Scielo RSS <![CDATA[Revista médica de Chile]]> http://www.scielo.cl/rss.php?pid=0034-988720170005&lang=en vol. 145 num. 5 lang. en <![CDATA[SciELO Logo]]> http://www.scielo.cl/img/en/fbpelogp.gif http://www.scielo.cl <![CDATA[<strong><i>Analysis of Crowding in an Adult Emergency Department of a tertiary university hospital</i></strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000500001&lng=en&nrm=iso&tlng=en Background: Crowding in Emergency Departments (ED), results from the imbalance between the simultaneous demand for health care and the ability of the system to respond. The NEDOCS scale (National Emergency Department Crowding Scale) measures the degree of crowding in an ED. Aim: To describe ED Crowding characteristics, using the NEDOCS scale, in an Argentinean hospital. Material and Methods: A retrospective cohort study was conducted with all adult patient consultations between July 2013 and July 2014 at the ED of Hospital Italiano de Buenos Aires. We included all hours in the analysis period (365 days x 24 h = 8,760). The NEDOCS value was calculated for each hour using an automatic algorithm and was quantified in a six points score. Levels 4 (overcrowded), 5 (severely overcrowded) and 6 (dangerously overcrowded) were defined as overcrowding. Contour plots analysis was applied to identify patterns. Results: During the study period, 124,758 visits to the ED were registered. Overcrowding was present in 57.7% (5,055) of the analyzed hours. A predominance of scores between four and five was observed between 10:00 and 24:00 hours. The months with predominance of overcrowding were June, July and August (southern winter). Conclusions: The calculation of the NEDOCS score and the analysis of its temporal distribution are highly relevant to identify opportunities for improvement and to develop mechanisms to prevent the highest categories of overcrowding. <![CDATA[<strong><i>Coverage of a screening program and prevalence of diabetic retinopathy in primary care</i></strong><strong>ç</strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000500002&lng=en&nrm=iso&tlng=en Background: Diabetic retinopathy is the first cause of blindness during working years. Aim: Provide knowledge of screening coverage, prevalence and level of diabetic retinopathy in patients that belong to the Cardiovascular Health Program in primary care. Material and Methods: Analysis of retinographies performed to 9076 diabetic patients aged 61 ± 13 years (61% women) adscribed to a Cardiovascular Health program in primary care centers of South-East Metropolitan Santiago. The examination was carried out by the evaluation of retinographies by trained optometrists. Results: The coverage of the screening program was 21%. The prevalence of sight threatening diabetic retinopathy was 3,1%. The prevalence of these entities was 45% higher in people aged between 18 and 44 years than in older people. Their prevalence in urban communities was 32% higher than in rural locations. Conclusions: The coverage of the screening program is low. Diabetic patients aged 18 to 44 years and those coming from urban communities have a higher prevalence of severe non-proliferative and proliferative diabetic retinopathy. <![CDATA[<strong><i>Prediction of hospital mortality of ST elevation myocardial infarction using TIMI score</i></strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000500003&lng=en&nrm=iso&tlng=en Background: Thrombolysis in myocardial infarction risk score (TIMI-RS) was designed to predict early mortality in patients with a ST elevation acute myocardial infarction (STEAMI). Aim: To evaluate the predictive capacity for hospital mortality of TIMI-RS. Material and Methods: Patients with ≤ 12-hour evolution STEAMI were selected from a prospective registry of all patients hospitalized in our coronary unity within January 1988 and December 2005. Observed mortality was analyzed according to TIMI-RS and its predictive capacity was estimated. Results: We analyzed 1125 consecutive patients aged 61 ± 13 years (76% men). Fifty one percent were smokers, 47% hypertensive and 40% had a history of angina. Fifty eight percent of patients underwent reperfusion therapy. Most patients had TIMI-RS scores ≤ 5 points and only 3.6% had scores ≥ 10 points. Overall mortality was 14.8% and there was an 80% concordance between observed mortality and that predicted with the TIMI-RS score. The area under the curve for the receiver operating characteristic (ROC) curve was 0.7. Conclusions: TIMI-RS was acceptably useful to predict in-hospital mortality in this group of patients with STEAMI. Differences between the observed and originally predicted mortality are explained by the clinical profile and therapeutic protocols applied to patients in different studies. Thus, caution needs to be taken when interpreting the risk associated to a specific score, particularly within non-reperfused patients whose risk might be underestimated. <![CDATA[<strong><i>Usefulness of imaging studies in prostate cancer</i></strong>: <strong><i>Analysis of 241 patients</i></strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000500004&lng=en&nrm=iso&tlng=en Background: The role of staging studies in patients with prostate cancer (PCa) is a topic of discussion. Aim: To evaluate the usefulness of imaging studies in patients with prostate cancer. Material and Methods: We reviewed the pathology service records to identify patients with prostate cancer diagnosed between 2003 and 2013. We reviewed the electronic medical records of those patients identified as having a prostate cancer. Patients were grouped according D’amico’s classification of cancer dissemination risk. We analized the frequency of imaging studies requested and their efficacy to detect metastases in each risk group. Results: We identified 241 patients with a mean age of 67 years. Fifty two percent of patients were classified as low-risk, 32% as intermediate-risk and 16% as high risk. At least one imaging study was requested to 64% of patients (49, 78 and 87% of patients with low, intermediate and high risk respectively). Among the 155 patients in whom an imaging study was requested, no metastases were found in the low risk group. On the other hand, dissemination was found in 7% of the intermediate-risk group and 62% of the high-risk group. Conclusions: Half of patients with prostate cancer were classified as low risk. In half of this group of low risk patients, staging studies were requested and the probability of detecting metastases was low or nil. The odds of detecting metastases increased in higher risk groups. <![CDATA[<strong><i>Effects of a lower body weight or waist circumference on cardiovascular risk</i></strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000500005&lng=en&nrm=iso&tlng=en Background: Overall and central obesity are important risk factors for cardiovascular disease. Aim: To investigate the association of body weight, body mass index (BMI) and waist circumference (WC) with cardiovascular risk factors in Chile. Material and Methods: We included 5,157 participants from the National Health Survey 2009-2010. Prevalence of type 2 diabetes, hypertension, metabolic syndrome and dyslipidemia (high total cholesterol and triglyceride levels and low HDL-cholesterol) were defined using international recommendations. BMI and WC were measured using standardized protocols. Results: A five percent lower body weight, BMI and WC were associated with a significant reduction in cardiovascular risk factors. For each 5% reduction in body weight, the risk for hypertension decreased by 8 and 9% in women and men respectively. Similar risk reductions were observed for diabetes (9 and 11% respectively), metabolic syndrome (23 and 30% respectively), low HDL cholesterol (13 and 13% respectively), high triglyceride levels (16 and 18% respectively) and total cholesterol (8 and 10% respectively). Similar findings were observed for BMI and WC. Conclusions: Lower body weight, BMI or WC are associated with important reductions in cardiovascular risk factors. A 5% reduction in these adiposity markers could be a perfectly feasible goal for lifestyle interventions. <![CDATA[<strong><i>The impact of a self-directed teaching approach on academic performance of medical students</i></strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000500006&lng=en&nrm=iso&tlng=en Background: Students should be encouraged to become reflexive and develop autonomous, lifelong learning habits. Therefore, teachers should focus on learning strategies which stimulate autonomous learning. Aim: To assess the impact of a self-directed teaching methodology on the academic performance of medical students in cellular biology and biochemistry. Materials and Methods: During 2013, 85 students received a traditional teaching methodology and during 2014, 85 students received a self-directed learning methodology. The grades obtained and the number of failures in the courses of cellular biology and biochemistry were compared in both groups. Results: The percentages of students approved at the end of the courses during 2013 and 2014 were 64 and 96% respectively (p < 0.01). The grades obtained by the 2014 students were also significantly higher than those obtained by 2013 students. Conclusions: This study confirms that academic performance improves with a self-directed teaching approach. <![CDATA[<strong><i>Analysis of human cyst echinococcosis in a northern Chilean region from 2008 to 2012</i></strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000500007&lng=en&nrm=iso&tlng=en Background: The Coquimbo Region in Chile has the highest incidence of hydatidosis in central and northern Chile. Aim: To analyze the incidence of human cystic echinococcosis (CE) in the Coquimbo Region between 2008 and 2012. Material and Methods: Official records of reported cases were analyzed. The association of the location, age and sex with the presence/absence of CE was analyzed by means of logistic regressions. The incidence was reported as cases per 100,000 inhabitants. Results: The mean annual incidence was 2.6 cases per 100,000 inhabitants, which ranged from 3.1 (2010) to 1.9 (2012) cases. The districts with higher incidence were Punitaqui (21.2 cases), Paihuano (9 cases), Rio Hurtado (8 cases), Canela (8.1 cases), Monte Patria (7.9 cases), Vicuña (6.9 cases) and Combarbalá (6.9 cases). The incidence in these locations was significantly higher than elsewhere in the region. Males had a significantly higher incidence than females (3.3 and 1.8 respectively). Incidence increased significantly with age, notably increasing after 45 years of age. Conclusions: Rural locations had the highest incidences of CE in the Coquimbo Region. The disease was reported more commonly in adults and mainly in men. <![CDATA[<strong><i>The influence of pedagogic and discipline training on the teaching quality of university professors</i></strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000500008&lng=en&nrm=iso&tlng=en Background: University teachers prioritize acquiring knowledge about their disciplines over pedagogic training. However, the latter is becoming increasingly important in the present teaching scenario. Aim: To relate pedagogic practices with pedagogic training of teachers from health care careers of public and private universities. Material and Methods: Pedagogic practice and training activities participation questionnaires were answered by 296 teachers of undergraduate students from Chilean public and private universities. Results: There was a direct correlation between discipline training and all pedagogic practice factors. However, pedagogic training correlated with all the factors with the exception of teacher centered learning. Teachers with a master degree had higher scores in factors related to teaching planning and process assessment. Having a doctor degree had no impact on these factors. A multiple regression analysis showed that both discipline and pedagogic training and having a master degree were associated with pedagogic practices of teachers. Conclusions: Both pedagogic and discipline training influence the quality of teaching provided by undergraduate teachers. <![CDATA[<strong><i>Response to ABVD chemotherapeutic protocol in patients with early stage Hodgkin’s lymphoma</i></strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000500009&lng=en&nrm=iso&tlng=en Background: Recent trials show that > 90% of patients with early stage Hodgkin`s Lymphoma (ESHL) can be cured, especially when using the ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) chemotherapeutic (CT) protocol. The use of radiotherapy (RT) is variable and can be selected according to the presence of specific risk factors, including PET-CT, as recently reported. Aim: To report the experience in the treatment of ESHL. Material and Methods: Retrospective and descriptive analysis of patients with ESHL treated at the Red de Salud UC-Christus between 2011-2015. Results: Twenty-two patients were treated. In 73%, the tumor was of nodular sclerosis histologic type. Most patients (95%) were in stage II, and 78% had a favorable prognosis according to the Deutsche Hodgkin Studiengruppe (GHSG) criteria. All patients were stratified using PET-CT and treated using the ABVD CT protocol, for 4-6 cycles. Only 5 patients received RT. There was no change of conduct after interim-PET-CT results. Ninety one percent of patients achieved complete response and there were two cases of refractory disease. Both cases underwent hematopoietic stem cell transplantation. After 17 months of median follow-up, 91% of patients are relapse-free, and only one patient died (5%). Conclusions: ABVD offers excellent results for ESHL patients. The benefit of PET-CT should be evaluated with prospective protocols, aiming to select patients needing RT or to reduce the number of CT cycles. <![CDATA[<strong><i>Young woman, daughter of a father with Alport’s syndrome, debuts with a impure nephrotic syndrome</i></strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000500010&lng=en&nrm=iso&tlng=en Background: Recent trials show that > 90% of patients with early stage Hodgkin`s Lymphoma (ESHL) can be cured, especially when using the ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) chemotherapeutic (CT) protocol. The use of radiotherapy (RT) is variable and can be selected according to the presence of specific risk factors, including PET-CT, as recently reported. Aim: To report the experience in the treatment of ESHL. Material and Methods: Retrospective and descriptive analysis of patients with ESHL treated at the Red de Salud UC-Christus between 2011-2015. Results: Twenty-two patients were treated. In 73%, the tumor was of nodular sclerosis histologic type. Most patients (95%) were in stage II, and 78% had a favorable prognosis according to the Deutsche Hodgkin Studiengruppe (GHSG) criteria. All patients were stratified using PET-CT and treated using the ABVD CT protocol, for 4-6 cycles. Only 5 patients received RT. There was no change of conduct after interim-PET-CT results. Ninety one percent of patients achieved complete response and there were two cases of refractory disease. Both cases underwent hematopoietic stem cell transplantation. After 17 months of median follow-up, 91% of patients are relapse-free, and only one patient died (5%). Conclusions: ABVD offers excellent results for ESHL patients. The benefit of PET-CT should be evaluated with prospective protocols, aiming to select patients needing RT or to reduce the number of CT cycles. <![CDATA[<strong><i>From insulin pump and continuous glucose monitoring to the artificial pancreas</i></strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000500011&lng=en&nrm=iso&tlng=en 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 has led to sensor-augmented pump therapy and more recently, a technology that has automated delivery of basal insulin therapy, known as hybrid system. These new technologies have led to benefits in attaining better metabolic control and decreasing the incidence of severe hypoglycemia, especially in patients with type 1 diabetes. This review describes the types of technologies currently available or under investigation for these purposes, their benefits and disadvantages, recommendations and the appropriate patient selection for their use. The clinical use of the hybrid system and artificial pancreas seem to be possible in the near future. <![CDATA[<strong><i>Shared decision making in patients with diabetes mellitus</i></strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000500012&lng=en&nrm=iso&tlng=en Patients with diabetes mellitus often have several medical problems and carry a burden imposed by their illness and treatment. Health care often ignores the values, preferences and context of patients, leading to treatments that do not fit into patients’ overwhelmed lives. Shared Decision Making (SDM) emerges as a way to answer the question: “What’s best for the patient?”. SDM promotes an empathic conversation between patients and clinicians that integrates the best evidence available with their values, preferences and context. We discuss three SDM approaches for patients with diabetes: one focused on sharing information, another on making choices, and a third one on helping patients and clinicians to talk about how to address the problems of living with diabetes and its comorbidities. Despite the benefits demonstrated in studies conducted in the U.S. and Europe, the implementation of SDM continues to be a challenge. In Latin America, healthcare and socio-economic conditions render the implementation of SDM more challenging. Research aimed to respond to this challenge is necessary. Meanwhile, clinicians can practice SDM by sharing evidence-based information, giving voice to patients’ values and preferences in making choices, and creating empathic conversations aimed at decisions aligned with patients’ context, dreams, goals, and life expectations. <![CDATA[<strong><i>An update on inpatient treatment of anorexia nervosa</i></strong>: <strong><i>practical recommendations</i></strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000500013&lng=en&nrm=iso&tlng=en Anorexia Nervosa (AN) is the psychiatric illness with the highest mortality, especially if it is associated with psychiatric and somatic comorbidity. Medical complications can be multiple and jeopardize the normal development of children and adolescents, even permanently. Although its prevalence is lower compared with other psychiatric disorders, its tendency to chronicity and the severity of its consequences are remarkable. Although outpatient treatment of anorexia is privileged as far as possible, the risks associated with poor response to treatment or lack of adherence of the patient or family, require the possibility of hospitalization at any time of the disease. We searched and analyzed the national and international literature available (especially clinical guidelines) about the indication for hospital treatment in AN and the interventions recognized as necessary and effective during hospitalization. Despite the lack of standardized criteria for hospitalization, the available information converge on the need for a multidisciplinary work by a specialist team, to make family interventions especially in adolescents and tailor treatment according to the individual physical, psychological and social needs. <![CDATA[<strong><i>Differential diagnosis of bone marrow and lung granulomas</i></strong>: <strong><i>Report of one case</i></strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000500014&lng=en&nrm=iso&tlng=en The differential diagnosis of pulmonary tuberculosis and lymphoma with pulmonary infiltration is very difficult, given their similar clinical characteristics. We report a 59 year old female with weight loss, fever, dyspnea and cough of several months of duration. She had a cavitated mass in lung imaging. A positive conventional PCR lead to the diagnosis of tuberculosis, but she had negative smears and cultures for Mycobacterium tuberculosis. The patient did not respond to treatment and her clinical condition worsened. A peripheral lymph node biopsy confirmed the presence of a diffuse large B cell non-Hodgkin lymphoma. Bone marrow pathology showed non caseating granulomas, again with negative microbiological tests for M. tuberculosis. Findings in the bone marrow were interpreted as a secondary sarcoid reaction to cancer and PCR results as a false positive. The lymphoma was treated, achieving complete remission. This case highlights the importance of the differential diagnosis between these two entities. <![CDATA[<strong><i>Lung epithelioid hemangioendothelioma</i></strong>: <strong><i>Report of one case</i></strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000500015&lng=en&nrm=iso&tlng=en Epithelioid hemangioendothelioma is a multifocal tumor that rarely metastasizes. It is difficult to diagnose, most often it is an incidental finding in young asymptomatic women. The radiologic pattern is heterogeneous. Histologic confirmation of Weibel-Palade bodies or immunohistochemistry based on specific tumor markers such as factor VIII and CD34 are the most important finding to confirm the diagnosis. We report a 21 years old woman Presenting with cough and dyspnea. A chest X ray was suggestive of tuberculosis. Sputum smears were negative for acid fat bacilli and the tuberculin test was negative. A chest CAT scan showed multiple nodular lesions. A surgical biopsy of the lesions confirmed the presence of a hemangioendothelioma. The patient was initially treated with prednisone and azathioprine without response. Thereafter, the patient is without treatment and without evidence of disease progression. <![CDATA[<strong><i>Endoscopic lung volume reduction in advanced pulmonary emphysema</i></strong>: <strong><i>initial experience in Chile</i></strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000500016&lng=en&nrm=iso&tlng=en Chronic obstructive pulmonary disease (COPD) has no curative treatment, and in moderate to advanced stages, functional parameters and quality of life are affected. Lung volume reduction improves respiratory parameters and quality of life of these patients. Endoscopic lung volume reduction is a minimally invasive procedure that uses endobronchial valves or coils. Valves are unidirectional, blocking the air from entering the target lobe during inspiration, allowing the exit of air and secretions during expiration. Complete fissure and absence of collateral ventilation are needed for an adequate functioning of endobronchial valves. Endobronchial coils cause mechanical retraction of the lung parenchyma. We report two patients who underwent endoscopic lung volume reduction by endobronchial valves. One patient was on continuous positive pressure non-invasive ventilation due to his severe emphysema. <![CDATA[<strong><i>Treatment of hyperthyroidism with radioiodine during hemodialysis</i></strong>: <strong><i>Report of one case</i></strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000500017&lng=en&nrm=iso&tlng=en Although radioiodine (131-I) can be used as treatment of hyperthyroidism for patients in hemodialysis, its use is limited and the experience is mainly related to differentiated thyroid carcinoma. We report a 58 years old female on hemodialysis with recurrent hyperthyroidism after propylthiouracil treatment. She was successfully treated with 131-I and four months after the intervention her euthyroid state was confirmed. We measured 131-I activity in blood, dialysate liquid and other waste products, as well as patient radiation exposure rates. We found that 131-I elimination was prolonged through time with no major dependence on hemodialysis, as opposed to the elimination of 131-I in patients with thyroid carcinoma. This was probably due to high radiotracer uptake in hyper functioning thyroid tissue. Conversely, radiation content in dialysate wastes or equipment was minimal. Furthermore, the rate of both environmental exposure and exposure of nursing staff in charge of hemodialysis sessions, was minimal and met international security standards. In conclusion, I-131 therapy showed both appropriate effectiveness and safety in this case and may be considered as a suitable treatment alternative to thyroidectomy when antithyroid drugs are unsuccessful. <![CDATA[<strong>The problem of medical approach to disability</strong>: <strong>An interdisciplinary challenge between health, education and law</strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000500018&lng=en&nrm=iso&tlng=en Although radioiodine (131-I) can be used as treatment of hyperthyroidism for patients in hemodialysis, its use is limited and the experience is mainly related to differentiated thyroid carcinoma. We report a 58 years old female on hemodialysis with recurrent hyperthyroidism after propylthiouracil treatment. She was successfully treated with 131-I and four months after the intervention her euthyroid state was confirmed. We measured 131-I activity in blood, dialysate liquid and other waste products, as well as patient radiation exposure rates. We found that 131-I elimination was prolonged through time with no major dependence on hemodialysis, as opposed to the elimination of 131-I in patients with thyroid carcinoma. This was probably due to high radiotracer uptake in hyper functioning thyroid tissue. Conversely, radiation content in dialysate wastes or equipment was minimal. Furthermore, the rate of both environmental exposure and exposure of nursing staff in charge of hemodialysis sessions, was minimal and met international security standards. In conclusion, I-131 therapy showed both appropriate effectiveness and safety in this case and may be considered as a suitable treatment alternative to thyroidectomy when antithyroid drugs are unsuccessful. <![CDATA[<strong>Feedback</strong>: <strong>Cornerstone of clinical teaching</strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000500019&lng=en&nrm=iso&tlng=en Although radioiodine (131-I) can be used as treatment of hyperthyroidism for patients in hemodialysis, its use is limited and the experience is mainly related to differentiated thyroid carcinoma. We report a 58 years old female on hemodialysis with recurrent hyperthyroidism after propylthiouracil treatment. She was successfully treated with 131-I and four months after the intervention her euthyroid state was confirmed. We measured 131-I activity in blood, dialysate liquid and other waste products, as well as patient radiation exposure rates. We found that 131-I elimination was prolonged through time with no major dependence on hemodialysis, as opposed to the elimination of 131-I in patients with thyroid carcinoma. This was probably due to high radiotracer uptake in hyper functioning thyroid tissue. Conversely, radiation content in dialysate wastes or equipment was minimal. Furthermore, the rate of both environmental exposure and exposure of nursing staff in charge of hemodialysis sessions, was minimal and met international security standards. In conclusion, I-131 therapy showed both appropriate effectiveness and safety in this case and may be considered as a suitable treatment alternative to thyroidectomy when antithyroid drugs are unsuccessful. <![CDATA[<strong>Teaching blindly</strong>: <strong>Need for surveys and evaluations in medical students and physicians from Peru</strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000500020&lng=en&nrm=iso&tlng=en Although radioiodine (131-I) can be used as treatment of hyperthyroidism for patients in hemodialysis, its use is limited and the experience is mainly related to differentiated thyroid carcinoma. We report a 58 years old female on hemodialysis with recurrent hyperthyroidism after propylthiouracil treatment. She was successfully treated with 131-I and four months after the intervention her euthyroid state was confirmed. We measured 131-I activity in blood, dialysate liquid and other waste products, as well as patient radiation exposure rates. We found that 131-I elimination was prolonged through time with no major dependence on hemodialysis, as opposed to the elimination of 131-I in patients with thyroid carcinoma. This was probably due to high radiotracer uptake in hyper functioning thyroid tissue. Conversely, radiation content in dialysate wastes or equipment was minimal. Furthermore, the rate of both environmental exposure and exposure of nursing staff in charge of hemodialysis sessions, was minimal and met international security standards. In conclusion, I-131 therapy showed both appropriate effectiveness and safety in this case and may be considered as a suitable treatment alternative to thyroidectomy when antithyroid drugs are unsuccessful. <![CDATA[<strong><i>Julio Nazer M.D. (1926-2016)</i></strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000500021&lng=en&nrm=iso&tlng=en Although radioiodine (131-I) can be used as treatment of hyperthyroidism for patients in hemodialysis, its use is limited and the experience is mainly related to differentiated thyroid carcinoma. We report a 58 years old female on hemodialysis with recurrent hyperthyroidism after propylthiouracil treatment. She was successfully treated with 131-I and four months after the intervention her euthyroid state was confirmed. We measured 131-I activity in blood, dialysate liquid and other waste products, as well as patient radiation exposure rates. We found that 131-I elimination was prolonged through time with no major dependence on hemodialysis, as opposed to the elimination of 131-I in patients with thyroid carcinoma. This was probably due to high radiotracer uptake in hyper functioning thyroid tissue. Conversely, radiation content in dialysate wastes or equipment was minimal. Furthermore, the rate of both environmental exposure and exposure of nursing staff in charge of hemodialysis sessions, was minimal and met international security standards. In conclusion, I-131 therapy showed both appropriate effectiveness and safety in this case and may be considered as a suitable treatment alternative to thyroidectomy when antithyroid drugs are unsuccessful. <![CDATA[<strong>CORRECTION</strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000500022&lng=en&nrm=iso&tlng=en Although radioiodine (131-I) can be used as treatment of hyperthyroidism for patients in hemodialysis, its use is limited and the experience is mainly related to differentiated thyroid carcinoma. We report a 58 years old female on hemodialysis with recurrent hyperthyroidism after propylthiouracil treatment. She was successfully treated with 131-I and four months after the intervention her euthyroid state was confirmed. We measured 131-I activity in blood, dialysate liquid and other waste products, as well as patient radiation exposure rates. We found that 131-I elimination was prolonged through time with no major dependence on hemodialysis, as opposed to the elimination of 131-I in patients with thyroid carcinoma. This was probably due to high radiotracer uptake in hyper functioning thyroid tissue. Conversely, radiation content in dialysate wastes or equipment was minimal. Furthermore, the rate of both environmental exposure and exposure of nursing staff in charge of hemodialysis sessions, was minimal and met international security standards. In conclusion, I-131 therapy showed both appropriate effectiveness and safety in this case and may be considered as a suitable treatment alternative to thyroidectomy when antithyroid drugs are unsuccessful.