Revista Hospital Clínico Universidad de Chile

El cáncer de piel no melanoma: carcinoma basocelular. Revisión de la literatura

Daniel Rappoport — 2025-12-19

Basal cell carcinoma (BCC) is the most common type of non-melanoma skin cancer, representing 80% of cases. Its incidence has increased due to population aging and sun exposure. Although it rarely metastasizes, its high prevalence places a significant burden on healthcare systems. Risk factors include UV radiation exposure, radiotherapy, genetic predisposition, immunosuppression, skin phototype, and previous BCC history, among others. BCC is classified into histopathological subtypes such as nodular, superficial and morpheaform, each with distinctive clinical characteristics. Diagnosis is made through clinical examination, dermatoscopy, and biopsy. The main treatment is surgical excision, with options like micrographic surgery or Mohs surgery for high-risk lesions or critical locations. In selected cases, topical therapies and radiotherapy can be used. Long-term follow-up is crucial as patients with BCC have a high risk of developing new lesions. Prevention, early detection, and appropriate treatment are essential to reduce morbidity and mortality associated with BCC. Continuous efforts in education and research are needed to address this public health issue.

Abordaje del síndrome de hombro doloroso desde la Atención Primaria de Salud: una propuesta esquemática basada en factores clínicos y demográficos

Antonia Vacarezza A. — 2025-12-19

Painful shoulder syndrome is the third most common reason for consultation due to musculoskeletal disorders in primary health care (PHC). This condition carries significant morbidity and places a considerable burden on higher-level hospitals, mainly due to unnecessary referrals resulting from inadequate initial management. This article proposes a structured framework for managing painful shoulder syndrome from the PHC perspective. It outlines the most prevalent clinical situations and the populations most frequently affected, offering a diagnostic and therapeutic algorithm that incorporates patient demographics, guiding factors toward the most likely pathologies. Once a diagnostic hypothesis has been formulated, and without red flags, initial management should include analgesia and physical therapy. Advanced imaging studies (ultrasound or magnetic resonance) should be reserved for cases where clinical suspicion warrants them. If pain persists for more than three months, depending on the suspected condition, referral to specialties such as orthopedics for further evaluation or physiatry for chronic pain management should be considered.

La importancia de la reversión a ritmo sinusal en la fisiopatología de la fibrilación auricular: un abordaje desde la perspectiva básico-clínica

Alfredo Parra L. — 2025-12-19

Atrial Fibrillation (AF) represents a major global public health concern, with its prevalence projected to rise in the coming years primarily due to population aging — the principal risk factor associated with the condition. AF imposes a substantial economic burden on healthcare systems and is linked to elevated morbidity and mortality rates. Numerous studies have underscored the clinical relevance of achieving early restoration of sinus rhythm in patients with AF, as prolonged periods of irregular atrial activity are associated with adverse hemodynamic and thromboembolic consequences. Nevertheless, atrial rhythm irregularity is not the sole defining feature of AF. The progressive electrical and structural remodeling that characterizes the natural history of this arrhythmia drives its evolution from paroxysmal AF toward long-standing persistent and ultimately permanent AF. The term “permanent AF” reflects, more than the duration of the arrhythmia, a therapeutic decision to forego further attempts at rhythm control, given that advanced atrial remodeling often renders cardioversion ineffective. Multiple strategies have been employed to restore and maintain sinus rhythm, including pharmacologic suppression of aberrant electrical activity, modulation of the cellular action potential, and disruption of micro–reentrant circuits through physical or ablative interventions. Each approach exhibits variable efficacy and carries specific risks of adverse effects. Despite significant therapeutic advances, ongoing research is warranted to develop novel and more individualized management strategies for AF, enabling tailored interventions based on the underlying pathophysiologic substrate and patient profile.

Exámenes genéticos. Avances, desafíos y perspectivas futuras

Gustavo Albornoz Arriagada — 2025-12-19

Technological advancement in genetics has triggered the exponential development of genetic testing, fundamental tools in modern medicine. The objective of this narrative review is to describe the main genetic tests used in current clinical practice, analyzing their technical characteristics, clinical applications, and limitations. This review examines the main technologies currently used—karyotype, fluorescence in situ hybridization (FISH), chromosomal microarray analysis (CMA), multiplex ligation-dependent probe amplification (MLPA), Sanger Sequencing, next-generation sequencing (NGS), long-read sequencing (LRS), and optical genome mapping (OGM)—analyzing their capabilities, limitations, and specific clinical applications. Emerging technologies such as LRS and OGM resolve some limitations of previous methodologies, particularly in complex genomic regions and structural variants. Appropriate selection of genetic testing requires understanding their technical capabilities and clinical, ethical, and economic considerations to optimize diagnostic performance. Successful implementation of these tests requires genetic counseling that enables understanding of results and their implications.

Dermatosis y manifestaciones cutáneas asociadas al uso de equipos de protección personal en profesionales de la salud chilenos durante la pandemia Covid-19

Francisca Pineda Acuña — 2025-12-19

Introduction: The COVID-19 pandemic showed an unprecedented challenge for healthcare workers (HCWs), who required the use of personal protective equipment (PPE) for extended periods. This has led to various cutaneous manifestations (CM) and skin dermatoses (SD), whose prevalence in Chile is unknown. Materials and Methods: A quantitative, descriptive, and cross-sectional study was conducted through an online survey administered between February 10 and 18, 2022, to 863 healthcare workers in Chile. The relationship between PPE use and the presence of skin conditions was evaluated. Results: A 92.4% of participants presented cutaneous manifestations such as erythema, comedones, xerosis, and pruritus, while 54.6% developed skin dermatoses, primarily mask-induced acne (MA) and hand dermatitis (HD). A significant association was found between the use of KN95 mask and MA (p=0.004). A significant relationship was also reported between PPE use for more than 4 hours daily and HD (p=0.015), and PPE use for more than 6 hours daily with both MA and HD (p=0.006). Discussion: An increase in cutaneous manifestations among healthcare workers due to PPE use was observed, consistent with international reports. Conclusion: This study reveals the Chilean reality regarding skin conditions among healthcare workers due to PPE use during the pandemic. These findings may help guide prevention and mitigation strategies for these conditions in the future.

Editorial. El valor de ser y actuar como comunidad

Rosa Andrea Pardo Vargas — 2025-12-19

Test radiológico

Gonzalo Miranda González — 2025-12-19

Resultado test radiológico

Gonzalo Miranda González — 2025-12-19

Resúmenes VII Jornadas de Investigación 2025

Revista Hospital Clínico Universidad de Chile — 2025-12-19