Juan Jorge Manríquez

A highly sensitive search strategy for clinical trials in Literatura Latino Americana e do Caribe em Ciências da Saúde (LILACS) was developed.

BACKGROUND Systematic reviews should include as many articles as possible. However, many systematic reviews use only databases with high English language content as sources of trials. Literatura Latino Americana e do Caribe em Ciências da Saúde (LILACS) is an underused source of trials, and there is not a validated strategy for searching clinical trials to be used in this database. OBJECTIVE The objective of this study was to develop a sensitive search strategy for clinical trials in LILACS. STUDY DESIGN AND SETTING An analytical survey was performed. Several single and multiple-term search strategies were tested for their ability to retrieve clinical trials in LILACS. Sensitivity, specificity, and accuracy of each single and multiple-term strategy were calculated using the results of a hand-search of 44 Chilean journals as gold standard. RESULTS After combining the most sensitive, specific, and accurate single and multiple-term search strategy, a strategy with a sensitivity of 97.75% (95% confidence interval [CI]=95.98-99.53) and a specificity of 61.85 (95% CI=61.19-62.51) was obtained. CONCLUSIONS LILACS is a source of trials that could improve systematic reviews. A new highly sensitive search strategy for clinical trials in LILACS has been developed. It is hoped this search strategy will improve and increase the utilization of LILACS in future systematic reviews.

Tricodisplasia espinulosa asociada a pancitopenia autoinmune: Reporte de un caso

Trichodysplasia spinulosa is a rare disease that occurs in the setting of immunosuppression, associated with tolerogenic therapy used in allograft recipients or patients with hematologic malignancies. Clinically, it is characterized by a centrofacial cutaneous eruption of erythematous papules with a central keratinous spicule, often associated with variable degrees of alopecia. Histologic findings are characteristic, and electron microscopy reveals the presence of trichodysplasia spinulosa associated polyomavirus. We report a 47-year-old woman with idiopathic autoimmune pancytopenia refractory to diverse immunosuppressant regimens, with clinical and pathologic findings compatible with the disease, in whom complementary studies were required to exclude other differential diagnoses. (Rev Med Chile 2018; 146: 107-110)Trichodysplasia spinulosa is a rare disease that occurs in the setting of immunosuppression, associated with tolerogenic therapy used in allograft recipients or patients with hematologic malignancies. Clinically, it is characterized by a centrofacial cutaneous eruption of erythematous papules with a central keratinous spicule, often associated with variable degrees of alopecia. Histologic findings are characteristic, and electron microscopy reveals the presence of trichodysplasia spinulosa associated polyomavirus. We report a 47-year-old woman with idiopathic autoimmune pancytopenia refractory to diverse immunosuppressant regimens, with clinical and pathologic findings compatible with the disease, in whom complementary studies were required to exclude other differential diagnoses.

[Acute generalized exanthematous pustulosis associated with Mycoplasma pneumoniae infection: a case report].

Acute generalized exanthematous pustulosis is an uncommon skin eruption, characterized by fever and the rapid onset of disseminated, non-follicular, sterile pustules, over an erythematous skin background. It is usually classified as a severe cutaneous adverse drug reaction, whose most relevant triggers are antibiotics and anticonvulsants. However, viral and bacterial infections have also rarely been associated with this dermatosis. We report the case of a patient, who developed lesions of acute generalized exanthematous pustulosis as an extrapulmonary manifestation of Mycoplasma pneumoniae infection.

Tuberculosis en patrón esporotricoide: una presentación inusual de tuberculosis cutánea en un paciente inmunocompetente

Resumen En la actualidad, la tuberculosis sigue siendo un proble -ma de salud publica en el mundo. El compromiso cutaneo es una manifestacion poco frecuente de la infeccion por Mycobacterium tuberculosis . El patron esporotricoide se refiere a la disposicion lineal de los nodulos cutaneos siguiendo el trayecto de los vasos linfaticos, forma de presentacion caracteristica de la esporotricosis, de ahi su nombre. Muy pocos casos han sido reportados sobre tuberculosis cutanea con patron esporotricoide. Se pre-senta el caso clinico de una mujer de 84 anos con nodulos ulcerativos de disposicion lineal en miembro superior causados por Mycobacterium tuberculosis , destacando la importancia de incluir a la tuberculosis cutanea en el diag-nostico diferencial de lesiones con patron esporotricoide. Referencias bibliograficas 1.- World Health Organization. Global Tuberculosis Report 2013. Disponible en: http://apps.who.int/iris/bitstream/10665/91355/1/9789241564656_eng.pd0f. (accedido: 18 de julio de 2014).2.- Ministerio de Salud, Chile. Tuberculosis: Informe de situacion en Chile 2012. Disponible en: http://web.minsal.cl/sites/default/files/files/tuberculosisInforme2012.pdf (accedido: 18 de julio de 2014).3.- Lai-Cheong J E, Perez A, Tang V, Martinez A, Hill V, Menage Hdu P. Cutaneous manifestations of tuberculosis. Clin Exp Dermatol 2007; 32: 461-6.4.- Pau W S, AlSaffar H, Weinstein M, Kitai I. Sporotrichoid-like tuberculosis. Pediatr Infect Dis J 2009; 28: 1135-6.5.- Pandhi D, Reddy B S, Chowdhary S, Khurana N. Cutaneous tuberculosis in Indian children: the importance of screening for involvement of internal organs. J Eur Acad Dermatol Venereol 2004; 18: 546-51.Tuberculosis remains a major global health problem. Cutaneous involvement is a rare manifestation of tuberculosis infection. Sporotrichoid clinical pattern consists of a linear arrangement of nodules along the lymphatic vessels. It is often seen in sporotrichosis. Few cases have been reported of cutaneous tuberculosis presenting as a sporotrichoid clinical pattern. We describe a 84-year-old female with ulcerative nodules on upper extremity caused by Mycobacterium tuberculosis, emphasizing the importance of considering cutaneous tuberculosis in the differential diagnosis of sporotrichoid lesions.

Medición de riesgo y pronóstico en dermatología: estudios de cohorte y de casos y controles

La mayoria del conocimiento medico deriva del estudio profundo de los pacientes, sus enfermedades y el medio que los rodea. Cuando estamos cara a cara con los pacientes, muchas veces notamos asociaciones entre sus dolencias y posibles causas o potenciales factores de riesgo relacionados con estas enfermedades. Diversas preguntas e hipotesis surgen de esta observacion, y por medio de la investigacion clinica podemos evaluar la veracidad y la fuerza de estas relaciones. Para esclarecer estas dudas razonablemente, es necesario el diseno de estudios que permitan, basado en metodos estadisticos que disminuyan el sesgo y el azar, encontrar asociaciones reales entre las alteraciones que investigamos y sus causas o consecuencias. En este articulo, describiremos las caracteristicas de los principales estudios que permiten evaluar el riesgo y el pronostico en medicina, con el analisis de caracteristicas de su diseno, usos, ventajas y desventajas.