Abstract:
:Cholangiocarcinoma is a malignant lesion of the bile duct epithelium. Its incidence and prevalence are low. It appears from the sixth decade of life and there is slight male predominance. It is most frequently found in the confluence of the hepatic ducts, where it is called hilar cholangiocarcinoma or Klatskin tumor. Its etiology is unknown but there are predisposing conditions and environmental risk factors such as primary sclerosing cholangitis, Caroli's disease, bile duct malformations, industrial toxins and parasitic infections. The classic presentation of cholangiocarcinoma includes jaundice, weight loss and right upper quadrant pain. These, in addition to laboratory exams, endoscopical and imaging procedures, lead to the diagnosis. Hilar cholangiocarcinoma must be distinguished from other malignant or benign causes of biliary obstruction. Cholangiocarcinoma of the distal common bile duct must be differentiated from other periampullary tumors and intrahepatic cholangiocarcinoma can be confused with a hepatocellular carcinoma. Two classifications are used for clinical staging: TNM and Bismuth-Corlette. The best treatment is the complete surgical excision with negative histological margins, although the resectability index is low. The type and size of surgery depends on the location and extent of the tumor. Patients with unresectable tumors can be subjected to palliative procedures such as biliary-enteric bypass, endoscopic or pecutaneous stent placement. Chemotherapy is not effective. Recently, endoscopic phototherapy has emerged as a better alternative for palliative care.
journal_name
Rev Med Chiljournal_title
Revista medica de Chileauthors
Burgos San Juan Ldoi
/S0034-98872008000200015subject
Has Abstractpub_date
2008-02-01 00:00:00pages
240-8issue
2eissn
0034-9887issn
0717-6163pii
S0034-98872008000200015journal_volume
136pub_type
杂志文章,评审abstract:BACKGROUND:The dose of oral anticoagulants (OAC) shows great variability among patients. Pharmacogenetic studies have shown that common variants in genes CYP2C9 (*2 and *3) and VKORC1 (-1639G>A) are associated with lower requirements of OAC. AIM:To study the association between average maintenance doses of oral antico...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:10.4067/S0034-98872015001100001
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:In patients with colorectal carcinoma, insertions or deletions of short sequences of DNA, a phenomenon called microsatellite instability, are observed. AIM:To look for microsatellite instability and mutations of MLH1 and MSH2 gene mutations in patients with colorectal carcinoma. MATERIAL AND METHODS:Ten pa...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:10.4067/s0034-98872006001000002
更新日期:2006-10-01 00:00:00
abstract:BACKGROUND:Subacute combined degeneration is a clinical manifestation of vitamin B12 deficiency, that we observe with unusual frequency. AIM:To report a series of eleven patients with subacute combined degeneration. PATIENTS AND METHODS:Retrospective analysis of 11 patients hospitalized in a public hospital in Santia...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:10.4067/s0034-98872004001100006
更新日期:2004-11-01 00:00:00
abstract::Myocardial bridging of the epicardic coronary arteries is not an uncommon finding in angiographic or necropsic studies. Patients who have symptoms usually improve with medical treatment. However, in refractory patients a surgical myotomy of overlying myocardium and/or a coronary bypass may be needed. We report two pat...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:
更新日期:1998-11-01 00:00:00
abstract:BACKGROUND:Subjects with glucose intolerance or high fasting glucose levels have a higher cardiovascular risk and frequently become diabetic. AIM:To assess clinical and metabolic characteristics of patients with glucose intolerance or high fasting glucose levels. MATERIAL AND METHODS:Fasting and post glucose load ser...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:/S0034-98872009000200002
更新日期:2009-02-01 00:00:00
abstract::We report nine patients with acute mitral regurgitation secondary to post-infarction papillary rupture operated between 1980 and 1992. Seven cases had posterior papillary muscle rupture. All patients were in critical conditions with pulmonary edema at the moment of surgery. In eight cases, mitral valve replacement was...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:
更新日期:1995-02-01 00:00:00
abstract::This essay looks into the meaning of today's professionalism and the apparent inconsistency between its growing status and a context of profound changes and dissatisfaction with medical practice. The cultural climate of our times is reviewed, as the framework for understanding changes in the social organization of med...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:10.4067/s0034-98872006000400017
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND:The classic diagnosis of Barret esophagus is based on the finding of three of more cm of distal esophagus covered by specialized columnar epithelium. However, at the present time, it is based on the presence of intestinal metaplasia in the junction of squamous-columnar mucosae. AIM:To assess the prevalence ...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:
更新日期:1998-02-01 00:00:00
abstract:BACKGROUND:Medical care of HIV infected and AIDS patients may represent an important economical burden for public hospitals. AIM:To assess direct and indirect costs of medical care for HIV infected and AIDS patients in public hospitals of the Metropolitan Region of Chile. MATERIAL AND METHODS:Between August 1994 and ...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:
更新日期:1998-02-01 00:00:00
abstract::The great diversity of commercially available products for the serologic diagnosis of Chagas disease led us to conduct a study of these products in comparison with the indirect immunofluorescence test. Percent agreement between methods ranged from 79 to 100%, the details for each product being given in the text. Bette...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:
更新日期:1990-10-01 00:00:00
abstract:BACKGROUND:Demands on primary health care services in Chile are increasing. The staff perception of specific sources of tension at work is not known. This knowledge is necessary to avoid preventable health problems caused by distress. AIM:To identify specific work stressors in primary health care facilities and to exa...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:10.4067/s0034-98872006000400007
更新日期:2006-04-01 00:00:00
abstract::To measure the proportion, reasons and frequency of battering and punishment, we surveyed seventh and eight grade children coming from a low and middle income area, state funded school (n = 84) and from a payed, private and catholic school (n = 98). Of children coming from the payed school, 67% lived with both parents...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:
更新日期:1994-08-01 00:00:00
abstract::A 37-year-old female with systemic lupus erythematosus and chronic treatment with steroids developed spontaneous bilateral rupture of tendons of both quadriceps muscles below the patella. Surgical treatment was undertaken with good results. The histologic features and a review of the literature are included. ...
journal_title:Revista medica de Chile
pub_type: 杂志文章,评审
doi:
更新日期:1990-09-01 00:00:00
abstract::We report the case of a woman with rapidly progressive IgA nephropathy. She was treated with pulse methylprednisolone sodium succinate (1 g/d for three days), cyclophosphamide, dipyridamole and aspirin. The rapid progression of renal failure was apparently halted after 6 months. ...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:
更新日期:1989-10-01 00:00:00
abstract:BACKGROUND:Soft tissue foreign bodies are a frequent cause of consultation in emergency rooms. It is difficult to verify their existence since conventional radiology only detects radio opaque objects. Ultrasound can be a useful diagnostic procedure. AIM:To report our experience in the detection of soft tissue foreign ...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:
更新日期:2000-04-01 00:00:00
abstract::Technology for diabetes care has undergone major development during recent decades. These technological advances include continuous subcutaneous insulin infusion (CSII), also known as insulin pumps, and real-time continuous glucose monitoring system (RT-CGMS). The integration of CSII and RT-CGMS into a single device h...
journal_title:Revista medica de Chile
pub_type: 杂志文章,评审
doi:10.4067/S0034-98872017000500011
更新日期:2017-05-01 00:00:00
abstract::The rapid advances in immunobiology, pharmacology and molecular biology have made successful renal transplantation the optimal therapeutic modality for adults and children, reaching a near--90% of patient-graft survival among the first years of transplant. But this knowledge also presents clinicians and scientists wit...
journal_title:Revista medica de Chile
pub_type: 杂志文章,评审
doi:
更新日期:1998-01-01 00:00:00
abstract::This article reviews some key issues of early rheumatoid arthritis such as the dfficulties to recognize this condition during the first months after onset. Therefore, three reference diagnostic criteria have been proposed for any patient presenting with more than three simultaneously inflammed joints, involvement of m...
journal_title:Revista medica de Chile
pub_type: 杂志文章,评审
doi:10.4067/s0034-98872008001100015
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND:The current recommendations for treatment of patients with newly diagnosed acute promyelocytic leukemia (APL) include all-trans-retinoic acid (ATRA) and anthracycline based chemotherapy. AIM:To evaluate the results of the Chilean protocol following the LPA99 regimen of the Spanish PETHEMA group, except for ...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:10.4067/S0034-98872013001000001
更新日期:2013-10-01 00:00:00
abstract::Lung computed tomography (CT) is being used increasingly to assess lung morphology in patients on mechanical ventilation. Lung CT under known levels of airway pressure (dynamic CT) can also assess the response of lung parenchyma to ventilatory therapy. We report a patient with acute respiratory distress syndrome secon...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:
更新日期:2003-02-01 00:00:00
abstract:BACKGROUND:Several studies indicate that doctors who work in the same area of the medical profession tend to behave somehow similarly. Thus, it has been suggested that personality relates to the medical specialty choice. However, it is not known whether people self-select into the medical specialties according to their...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:10.4067/s0034-98872005001000008
更新日期:2005-10-01 00:00:00
abstract:BACKGROUND:Professional Social Responsibility is now imperative for the practice of medicine. However, there are no instruments to assess it among physicians. AIM:To construct and evaluate the factorial structure and reliability of a questionnaire designed to measure socially responsible behavior in physicians. MATER...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:10.4067/S0034-98872014000100014
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Enterococcus is a bacterial genus with low virulence. However, in the last years, the importance of some enterococcus species as nosocomial pathogens has increased, specially due to their resistance to some antimicrobial. AIM:To identify enterococcus strains using classical biochemical techniques and genomi...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:
更新日期:2002-01-01 00:00:00
abstract::To study the effect of old age on phenytoin pharmacokinetics, twelve young and nine old adults aged 21.7 +/- 1.8 and 71.8 +/- 4.9 years respectively, were studied. No significant differences of phenytoin indicating the drug distribution and elimination does not change with aging. After oral administration, significant...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:
更新日期:1992-10-01 00:00:00
abstract:BACKGROUND:Illicit drug abuse is a public health problem, generally starting in adolescence. Medical students are not an exception. AIM:To assess the consumption of illicit drugs among medical students of the Pontificia Universidad Católica de Chile. MATERIAL AND METHODS:A questionnaire used by the National Council f...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:/S0034-98872009000400002
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:Education may induce voluntary behavioral changes in patients that lead to an improvement in health status. AIM:To assess the impact of the educational manual "Aches and Pain" on knowledge and attitudes of patients with chronic rheumatism and paramedics, using an instrument with 40 asseverations extracted f...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:
更新日期:1996-09-01 00:00:00
abstract:BACKGROUND:Vildagliptin is a dipeptidyl peptidase IV inhibitor (DPP4i). Its efficacy and safety of DPP4i in Chilean real life type 2 diabetic (T2D) patients is not well known. AIM:To assess the safety profile and effectiveness of 12 weeks of treatment with Vildagliptin for glycemic control in T2D Chilean patients with...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:10.4067/S0034-98872015000100008
更新日期:2015-01-01 00:00:00
abstract::Between January 1986 and December 1990 the prevalence of F. hepatica infection was studied in 5861 rural inhabitants of the provinces of Curico, Talca and Linares, VII Region, an hyperendemic zone of animal fascioliasis. Every one was screened by intradermal (IDR), complement fixation (CF), double diffusion (DD) count...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:
更新日期:1992-06-01 00:00:00
abstract::The development of the subspecialties of internal medicine in the western world is reviewed from a historical perspective, focusing on the case of the United States of America. During the last decades, changes both in society and in medicine as a whole have prompted a great dispersion of medical practice styles, not a...
journal_title:Revista medica de Chile
pub_type: 历史文章,杂志文章
doi:
更新日期:1996-04-01 00:00:00
abstract:BACKGROUND:Behçet's disease (BD) is a rare multisystemic inflammatory disease that is potentially disabling and may cause death. AIM:To describe the characteristics of BD patients from two Chilean centers. PATIENTS AND METHOD:Retrospective review of the clinical records of patients with BD attended in two rheumatolog...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:/S0034-98872009001000008
更新日期:2009-10-01 00:00:00