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Biomedical subjects

Humberto Reyes

Publications and source records attributed to Humberto Reyes.

14 recordsLinked to original sources
PubMed2006

[What is Internal Medicine?].

Internal Medicine can be defined as a medical specialty devoted to the comprehensive care of adult patients, focused in the diagnosis and non surgical treatment of diseases affecting internal organs and systems (excluding gyneco-obstetrical problems) and the prevention of those diseases. This position paper reviews the history of Internal Medicine, the birth of its subspecialties and the difficulties faced by young physicians when they decide whether to practice as internist or in a subspecialty. In Chile as in most occidental countries formal training in a subspecialty of internal medicine requires previous certification in internal medicine but the proportion of young physicians who remain in practice as general internists appears to be considerably lower than those who choose a subspecialty. The main reasons for this unbalance can be related to financial advantages (by the practice of specialized technologies) and the patients' tendency to request direct assistance by a professional thought to be better qualified to take care of their specific problems. Training programs in internal medicine should consider a greater emphasis in comprehensive outpatient care instead of the traditional emphasis for training in hospital wards.

Adult↗
PubMed2006

Is a leaky gut involved in the pathogenesis of intrahepatic cholestasis of pregnancy?

Increased gastrointestinal permeability has been demonstrated in several liver diseases. It may facilitate the absorption of gut-derived endotoxin-stimulating Kupffer cells to release proinflammatory cytokines or other potentially hepatotoxic compounds. We examined gastrointestinal permeability, plasma levels of anti-lipopolysacharides (anti-LPS), and four proinflammatory cytokines in 20 patients with intrahepatic cholestasis of pregnancy (ICP) compared with 22 normal pregnant and 29 non-pregnant women. Urinary excretion of sucrose and the urinary lactulose/mannitol (L/M) ratio after a standard oral load were used to assess gastrointestinal permeability. Anti-LPS (IgA, IgM, and IgG) were measured in peripheral blood by Human EndoCAb test kit; TNF-alpha, IL-1beta, IL-6, and IL-10 by Quantikine HS human immunoassays. Sucrose urinary excretion was similar in the three groups, indicating normal gastric permeability. The urinary L/M ratio was significantly higher in ICP than in the other groups [median (interquartile range): 0.018% (0.011-0.023) in ICP, 0.012% (0.009-0.016) in normal pregnancies, and 0.009% (0.008-0.012) in non-pregnant women, P < .01]. No significant differences were found in anti-LPS or cytokines plasma levels except slightly higher levels of IL-6 in ICP patients than in non-pregnant women (P < .05). Four of five women with abnormal urinary L/M ratio during ICP continued to show abnormalities in tests up to 2 years after delivery. In conclusion, an increased intestinal permeability was detected in ICP patients during and after pregnancy. A "leaky gut" may participate in the pathogenesis of ICP by enhancing the absorption of bacterial endotoxin and the enterohepatic circulation of cholestatic metabolites of sex hormones and bile salts.

Adult↗
PubMed2005

[75th anniversary of the Pontifical Catholic University of Chile School of Medicine].

The Pontifical Catholic University of Chile founded its School of Medicine in 1930, preceded by the Schools of Medicine of the University of Chile (founded in 1833) and the University of Concepción (founded in 1924). The founders of the new School were prominent members of the Catholic Church, advised by distinguished Chilean physicians and scientists, most of them already full Professors at the University of Chile. During the first decades, only a small number of full-time faculties could be recruited and the academic team included mostly part-time teachers, generally shared with the already established Medical Schools, as well as practising physicians with little or no previous teaching experience. Along 75 years of fruitful existence, this Medical School has evolved to become one of the leading organizations in graduate and post-graduate medical education in Latin America, with high standards in teaching methodology and a superb productivity in clinical and biomedical research. The history of this Medical School stands as an example to the currently nascent Medical Schools founded by private universities in Chile. The standards of high quality medical education should be maintained for the well-being of our population so that these new Medical Schools can become respected and accepted as peers by the entire community of Chilean Universities.

Chile↗
PubMed2005

Ursodeoxycholic acid in the treatment of intrahepatic cholestasis of pregnancy. A 12-year experience.

OBJECTIVE: To assess the efficacy of ursodeoxycholic acid (UDCA) in patients with intrahepatic cholestasis of pregnancy (ICP) and in the outcome of pregnancy. METHODS: Retrospective analysis of our 12-year experience treating ICP patients with UDCA. Thirty-two patients with pruritus starting before week 34 of pregnancy and with increased serum bile salts (BS) and alanine aminotransferase (ALT) received UDCA (15 mg/kg/day) for at least 3 weeks before delivery. They were compared with 16 historical controls who did not receive UDCA. All patients were followed up until delivery and in puerperium. Newborns were followed up during 3 months. RESULTS: UDCA treatment attenuated pruritus (P < 0.05), serum bilirubin and ALT decreased (P < 0.05) and BS declined. Delivery at term (> or = 37 weeks) occurred in 65.7% of UDCA-treated patients compared with only 12.5% in controls (P < 0.01). Infants born to mothers treated with UDCA weighed a mean of 500 g more than the controls (2882+/-582 vs 2385+/-582; P < 0.01). At 3 months, all infants developed normally. Twenty-six children whose mothers received UDCA were re-examined after 1-12 years and they and their mothers were healthy. CONCLUSIONS: UDCA improved pruritus and biochemical cholestasis, and facilitated deliveries at term in ICP patients, with a higher birthweight compared with historical controls. The drug was well tolerated and no adverse effects were detected in their infants.

Adult↗
PubMed2004

[The editorial handling of manuscripts submitted to Revista Médica de Chile].

This Editorial describes the steps followed by a manuscript when it is submitted to Revista Médica de Chile: its reception, format checking as requested in Instructions to Authors, and the editors' decision whether it is considered suitable for the purposes of this journal or not; the selection of peer reviewers, a direct contact with them to ask for their willingness to review this particular manuscript; an analysis by the editors of the reviewers' criticisms leading them to the decision of whether to accept it in the current version, or to return it to the authors with a request to prepare a new corrected version, or a definitive rejection; the editors' review of a corrected version (that may require again the opinion of the external reviewers) and the final decision to accept it or not; printing of the manuscript, two successive galley proofs reviewed by authors and editors; and the final printing of the journal with its simultaneous reproduction in the web page www.scielo.cl. Roughly 70% of the manuscripts are returned to the authors offering them the opportunity to resubmit a corrected version, 12% are definitively rejected and 20% are accepted in their first version. The mean time taken for an accepted manuscript since its first submission until it appears printed is currently 7.6 months. Having only part time editors and a time-limited secretarial staff efforts to shorten this time are difficult to implement, although electronic mail and fax are increasingly being used in this editorial process.

Chile↗
PubMed2003

[The relevance of declaring a conflict of interest in medical journals].

Medical journals are often at risk of difusing research articles, reviews, position articles, editorials or letters whose message has been influenced by a conflict of interest. The readers may then be induced to accept conclusions and recommendations based on biased protocols or an unwarranted interpretation of the results. Financial support or professional links with pharmaceutical companies or other supporting agencies are the most common sources of conflict of interests, often difficult to detect. Similarly, reviews of manuscripts can be biased by personal relationships (good or bad) between reviewers and authors, by academic competition or intellectual passion, becoming other sources of conflict of interest. Even when a potential conflict of interest exists, it may not necessarily have influenced the manuscript or its review but in order to defend the transparency of the editorial process, from submission to publication, authors, reviewers and editors should declare any conflict of interest they may have and allow others to decide whether the action has been biased or not. In the present issue of Revista Médica de Chile, an updated text of the Instructions to Authors establishes that all authors should sign a statement of having or not a conflict of interest, clarifying which aspects of the work might have been affected by it.

Conflict of Interest↗
PubMed2003

[Evidence Based Medicine, in Revista Médica de Chile].

Since the beginning of the 20th century, the principles of the experimental method in biological sciences have been progressively applied in biomedical and clinical research. After the pioneering work of AB Hill et al, biostatistics became a fundamental tool in the appraisal of new therapeutic agents or methods, and of diagnostic tests. From 1990 on, "Evidence based Medicine" has been added to it. This journal opens in this issue a section containing critical analysis of articles published in the medical literature deserving the attention of its readers. However, as several other medical journals have stressed, we recommend that the conclusions of these analysis should not be used as a substitute for clinical judgment and they do not represent an official position of our journal. Revista Médica de Chile welcomes the new Section and invites contributions to it.

Chile↗
PubMed2003

[Activation in the metaloproteinases complex in the follicle-embryonic generative capability].

OBJECTIVE: To evaluate the impact of the enzymatic inhibition complex of metaloproteinases [TIMP(MMP-3 stromelisine-1)] in follicle/genesis processes and their ovule/embryonic subsequent development in stimulated cycles. TYPE OF STUDY: Prospective longitudinal in research center. MATERIALS AND METHODS: A total of 20 patients were evaluated in vitro fertilization cycles measuring matrix metaloproteinases concentrations in days 3 and 12 of ovarian stimulation, as well as in the follicular liquid at the moment of ovarian retrieval. The determination of [TIMP/(MMP-3 stromelisine-1)] was done by ELISA and monoclonal antibodies type of immunoassay methods. For its statistical evaluation were applied linear regression models ( r/r2 ) and Kolmogorov-Smirov test comparing the two groups where values were expressed in agreement at its mean, standard deviation and a significance of p < 0.05. RESULTS: For regression models was found a positive correlation between basal FSH and the age of patients [(r2 = 0.26)(p = 0.003)], dividing groups in older and younger patients than 35 years; it was observed significant difference in metaloproteinases concentration as in serum concentration (days 3 and 12 of stimulation) as in the follicular liquid. A decrease in the 14% [(TIMP/(MMP-3/stromelisine-1)] complex concentration was increasing in accordance at the female patients age. CONCLUSIONS: The matrix metaloproteinases complex study has allowed observing a status not only in the ovular quality but in the embryonic development and fertilization processes too.

Adult↗
PubMed2002

[V Chilean Symposium of Biomedical Journal Editors].

In August, 2001, the Editors of over 40 Chilean journals in biological, medical and health issues were gathered in Santiago, Chile, by the Chilean Association of Biomedical Journal Editors, together with guest librarians from Chile and Brazil, in a 2-day symposium. The main topics discussed were: the educational role of biomedical journals in Chile; how can Chilean journals become included in international databases; requisites for authorship in scientific articles; how to attract more and better manuscripts; advantages and limitations of the peer-review system; ethical problems and conflicts of interest in the editorial process; electronic tendencies in scientific publications. This was the fifth meeting on similar topics held in Chile, starting in 1972, and the interchange of experiences and opinions among editors, librarians and other experts was fruitful and stimulating.

Chile↗
PubMed2002

[Update of authorship criteria in biomedical articles].

In the year 2000, a previous Editorial in this journal reviewed the criteria for authorship as defined by experienced authors and editors, discussed in selected references from the biomedical literature. An emphasis was given to the definition of authorship stated in the available 1997 version of the "Uniform Requirements for Manuscripts Submitted to Biomedical Journals". After that Editorial was published, an updated version of the "Uniform Requirements" established important changes in their criteria; e.g. Participation of each author in the work should permit them to take public responsibility for "appropriate portions of the content"; and acquisition of data was added as an acceptable alternative in the first requisite for authorship. These and other changes should be disused to prospective authors, particularly in multicentric studies usually leading to multi-authorship. This new Editorial and a translation into Spanish of the authorship criteria contained in an-updated (2001) version of the "Uniform Requirements" are included in this issue of Revista Médica de Chile with the purpose of stimulating authors and readers to think in their implications.

Authorship↗
PubMed2002

[An analysis of authorship in articles published in Revista Médica de Chile].

BACKGROUND: Multiauthorship and unjustified authorship have been documented in journals with wide international circulation but this has not been thoroughly studied in journals from developing countries. Revista Médica de Chile is published in Spanish and it contains about 40% of the clinical and biomedical manuscripts generated by Chilean authors. OBJECTIVES: To evaluate temporal trends in the number of authors per article in Rev Med Chile and authors' compliance with the International Committee of Medical Journal Editors (ICMJE) criteria of authorship (updated 2001). DESIGN: A retrospective analysis of the number of authors per article between 1969 and 2000; and a prospective survey applying a contribution checklist to authors of manuscripts published in the year 2000. "Justified authorship" was assigned to whom self-declared contributions to: 1) conception and design of the study, or acquisition of data, or analysis and interpretation of data; 2) drafting the article, or critically reviewed it; and 3) approved the final version. "Partial authorship" to whom lacked one of those 3 criteria. "Unjustified authorship" was assigned to whom participated only in data collection, or in diagnostic/therapeutic procedures, or in the statistical analysis, or in combinations lacking the main descriptors required for justified authorship. RESULTS: The number of authors in research articles increased in the last decade: From 3.9 +/- 1.6 (mean +/- SD) in 1969 and 4.9 +/- 2.0 in 1989 to 5.7 +/- 2.5* in 1994, 5.2 +/- 2.6* in 1999 and 5.4 +/- 2.2* in 2000 (*p < 0.05 compared to previous years). In contrast, it remained stable in case reports (4.1 +/- 1.9) and in reviews, public health or medical education articles (3.3 +/- 1.8). Among 921 authors surveyed (90% of authors in the year 2000), 51.2% qualified for "justified authorship", 42.3% for "partial authorship" and only 6.4% for "unjustified authorship". CONCLUSIONS: In a medical journal from a developing country, multiauthorship has increased mildly in research articles. Most participants complied fully or partially with the ICMJE criteria of authorship. Creditable authorship can be improved by continuous education and a critical attitude by the authors, readers, reviewers and editors.

Authorship↗
PubMedDate not supplied

Intrahepatic cholestasis of pregnancy: a past and present riddle.

Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy-specific disorders that occurs mainly in the third trimester of pregnancy and is characterized by pruritus and elevated bile acid levels. ICP is regarded as a benign disease with no meaningful consequences to the mother but associated to an increased perinatal risk with increased rates of fetal morbidity and mortality. The pathogenesis of disease is unknown but likely involves a genetic hypersensitivity to estrogen or estrogen metabolites. Mutations or polymorphisms of some hepatobiliary transport proteins may contribute to disease pathogenesis or severity. Treatment is focused on a) reducing symptoms in the mother and b) to provide an adequate obstetric management in order to prevent fetal distress. Currently, only Ursodeoxycholic acid treatment has been proven to be useful and should be considered mainly in patients with severe pruritus or complications in previous pregnancies.

Cholagogues and Choleretics↗