El uso de la evidencia en ciencias se atribuye a la medicina tradicional china, en los tiempos del emperador Qianlong, cuando ya se señalaba el mé
Este estudio ha sido fi nanciado parcialmente por el proyecto DI09-0060
Clinical and surgical aspects of hydatidosisHydatidosis is common in Southern Chile and it is usually located in the liver. The complications of surgical procedures for liver hydatidosis, which fl uctuate from 11 to 86%, are superposed to the own complications of the disease. The frequency of surgical complications is associated with evolutionary complications of the cysts, the need to perform additional procedures to treat the disease in other simultaneous locations and previous surgical interventions for the disease. Operative mortality is lower than 5%. The surgical treatment of hydatidosis is divided in four phases: isolation of the surgical zone, cyst evacuation, treatment of cyst complications and treatment of residual cavity. The conservative surgical procedures are marsupialization, cystostomy, Posadas intervention and cystojejunostomy. Surgical procedures involving resection are pericystectomy, subtotal cystectomy and liver resections. ResumenLa hidatidosis es una zoonosis endémica en el sur de Chile, por lo que tenemos la oportunidad de tratar un número importante de pacientes, especialmente hepática, localización más común de esta enfermedad. La hidatidosis hepática (HH) tiene morbilidad y mortalidad propia debido a sus complicaciones evolutivas, a lo que se agrega el riesgo de complicaciones asociados a los procedimientos quirúrgicos, cuya morbilidad se ha reportado entre 11% y 86%; la que se ha relacionado con intervenciones previas por HH, complicaciones evolutivas de los quistes, la necesidad de realizar procedimientos adicionales como el tratamiento de la enfermedad en otras localizaciones simultáneas. La mortalidad reportada es inferior al 5%. Sin embargo, tanto morbilidad como mortalidad persisten altas a pesar de los avances tecnológicos terapéuticos. El tratamiento quirúrgico de la HH se puede dividir en cuatro fases: aislamiento de la zona quirúrgica, evacuación del quiste, tratamiento de las complicaciones del quiste; y tratamiento de la cavidad residual. Por otro lado, la cirugía de la HH se puede clasifi car en procedimientos conservadores (marsupialización, quistostomía, operación de Posadas y quistoyeyunostomía) y resectivos (periquistectomía, quistectomía subtotal y resecciones hepáticas). Por último, cabe señalar el rol de la cirugía laparoscópica, que aún se encuentran en evaluación.Palabras clave: Equinococosis, hidatidosis, equinococosis hepática, hidatidosis hepática, quiste hidatídico hepático.
Productivity and methodological quality of clinical articles in oral and maxillofacial surgery in Chile. Period 2001-2012Introduction: Until now, there are no reports of quantity and quality of publications in oral and maxillofacial surgery (OMFS) conducted in Chile, which is why the aim of this study is to determine the productivity and methodological quality (MQ) of OMFS clinical articles in Chile in the period 2001-2012. Material and Methods: Bibliometric study. A systematic search in MEDLINE, Science Citation Index Expanded (Web of Science-ISI) and SciELO was conducted. Only clinical items related to OMFS made by Chilean authors were selected. Journal name, publication year, primary Chilean institution affiliated and specialty area were registered. Those articles related to surgical therapy were evaluated according to Sackett's level of evidence and MINCIR-therapy scale for MQ. Results are presented using descriptive statistics. Results: 68 articles were selected. Growth was observed in the number of publications, from 3 (4.4%) in 2002 to 8 (11.7%) in 2012, showing a peak (13 articles) in 2009. The most productive institution was Universidad de Chile (n = 20). Majority of items are cases of surgical pathology. 91.2% of the articles observed had a type 4 level of evidence. The MQ average of analyzed articles was 9.9 ± 4.0 points, verifying only 4 items of good MQ (18 or more points). Conclusion: OMFS scientific production in Chile has increased during the last decade. However, the amount of articles of good level of evidence is low and MQ is poor.
Rol de las características clínicas e histológicas como factores pronósticos para la sobrevida en pacientes con carcinoma de células escamosas de la cavidad oral* Background: Survival of patients with oral squamous cell carcinoma is low and depends mostly on TNM staging of the tumor. Aim: To perform a retrospective analysis of a series of patients with oral squamous cell carcinoma. Material and Methods: Retrospective review of patients with the diagnosis, seen between 1995 and 2006 in a regional hospital. Host infl ammatory response and pattern of tumor invasion were assessed using the staging proposed by Bryne et al. Results: The medical records of 36 patients aged 39 to 89 years, were reviewed. During the study period, 15 patients died. Better survival was associated to a low pattern of tumor invasion and a high infl ammatory response and the topographic location of the tumor. Conclusions: Infl ammatory response, tumor invasion and location are associated with survival in oral squamous cell carcinoma.Key words: Oral cancer, squamous cell, survival. ResumenIntroducción: El carcinoma de células escamosas de la cavidad oral (CCECO) es una patología cuyo comportamiento es producto de interrelaciones con el huésped, esto es, por el patrón de invasión (PI) histopatológica y la respuesta infl amatoria (RI). El objetivo de este estudio es analizar las características clínicas e histopatológicas como factores pronóstico, en términos de supervivencia (SV) en pacientes con CCECO. Material y Método: Serie de casos. Se incluyeron pacientes diagnosticados en el Hospital Regional de Talca y Hospital Base de Curicó entre los años 1995 y 2006. Se revisaron las fi chas clínicas y biopsias de 36 pacientes con CCECO. Se determinó el Frente Invasivo Tumoral (FIT), evaluándose los parámetros propuestos por el sistema de graduación de Bryne (PI y RI) y factores de importancia clínica como localización topográfi ca de la lesión, edad y género, relacionándolos con SV mediante curvas de Kaplan-Meier y Log Rank test. Posteriormente, se aplicó una regresión de Cox para obtener un análisis multivariado y cálculo de RR. Del total de Rev.
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