Homenaje póstumo al profesor Dr. Mario Plaza de los Reyes / A tribute to professor Mario Plaza de los Reyes, MD

Revista Médica de Chile renders a tribute to Professor Mario T Plaza de los Reyes, one of the founders of nephrology as a specialty in Chile, a brilliant teacher and scholar. As member of the Sociedad Médica de Santiago (Chilean Society of Internal Medicine) and former president (1964-1965) he had an active role as contributor, reviewer and reader of our journal

Contribución del Profesor Armando Roa al conocimiento de las humanidades y de la ética en la Facultad de Medicina de la Universidad de Chile / Contribution of Professor Armando Roa to humanities and medical ethics at the University of Chile School of Medicine

Dr. Roa was the first professor of the Faculty of Medicine of the University of Chile to give an ethics course to medical students, even when the importance of formal teaching of medical ethics was not yet recognized internationally. His efforts contributed to the creation of the Center for Bioethical and Humanistic Studies in 1988 and to the creation of official ethics courses for first and sixth year medical students in 1993. During 20 years, he chaired the Ethics Committee of the Faculty of Medicine of the University of Chile. He also promoted a diffusion program about medical ethics through meetings, conferences and symposia. He was responsible for the Ministry of Health's decision to create ethics committees in public hospitals in 1988 and for the Presidential decision about organ transplantation in 1995. He carried out anthropology courses and gave numerous lectures on humanistic aspects of medicine. His ethical principles are resumed in what he called the "ethics of generosity", in which the dignity of human beings is respected above all. In his opinion, the way civilizations see goodwill has been preponderant in the course of history. The recent proposal to teach humanistic fundamentals to medical students is a tribute to the memory of Professor Roa

Historia de la Revista Médica de Chile, desde su fundación en 1872 hasta el año 1997 / History of Revista Médica de Chile from its foundations in 1872 until 1997

Revista Médica de Chile, official journal of Sociedad Médica de Santiago, was founded in 1872 and has appeared uninterruptedly until today. Its aim, since its creation, has been the diffusion of scientific knowledge of Chilean physicians through original contributions, medical review articles and information about foreign medical literature. During the first 50 years of existence, physicians of medical and surgical specialties collaborated with articles, butaftewards, its main interest was oriented towards internal medicine. Its preoccupation for public health has been constant. Between 1930 and 1950, the interest of internists to divulge national clinical investigation gave a great impulse to this journal. Two important design modifications in 1958 and 1973 allowed the magnification of its information range. The incorporation of peer review of manuscripts in 1973 was an important achievement. Since its foundation, Revista Médica de Chile has been the principal written source of postgraduate training in our country

Historia de la Revista Médica de Chile, desde su fundación en 1872 hasta el año 1997 / History of Revista Médica de Chile from its foundation in 1872 until 1997

Revista Médica de Chile, official journal of Sociedad Médica de Santiago, was founded in 1872 and has appeared uninterruptedly until today. Its aim, since its creation, has been the diffusion of scientific knowledge of Chilean physicians through original contributions, medical review articles and information about foreign medical literature. During the first 50 years of existence, physicians of medical and surgical specialties collaborated with articles, butaftewards, its main interest was oriented towards internal medicine. Its preoccupation for public health has been constant. Between 1930 and 1950, the interest of internists to divulge national clinical investigation gave a great impulse to this journal. Two important design modifications in 1958 and 1973 allowed the magnification of its information range. The incorporation of peer review of manuscripts in 1973 was an important achievement. Since its foundation, Revista Médica de Chile has been the principal written source of postgraduate training in our country (AU)

Neutropenia cíclica del adulto: ileítis aguda como manifestación clínica inicial / Adult cyclic neutropenia: acute ileitis as begining clinical manifestation

Cyclic neutropenia is a rare disease in which blood neutrophils periodically decrease and almost disappear, ensiung acute infections of variable severity. We report a 37 years old female presenting with severe abdominal pain, fever and neutropenia. During surgical abdominal exploration, an acute ileitis was found. During a follow-up of 6.5 months, transient episodes of neutropenia (mean count of 0.33x10 to 9/l), every 22-28 days, were detected. Coinciding with these episodes, band and segmented neutrophils disappeared from the bone marrow and its response to functional stimulation with prednisone was insufficient. No cyclical changes in lymphocytes, monocytes and packed red cell volume were observed. The episodes of severe transient neutropenia and infections persist after 3 years of follow up

Infecciones en el paciente neutropénico / Infections in neutropenic patients

Estudio prospectivo de 74 períodos consecutivos de neutropenia severa (menor o igual a 500 u/L) en 38 pacientes hematológicos del Hospital Clínico de la U. de Chile. La leucemia aguda constituye la principal enfermedad de base y la quimioterapia fue utilizada en el 81 por ciento de los episodios. En 60 períodos (81 por ciento) se logró demostrar infección y 51 de ellos (69 por ciento) cursaron febriles. Destacamos la presencia de 9 episodios de infección de curso afebril por constituir un hecho excepcional en estos pacientes. En los 60 períodos de neutropenia con infección se logró demostrar en el 80 por ciento uno o más focos, destacando el pulmonar, orofaríngeo, mucocutáneo y abdominal. El estudio microbiológico fue positivo en el 45 por ciento de los episodios febriles; se aislaron 34 microorganismos (bacilos Gram (-) 62 por ciento, cocáceas Gram (+) 26,3 por ciento, hongos 8,8 por ciento y virus 2,9 por ciento. Se constataron 11 bacteremias, todas por bacilos Gram (-) predominando K. pneumoniae y E. coli. El esquema ceftazidima-amikacina fue el más utilizado y se modificó en más del 50 por ciento de los casos (se asoció vancomicina, anfotericina B, u otro, o se reemplazó por imipenem, vancomicina y anfotericina B), con éxito terapéutico en el 75 por ciento de los casos. Se produjeron 17 fallecimientos, 13 de causa infecciosa. La mortalidad se asoció al diagnóstico de leucemia aguda, neutropenia prolongada, foco pulmonar y bacteremia por Gram (-). Los episodios febriles sin foco ni bacteriología se asociaron a buen pronóstico

Deficiencia congénita en factor X de la coagulación sanguínea: resultado exitoso del empleo de concentrados de complejo protrombínico en el control de la tendencia hemorrágica en operación cesárea en 2 embarazos / Congenital deficiency of blood coagulation factor X: successful result of prothrombin complex concentrates use in hemorrhagic diathesis in cesarean section in 2 pregnancies

There is little experience in the prevention of the severe hemorrhagic diathesis of factor X coagulation factor deficiency, before surgical procedures. A female with congenital deficiency of factor X that received prothrombin complex concentrates that contained 1000 IU of factor X (16.7 U/I Kg BW) inmediately prior to a cesarean section in two occasions, is reported. Factor X concentration rose from 1 to 25 percent in the first ocassion and from 10 to 63 percent in the second. In both episodes, factor X decreased in the first 24 h of the postoperative period and required new infusions of prothrombin complex concentrates. No episodes of abnormal bleeding were observed. It is concluded that the infusion of prothrombin complex concentrates prevents the hemorrhagic diathesis of factor X deficiency, despite its modest increase in plasma. A initial infusion of 1.000 UI of factor X (16-20 IU/Kg BW), followed by 500 IU (8-10 IU/Kg) every 24 hours is suggested for an adequate management of this condition