[Development of nephrotic syndrome in a patient with Hashimoto's Thyroiditis]. / Desarrollo de Síndrome nefrótico en paciente con Tiroiditis de Hashimoto.

The development of nephrotic syndrome in concomitance with Hashimoto's thyroiditis is an in frequent association in the pediatric age. OBJECTIVE: To report an infrequent complication of au toimmune thyroiditis, such as the appearance of nephrotic syndrome. CLINICAL CASE: A 10-year-old patient presenting with nephrotic syndrome and goiter. A history of autoimmune thyroiditis and un treated hypothyroidism was detected. Corticosteroid and hormone replacement therapy (levothyro- xine) is started, achieving a good clinical and laboratory response. CONCLUSION: Autoimmune thyroi ditis impacts renal physiology through immunological and non-immunological mechanisms. At the same time, renal repercussions can affect thyroid function. The importance of this communication lies in reporting an infrequent complication of autoimmune thyroiditis, such as the appearance of nephrotic syndrome.

[Fortuna and Serendipity: history of some drugs used in Pediatric Intensive Care]. / Fortuna y Serendipia: historia de algunos fármacos empleados en Cuidados Intensivos Pediátricos.

Serendipity has played a crucial role in the history of many different areas of science, including modern medicine. This corresponds to the ability to make a discovery, which occurs accidentally or by chance, in combination with the sagacity of the observer. Many of the most important and revolutio nary findings in medical science, specifically pharmacology, involved serendipitous events of a natu re. Some examples related to drug discovery and pharmacological research are briefly reviewed, such as the history of benzodiazepines, chloral hydrate, clonidine, warfarin, Ringer's solution, valproic acid, barbiturates, penicillin and insulin, in which there were events related to serendipity. All these drugs or their derivatives are currently in frequent use in Intensive Care Units.

[Historical milestones for the control of severe infections and sepsis in pediatrics. Approach through medical philately]. / Hitos históricos para el control de las infecciones graves y la sepsis en pediatría. Aproximación a través de la filatelia médica.

Medical philately, with its diverse themes, is a faithful testimony of the historical events that have affected humanity. Likewise, it allows us to evidence its role as a diffuser of diverse prevention cam paigns carried out to control and eradicate serious infections, together with other achievements of health policy in the child population. Nowadays, the knowledge and collection of postage stamps is an increasingly unusual pastime. On the other hand, sometimes there is a marked historical ignoran ce and lack of appreciation of the effective actions for the control of infectious diseases, forgetting the enormous effect of these on the daily life of the current society. Through the visual testimony offe red by the postage stamps, we review the sanitary, educational, and therapeutic actions destined to control the infections in the pediatric patient, with emphasis on our country. In addition, we discuss the new populations at risk for the appearance of septic episodes. Even today, serious infections and sepsis represent an important public health problem.

René Théophile Hyacinthe Laënnec (1781-1826). Doscientos años del uso del estetoscopio. Una breve reseña / René Théophile Hyacinthe Laënnec (1781-1826). Two hundred years of the stethoscope. A brief overview

Se han cumplido doscientos años desde la publicación en la que se dio a conocer la aplicación clínica del estetoscopio. Esta fue realizada en 1819 por René Théophile Hyacinthe Laënnec. El Dr. Laënnec vivió su infancia en la efervescencia social de la Revolución francesa y estudió Medicina en París, donde se graduó en 1804. Su experiencia clínica en el Hospital Necker culminó con la invención del estetoscopio en 1816. Tres años después, la publicación de su obra maestra De l'auscultation médiate enfatizó un enfoque clínico-patológico más racional, en especial, para el entendimiento de las enfermedades cardiorrespiratorias. Sin duda, el Dr. Laënnec revolucionó la medicina al perfeccionar el arte de la semiología torácica, que permitió al médico transformar los sonidos que escuchaba en una imagen, la cual podía visualizar.Con ocasión del bicentenario de este trascendental hito de la medicina moderna, se recuerda su historia

Two hundred years have passed since the publication that revealed the clinical use of the stethoscope. René Théophile Hyacinthe Laënnec published it in 1819. Laënnec spent his childhood in the social effervescence of the French Revolution and studied medicine in Paris, where he graduated in 1804. His clinical experience at Necker Hospital peaked with the invention of the stethoscope in 1816. Three years later, he published his masterpiece De L'Auscultation Médiate, which underlined a more rational clinical-pathological approach, especially in the understanding of cardiopulmonary diseases. Undoubtedly, Laënnec revolutionized medicine by perfecting the art of thoracic semiology, which allowed him to translate the sounds he heard into an image that could be visualized.In the bicentennial of the invention of such fundamental milestone in modern medicine, the purpose of this article is to go over its history

René Théophile Hyacinthe Laënnec (1781-1826). Two hundred years of the stethoscope. A brief overview. / René Théophile Hyacinthe Laënnec (1781-1826). Doscientos años del uso del estetoscopio. Una breve reseña.

Two hundred years have passed since the publication that revealed the clinical use of the stethoscope. René Théophile Hyacinthe Laënnec published it in 1819. Laënnec spent his childhood in the social effervescence of the French Revolution and studied medicine in Paris, where he graduated in 1804. His clinical experience at Necker Hospital peaked with the invention of the stethoscope in 1816. Three years later, he published his masterpiece De L'Auscultation Médiate, which underlined a more rational clinical-pathological approach, especially in the understanding of cardiopulmonary diseases. Undoubtedly, Laënnec revolutionized medicine by perfecting the art of thoracic semiology, which allowed him to translate the sounds he heard into an image that could be visualized. In the bicentennial of the invention of such fundamental milestone in modern medicine, the purpose of this article is to go over its history.

Se han cumplido doscientos años desde la publicación en la que se dio a conocer la aplicación clínica del estetoscopio. Esta fue realizada en 1819 por René Théophile Hyacinthe Laënnec. El Dr. Laënnec vivió su infancia en la efervescencia social de la Revolución francesa y estudió Medicina en París, donde se graduó en 1804. Su experiencia clínica en el Hospital Necker culminó con la invención del estetoscopio en 1816. Tres años después, la publicación de su obra maestra De l'auscultation médiate enfatizó un enfoque clínico-patológico más racional, en especial, para el entendimiento de las enfermedades cardiorrespiratorias. Sin duda, el Dr. Laënnec revolucionó la medicina al perfeccionar el arte de la semiología torácica, que permitió al médico transformar los sonidos que escuchaba en una imagen, la cual podía visualizar. Con ocasión del bicentenario de este trascendental hito de la medicina moderna, se recuerda su historia.

Patologías del niño inmigrante en la Unidad de Cuidados Intensivos: actualización / Pathologies of the immigrant child in the Intensive Care Unit: update

Resumen: Cada vez es más frecuente la atención médica en la Unidad de Cuidados Intensivos (UCI) de niños o adolescentes inmigrantes como también de aquellos nacidos en nuestro país con padres en tal condición. Esto ha ocasionado, en la actualidad, que el equipo de salud se deba enfrentar con problemas diagnósticos derivados del escaso conocimiento de condiciones genéticas propias de esta población y/o el desarrollo de diversas patologías infrecuentes en nuestro país, algunas resultantes de su condi ción sanitaria. En esta revisión se abordan diversos aspectos de la patología hematológica, infecciosa, parasitaria, respiratoria y cardiovascular, todos tópicos relevantes de conocer durante su estadía en la UCI. Es un deber del equipo de salud actualizarse sobre patologías de baja prevalencia en nuestro país, algunas de ellas muy poco conocidas hasta hace una década, pero que, actualmente, están cada vez más presentes en las UCI del sistema de salud público chileno.

Abstract: It is increasingly common to provide medical care in the Intensive Care Unit (ICU) for immigrant children and adolescents as well as those born in Chile with parents in such condition. Currently, this has caused that the health team has to face diverse infrequent pathologies in our country and/ or diagnostic problems derive from the poor knowledge of genetic conditions of this population, some resulting from their health conditions. This review addresses several aspects of hematological, infectious, parasitic, respiratory, and cardiovascular pathologies, all relevant topics to know during their stay in the ICU. It is a duty of the health team to be updated on pathologies of low prevalence in our country, some of them very little known until a decade ago, but which are currently increasingly present in the ICUs of the Chilean public health system.

[About the Chilean meningococcal epidemic (1941-1942): The children with septic shock 80 years ago from a medical and social perspective]. / A propósito de la epidemia meningocóccica chilena (1941-1942): El niño con shock séptico hace 80 años desde la perspectiva médica y social.

In our country, meningococcal disease has a low endemic and high lethality, with epidemic out breaks; some of them of historical character, like the one happened during the first half of the last century. The action of a group of doctors, pioneers in clinical, research and teaching aspects, together with the health personnel that constituted their team, immersed in a successful public health policy, allowed to consolidate the necessary care of the sick child of this serious pathology, as well as many others, thus enabling the development of a structured and scientific proposal, in the light of the knowledge available at that time. Therefore, after 80 years, it is important to review the various clini cal, pathophysiological and therapeutic aspects, in addition to the hospital and social context, of this successful history of the Chilean public health system.

A propósito de la epidemia meningocóccica chilena (1941-1942): el niño con shock séptico hace 80 años desde la perspectiva médica y social / About the Chilean meningococcal epidemic (1941-1942): the children with septic shock 80 years ago from a medical and social perspective

Resumen: En nuestro país, la enfermedad meningocóccica presenta una baja endemia y alta letalidad, con exis tencia de brotes epidémicos, algunos de ellos de carácter histórico, como el acaecido durante la pri mera mitad del siglo pasado. La acción de un grupo de médicos, pioneros en los aspectos clínicos, de investigación y docencia, junto al personal de salud que constituía su equipo, inmersos en una política pública sanitaria exitosa, permitieron consolidar el cuidado necesario del niño enfermo de esta grave patología, como también de muchas otras, posibilitando así el desarrollo de una propuesta estructurada y científica a la luz del conocimiento disponible en aquella época. Por ello, luego de 80 años, es importante revisar los diversos aspectos clínicos, fisiopatológicos y terapéuticos, además del contexto hospitalario y social de esta exitosa historia del sistema de salud público chileno.

Abstract: In our country, meningococcal disease has a low endemic and high lethality, with epidemic out breaks; some of them of historical character, like the one happened during the first half of the last century. The action of a group of doctors, pioneers in clinical, research and teaching aspects, together with the health personnel that constituted their team, immersed in a successful public health policy, allowed to consolidate the necessary care of the sick child of this serious pathology, as well as many others, thus enabling the development of a structured and scientific proposal, in the light of the knowledge available at that time. Therefore, after 80 years, it is important to review the various clini cal, pathophysiological and therapeutic aspects, in addition to the hospital and social context, of this successful history of the Chilean public health system.

[Pathologies of the immigrant child in the Intensive Care Unit. Update]. / Patologías del niño inmigrante en la Unidad de Cuidados Intensivos. Actualización.

It is increasingly common to provide medical care in the Intensive Care Unit (ICU) for immigrant children and adolescents as well as those born in Chile with parents in such condition. Currently, this has caused that the health team has to face diverse infrequent pathologies in our country and/ or diagnostic problems derive from the poor knowledge of genetic conditions of this population, some resulting from their health conditions. This review addresses several aspects of hematological, infectious, parasitic, respiratory, and cardiovascular pathologies, all relevant topics to know during their stay in the ICU. It is a duty of the health team to be updated on pathologies of low prevalence in our country, some of them very little known until a decade ago, but which are currently increasingly present in the ICUs of the Chilean public health system.

[The child with infectious diseases in the visual arts: Painting]. / El niño con enfermedades infecciosas en las artes visuales: Pintura.

The catastrophic impact of infectious diseases on children's health, as well the transcendental and be neficial role played by the establishment and execution of health measures and immunoprevention, has been a recurrent subject in the history of medicine, although once the disease has been controlled, they are easily forgotten. In view of this, it seems necessary to recall that social scenario through an approach through painting. The pictorial works are witnesses of that since diseases are subject of representation, and at the same time, they have become an invaluable document in the history of me dicine. Pediatric pathologies such as tuberculosis, diphtheria, polio, measles, smallpox, and syphilis, as well as the initiation of vaccination, are analyzed in various paintings with the aim of deepening knowledge of the historical era, the author and his or her link to this disease.

El niño con enfermedades infecciosas en las artes visuales: pintura / The child with infectious diseases in the visual arts: painting

Resumen: El impacto catastrófico de las enfermedades infecciosas sobre la salud infantil, como también el rol trascendental y benéfico aportado por la instauración y ejecución de medidas sanitarias y de inmuno- prevención ha sido un tema recurrente en la historia de la medicina, aunque una vez logrado el con trol de la enfermedad, estas pasan fácilmente al olvido. Ante esto, parece necesario rememorar aquel escenario social mediante un acercamiento a través de la pintura. Las obras pictóricas son testigo de aquello, pues las enfermedades son objeto de representación y a su vez se han convertido en un in valuable documento en la historia de la medicina. Patologías pediátricas como tuberculosis, difteria, poliomielitis, sarampión, viruela y sífilis como también el inicio de la vacunación, son analizadas en diversas pinturas con el objetivo de profundizar el conocimiento de la época histórica, el autor y su vínculo con dicha enfermedad.

Abstract: The catastrophic impact of infectious diseases on children's health, as well the transcendental and be neficial role played by the establishment and execution of health measures and immunoprevention, has been a recurrent subject in the history of medicine, although once the disease has been controlled, they are easily forgotten. In view of this, it seems necessary to recall that social scenario through an approach through painting. The pictorial works are witnesses of that since diseases are subject of representation, and at the same time, they have become an invaluable document in the history of me dicine. Pediatric pathologies such as tuberculosis, diphtheria, polio, measles, smallpox, and syphilis, as well as the initiation of vaccination, are analyzed in various paintings with the aim of deepening knowledge of the historical era, the author and his or her link to this disease.

[Origin of medical eponyms derived from mythology]. / Origen de epónimos médicos derivados de la mitología.

Many myths and legends have had a profound influence on modern medical language and are exten ded to all specialties as part of their culture and the history of medicine. This article briefly reviews the history of some eponyms which are usually used in medical practice. It is the knowledge of a few the mythological origin in its denomination.

Origin of certain eponyms used in pediatrics derived from literature. / Origen de algunos epónimos empleados en pediatría derivados de la literatura.

Eponyms are commonly used in medicine; some of them derive from the name of literary characters or make reference to classical myths. In this article, we underline some eponyms obtained from literature and review the characteristics of the literary characters, the circumstances that led to their creation, and the physicians who coined and adapted them to the field of medicine. A literary eponym offers a cultural and humanist perspective to our daily practice and is part of the history of medicine.

El uso de epónimos es frecuente en medicina; algunos de ellos son derivados del nombre de personajes literarios o en alusión a mitos clásicos. De esta manera, grandes escritores y sus historias, como los hermanos Grimm, Lewis Carroll y Charles Dickens, entre otros, han sido fuente de inspiración para nombrar diversos síndromes o enfermedades empleadas en pediatría. Este artículo destaca algunos epónimos nacidos de la literatura y revisa las características del personaje literario, las circunstancias que originaron su creación y a los médicos que las acuñaron y adaptaron a la disciplina médica. El epónimo literario agrega una perspectiva cultural y humanista a nuestro quehacer diario y son parte de la historia de la medicina.

Origen de epónimos médicos derivados de la mitología / Origin of medical eponyms derived from mythology

Resumen: Muchos mitos y leyendas han tenido una profunda influencia sobre el lenguaje médico moderno y están extendidos a todas las especialidades, formando parte de su cultura y de la historia de la Me dicina. Este artículo revisa en forma breve la historia de algunos epónimos los cuales son empleados habitualmente en medicina. Es conocimiento de pocos el origen mitológico en su denominación.

Abstract: Many myths and legends have had a profound influence on modern medical language and are exten ded to all specialties as part of their culture and the history of medicine. This article briefly reviews the history of some eponyms which are usually used in medical practice. It is the knowledge of a few the mythological origin in its denomination.

Childhood obesity: Pharmacokinetics considerations for drugs used in the Intensive Care Unit. / Obesidad pediátrica: consideraciones farmacocinéticas de los medicamentos utilizados en Terapia Intensiva.

An adequate drug dosage at treatment initiation is particularly relevant for critically ill patients. An inadequate dosage may result in therapeutic failure, potentially severe adverse events, and unnecessary health expenditures. At present, due to the higher incidence of childhood obesity, primary care physicians are more commonly faced with this population, so they need to make appropriate therapeutic decisions. Knowledge of the resulting pharmacokinetic alterations caused by increased body fat is critical. The optimal drug dosage is not completely defined and the correct body descriptor should be used, although there is no consensus on which is the most adequate one. The objective of this update is to gain insight on pharmacokinetic alterations that affect dosage in the critically ill obese pediatric patient and, specifically, those related to the drugs most commonly used in this population during their stay in the pediatric intensive care unit.

La correcta dosificación de un medicamento al inicio de la terapia es de particular relevancia para el paciente críticamente enfermo. Una dosis inadecuada puede ocasionar falla terapéutica, eventos adversos potencialmente graves y gastos innecesarios en salud. Hoy, debido al incremento en la incidencia de obesidad infantil, el médico clínico, cada vez más, se enfrentará a esta población, por lo que es necesaria la adecuada toma de decisiones terapéuticas. El conocimiento de las alteraciones farmacocinéticas resultantes del incremento de grasa corporal es trascendental. La dosis óptima de fármacos no está totalmente definida y debe utilizarse un adecuado descriptor corporal (no existe consenso sobre cuál es el más apropiado). El objetivo de esta actualización es conocer las alteraciones farmacocinéticas que influyen en la dosificación en el paciente pediátrico obeso críticamente enfermo y, en forma particular, las referidas a los fármacos más empleados en esta población durante su estadía en Terapia Intensiva Pediátrica.

[Origin of commonly used eponyms in the Intensive Care Unit daily job]. / Origen de epónimos comúnmente empleados en la Unidad de Cuidados Intensivos.

Eponyms reflect the history of medicine, diseases, and doctors in their time. Their use is controversial, presenting supporters and detractors. However, the use of eponyms persist in the modern medical language in the Intensive Care Units and includes some frequently used ones such as Foley, Seldinger, Down, Macintosh, Magill, Ringer, Yankauer, Doppler, and French. The objective of this review is to promote biographical knowledge and the historical period in which its medical use took place, in order to deepen aspects of medicine history.

Origen de epónimos comúnmente empleados en la Unidad de Cuidados Intensivos / Origin of commonly used eponyms in the Intensive Care Unit daily job

Los epónimos reflejan la historia de la medicina, las enfermedades y los médicos en su época. Su uso es controversial, presentando partidarios y detractores. No obstante, el empleo de epónimos persiste en el lenguaje médico contemporáneo en las Unidades de Cuidados Intensivos e incluyen a algunos de frecuente uso como: Foley, Seldinger, Down, Macintosh, Magill, Ringer, Yankauer, Doppler y French. El objetivo de la presente revisión es fomentar el conocimiento biográfico y la época histórica en la cual tomó lugar su quehacer médico o laboral, para así profundizar aspectos de la historia de la medicina.

Eponyms reflect the history of medicine, diseases, and doctors in their time. Their use is controversial, presenting supporters and detractors. However, the use of eponyms persist in the modern medical language in the Intensive Care Units and includes some frequently used ones such as Foley, Seldinger, Down, Macintosh, Magill, Ringer, Yankauer, Doppler, and French. The objective of this review is to promote biographical knowledge and the historical period in which its medical use took place, in order to deepen aspects of medicine history.

[Down Syndrome child in the Intensive care unit]. / El niño con Síndrome de Down en la Unidad de Cuidados Intensivos.

Down syndrome is the most common chromosomal abnormality in newborns, with a high incidence in Chile. This condition presents unique physiological aspects that should be known, which can affect the child during their stay in an Intensive Care Unit, beyond the neonatal period This review is focused on the respiratory, cardiovascular, infectious and neurological disorders. Anesthetic management and postoperative analgesia considerations, weaning from mechanical ventilation, cervical spine instability and prognosis of the critically ill child with Down syndrome are also analyzed. The evaluation of these conditions should be performed when the patient is admitted to the intensive care unit. The purpose of this update is to update the knowledge of the diagnosis and treatment of potential complications of children with Down syndrome during their stay in the unit of critical patient.