experiencia clínica con las submandibulectomias realizadas en el Servicio de Otorrinolaringología y Cirugía de Cabeza y Cuello del Hospital Guillermo Grant Benavente. Material y método: Estudio descriptivo retrospectivo. Revisión de fichas clínicas de pacientes intervenidos de submandibulectomía entre el 01 de enero de 2011 y el 31 de diciembre de 2016 en nuestro servicio. Resultados: Se realizaron 28 submandibulectomías por patología tumoral. La edad promedio fue de 54 años, siendo el 71% de sexo femenino. 21 tumores fueron benignos (75%), siendo el más frecuente el adenoma pleomorfo (14 casos), y 7 tumores malignos (25%), siendo el más frecuente el carcinoma adenoidequístico. Se reportaron dos complicaciones transitorias (7%), una paresia de la rama marginal del nervio facial y una paresia del nervio hipogloso. El 42% de los tumores malignos presentó recurrencia. Conclusión: Nuestra serie presenta resultados acordes a la literatura en cuanto a edad de presentación, distribución por sexo, tipos histológicos, tasa de complicaciones y recurrencia; sin embargo, difiere en la menor frecuencia de tumores malignos, siendo en nuestra serie de 25%. Patología poco frecuente. La presencia de una masa indolora submandibular debe ser derivada a los centros de referencia para estudio y eventual resolución quirúrgica por el riesgo de malignidad.

ABSTRACT Introduction: Submandibular gland tumors are rare. They represent less than 1% of all head and neck tumors. They correspond to 10% of the tumors of the salivary glands. Approximately 50% are malignant. Aim: To analyze the clinical experience with the submandibulectomies performed in the Otorhinolaryngology and Head and Neck Surgery Service of the Guillermo Grant Benavente Hospital. Material and Method: Retrospective descriptive study. Review of clinical records of patients treated with a submandibulectomy between January 1,2011 and December 31, 2016 in our service. Results: 28 submandibulectomies were performed due to tumor pathology. The average age was 54 years, being 71% female. 21 tumors were benign (75%), being the most frequent the pleomorphic adenoma (14 cases), and 7 malignant tumors (25%), being the most frequent the adenoidequistic carcinoma. Two transient complications (7%) were reported, a paresis of the marginal branch of the facial nerve and a paresis of the hypoglossal nerve. 42% of malignant tumors presented recurrence. Conclusion: Our series presents results according to the literature regarding age of presentation, distribution by sex, histological types, complication rate and recurrence; however, it differs in the lower frequency of malignant tumors, being in our series of 25%. Uncommon pathology. The presence of a submandibular painless mass must be referred to the reference centers for study and possible surgical resolution due to the risk of malignancy.

Síndrome antifosfolípido catastrófico: caso clínico / Catastrophic antiphospholipid syndrome: clinical case

El síndrome antifosfolípido (SAF) fue descrito y caracterizado durante la segunda mi-tad del siglo XX inicialmente como un fenómeno protrombótico secundario en con-texto de otras enfermedades del tejido conectivo, principalmente lupus. Sin embargo, el estudio de pacientes con enfermedad primaria impulsó a distintos consensos, tan-to clínicos como de laboratorio para su correcta identificación. Entre los pacientes con SAF destaca la forma de presentación catastrófica, de baja prevalencia, pero impor-tante por su mal pronóstico, caracterizada por el compromiso de múltiples sistemas en corto tiempo. Presentamos el caso de una paciente del Hospital Clínico San Borja-Arriarán con diag-nóstico de SAF primario, que presentó en su evolución la forma catastrófica. Este caso sirve de base para una revisión del proceso diagnóstico del SAF en relación a otras patologías reumatológicas y las características propias del SAF catastrófico.

Antiphospholipid syndrome (APS) was described and characterized during the second half of the 20th century initially as a secondary prothrombotic phenome-non in the context of other connective tissue diseases, mainly lupus. However, the study of patients with primary disease prompted different consensus, both clin-ical and laboratory for their correct identification. Among patients with APS, the catastrophic presentation is of low prevalence, but important because of its poor prognosis, characterized by the commitment of multiple systems in a short time. We present the case of a patient from the San Borja-Arriaran Clinic Hospital with di-agnosis of primary APS, which presented the catastrophic form in its evolution. This case serves as a basis for a review of the diagnostic process of APS in relation to other rheumatologic pathologies and the characteristics of catastrophic APS.

Allogeneic bone marrow transplantation is associated with a preferential femoral neck bone loss.

Osteoporosis is a major complication of organ transplantation. Little is known about the risk of developing osteoporosis in bone marrow transplant (BMT) recipients. We studied early and late changes in bone mineral density (BMD), as well as biochemical markers of bone remodeling, in patients at the time of allogeneic BMT (alloBMT) and up to 13 years thereafter. In a cross-sectional study, 102 patients (40 women, 62 men, mean age +/- SEM, 38.9 +/- 1.6 years) were segregated into a first group (A, n = 48) and evaluated before or during the first weeks (mean +/- SD 0.3 +/- 0.1 month, range -0.5 to 3 months) following alloBMT, and a second group (B, n = 54) studied 60.1 +/- 5.6 months (range 6-156 months) following alloBMT. Lumbar spine (LS) BMD was similar in groups A and B and was within normal limits. In contrast, femoral neck (FN) Z- and T-scores were significantly decreased in group B compared with group A (-0.68 +/- 0.14 vs -0.03 +/- 0.14 SD and -0.84 +/- 0.14 vs -0.22 +/- 0.14 SD, respectively; p < or = 0.002). Osteopenia (T-score between -1 and -2.5 SD) was present in 35% of group A and 43% of group B patients (NS). Osteoporosis (T-score < -2.5 SD) was detected in 7% of group B patients, but in none of those in group A (p = 0.05). In a longitudinal study, 56 subjects were evaluated at the time of alloBMT, and 33 and 23 were studied 6 or 12 months later, respectively (13 women, 20 men, 37.5 +/- 1.6 years). All were treated with supplements of calcium and vitamin D. Amenorrheic women received hormone replacement therapy (HRT). Three-monthly pamidronate infusions were given to 15 men and 10 non-amenorrheic women who were osteopenic/osteoporotic or had elevated baseline bone turnover markers. Mean baseline LS and FN Z- and T-scores were within normal range. Six months after BMT, FN BMD decreased by 4.2 +/- 0.7% (p < 0.001), and whole body BMD and bone mineral content by 1.5 +/- 0.4% and 3.1 +/- 0.6%, respectively (p < or = 0.0001). Twelve months after the graft, there was no further significant bone loss and only FN BMD decrease remained significantly different compared with baseline (-5.6 +/- 1.1%, p < or = 0.0001). These results indicate that the risk of decreased BMD is higher for the femoral neck than the lumbar spine and whole body levels in patients with allogeneic bone marrow transplantation, and that bone loss occurs mainly during the first 6 months after the graft.

Dynamics of estrogen binding by uterine cells in vivo.

The dynamics of the in vivo binding and release of tritiated estradiol in different uterine cell types are described. The very early binding of estrogens by the cytosol-nuclear and the eosinophil receptor systems is in accordance with the hypothesis that some estrogenic effects are mediated by these receptor systems.