Scielo RSS <![CDATA[Revista médica de Chile]]> https://scielo.conicyt.cl/rss.php?pid=0034-988720060008&lang= vol. 134 num. 8 lang. <![CDATA[SciELO Logo]]> https://scielo.conicyt.cl/img/en/fbpelogp.gif https://scielo.conicyt.cl <![CDATA[<B>Undergraduate medical students' expectative of their desired profile as medical doctors</B>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872006000800001&lng=&nrm=iso&tlng= Background: During the last few years, multiple new medical schools have emerged in Chile, associated to the constant preoccupation to provide a good quality medical care. This created the need to evaluate medical training programs and to open a discussion about the attributes that a good physician should have. Aim: To evaluate the medical student's perception of the ideal medical doctor profile. Material and methods: An analytical, descriptive and cross sectional study was designed. Eleven second year, 11 third year, nine fourth year, 13 fifth year, 6 sixth year and 8 seventh year students were studied. Data collection was gathered by focus groups. Codes and triangulation were used for data analysis. Results: As attitudes and moral-ethical values, students valued the absence of discrimination a listening attitude and empathy. Among job related issues, they valued responsibility and punctuality. Emotional and legal self-care were valued as self related attitudes. Among skills, competences and capacities, a value was given to communicational skills, team work and professional easiness. Knowledge about medical and non medical topics was appraised. The valued attributes among duties and activities were patient diagnosis, treatment and education, team leadership and continuous medical training. Conclusions: These findings should help to design new curricula for medical schools (Rev Méd Chile 2006; 134: 947-54) <![CDATA[<B>Student patient relationship from the patient's point of view</B>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872006000800002&lng=&nrm=iso&tlng= Background : Patients are becoming increasingly active in their relationship with medical professionals. Their relationship with medical students needing to learn clinical skills, may be specially problematic if patients are not willing to accept their involvement in the medical team. Aim: To examine patient's perceptions of their relation with medical students and their agreement to let students be part of the treating team. Material and Methods: Qualitative study using taped semi-structured interviews addressed to inpatients from one public and one private hospital in Chile. Results: Both groups of patients acknowledged that students dedicated more time to them, but they expressed their preference to limit student's participation to clinical history taking and physical examination. They also expected them to be observers rather than actors. Patients from the private hospital emphasized that only one student per instructor should participate in their care. Patients from the public hospital were more compliant about student's participation. The right to refuse students' involvement in their care was clearly known by all patients from the private system and by most patients from the public hospital. Conclusions: Patients in Chilean public and private hospitals were in general positive regarding student's participation in their care. Students' clinical practice ought to strictly respect patients's rights, and patients should be considered volunteers who generously agree to cooperate with the education of medical students (Rev Méd Chile 2006; 134: 955-9). <![CDATA[<B>Presence of antineutrophil cytoplasmic antibodies (ANCA) and anti Saccharomyces cerevisiae antibodies (ASCA) among patients with ulcerative colitis</B>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872006000800003&lng=&nrm=iso&tlng= Background: The diagnosis of inflammatory bowel disease is supported by clinical findings and complementary tests. The presence of specific serological markers could be helpful in the characterization of this condition. Aim: To assess the prevalence of ANCA and ASCA in a group of patients with ulcerative colitis (UC) and its association with clinical features. Material and Methods: Sixty four patients with UC in remission (age range 16-72 years, 33 males) were studied. In a venous blood sample ANCA were measured by indirect immunofluorescence and ASCA by enzyme immune assays for IgG and IgA. Results: Forty four percent of patients were positive for ANCA, 9% for ASCA and 6% for both markers. There was a significant correlation between the presence of ANCA and duration of the UC (<5 years 50%, 5-10 years 42.9%, 15 years 30%) and the number of crises (one crises 31%, 2-5 crises 51.9% and &gt;5 crises 87.5). The proportion of colectomized patients with positive ANCA was higher (57.1%). Conclusions: The prevalence of ANCA in the studied population is similar to the published data. The presence of ANCA was significantly higher in UC patients with shorter evolution, higher number of crises and in those with a history of colectomy. There was a low prevalence of ASCA positive patients (Rev Méd Chile 2006; 134: 960-4). <![CDATA[<B>Report of a new mutation in <I>CYBB </I>gene in two patients with X linked chronic granulomatous disease</B>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872006000800004&lng=&nrm=iso&tlng= Background: The X-linked form of chronic granulomatous disease (CGD) is a primary immunodeficiency that affects phagocytes of the innate immune system and is characterized by an increased susceptibility to severe bacterial and fungal infections. It is caused by mutations in the CYBB gene, which encodes the 91-kD subunit of phagocyte NADPH oxidase. Aim: To identify the mutation in the CYBB gene in two unrelated patients from Chile with the diagnosis of X-linked CGD and their families. Patients and methods: The molecular genetic defects of two unrelated patients from Chile with X-linked CGD caused by defects in the CYBB gene were investigated. The underlying mutation was investigated by single strand conformation polymorphism (SSCP) analysis of PCR-amplified genomic DNA and by sequencing of the affected gene region. Results: We found an insertion c.1267_1268insA in exon 10 leading to a frameshift mutation. This mutation is a novel report. We also identified a splice site mutation in the other patient, that presented a c.1326 +1 G>A substitution in intron 10. The mutation was also detectable in his heterozygous mother. Conclusions: This is the first report of the clinical and molecular characterization of Chilean patients with mutations in CYBB gene (Rev Méd Chile 2006; 134: 965-72) <![CDATA[<B>Multidisciplinary treatment of eating disorders in Chilean adolescents and young adults</B>: <B>Six months outcome</B>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872006000800005&lng=&nrm=iso&tlng= Background: Eating disorders may have serious organic consequences derived from under nutrition, specific nutrient deficiencies and electrolytic disturbances and reach a mortality as high as 12%. Aim: To describe the features and outcome after six months of treatment of patients attending the Eating Disorders Unit at the Catholic University Hospital in Chile. Material and methods: Review of medical records of patients with eating disorders that received a multidisciplinary treatment by a team of nutritionists, psychiatrists and psychologists and were seen at least twice in a period of six months. Results: The records of 81 patients (mean age 16.3±3 years, only one male) were included in the review. Forty nine patients had Anorexia Nervosa of the restricting type, five of the purging type, 22 had Bulimia Nervosa of the purging type and two of the non purging type and three patients had an eating disorder not otherwise specified. Eighty percent consulted within the first year of symptom appearance. Sixty five percent came from families with both parents living together, 57% had a rigid and agglutinated family structure and 65% had occult crises. Depression or dysthymia was found in 45% of patients and drug therapy was required at the beginning of treatment in 25%. Obsessive traits (40.4%) were significantly related to restrictive eaters. A past history of obesity or overweight was common. After six months of treatment, body mass index increasing significantly in restrictive eaters with obsessive traits and occult family crises was noticed. Conclusions: A multidisciplinary therapeutic intervention improved body mass index and family symptoms in patients with restrictive eating disorders (Rev Méd Chile 2006; 134: 973-80). <![CDATA[<B>Genotypying of clinical isolates of <I>Helicobacter pylori</I> by cagA, vacA and babA2 virulence associated genes</B>: <B>First detection of a babA2 positive strain in Chilean patients</B>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872006000800006&lng=&nrm=iso&tlng= Background: Helicobacter pylori-associated gastroduodenal diseases depends on host characteristics, environmental conditions and bacterial virulence factors, such as cagA, vacA y babA2 gene products. Moreover, peptic ulcer disease has been related with cagA+, vacAs1m1 strains, while metaplasia and gastric cancer has been associated to cagA+, vacAs1 and babA2+ H pylori strains. Gene babA2 has not yet been described in clinical isolates from Chilean patients. Aim: To investigate the presence of cagA, vacA (s and m) and babA2 genes in clinical isolates of H pylori from Chilean patients. Material and Methods: Sixty six isolates from 41 patients were genotyped by PCR, using primers for s1a, s1b, s2, m1, m2, cagA and babA2 genes as previously described. Results: cagA gene was detected in 16 isolates (24.2%) while vacAs1a, vacAs1b, vacAs2, vacAm1 and vacAm2 were detected in 28 (42.4%), 14 (21.2%), 17 (25.8%), 21 (31.8%) and 29 isolates (43.9%), respectively. One isolate (1.5%) was babA2 positive, being the first isolate with this genotype described in Chile. Besides the babA2+ genotype this clinical isolate also presented cagA+ and vacAs1a which has been related with metaplasia or gastric cancer. Five isolates showed an ulcerogenic profile cagA+, vacAs1m1. Conclusions: The results presented indicate the prevalence of vacAs1m1 genotype among the clinical isolates analyzed, and a low frequency of babA2 genotype (Rev Méd Chile 2006; 134: 981-8). <![CDATA[<B>Results of surgical treatment for acromegaly in 53 patients</B>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872006000800007&lng=&nrm=iso&tlng= Background: The treatment of choice for acromegaly is surgery that, according to the literature, is curative in 91% of pituitary microadenomas and 73% of macroadenomas. Aim: To report the results of surgical treatment in 53 patients with acromegaly. Material and methods: Retrospective review of medical records of all patients with acromegaly, operated between 1984 and 2004. When necessary, patients were contacted by telephone to complete information or to perform biochemical or imaging studies. A normal value of insulin like growth factor I (IGF-1) for age and sex, a growth hormone (GH) nadir of less than 1 ng/ml during a glucose tolerance test or a basal GH of less than 2.5 ng/ml, all assessed three months after surgery, were considered as criteria for cure. Results: Biochemical cure was achieved in 67% of patients with pituitary microadenomas and 21% of patients with macroadenomas. In 47% of patients with neuro-ophtalmological involvement, a partial or total recovery in the visual field defect was achieved. The most common surgical complications were transient diabetes insipidus in 19%, persistent diabetes insipidus in 4% and cerebrospinal fluid fistula in 4%. A lower size of the tumor and lower preoperative growth hormone levels were associated with a better chance of cure. Conclusions: The cure rates obtained in this group of patients are clearly lower than those reported abroad. These results stress the importance of having a national registry of acromegaly and the need to train neurosurgeons in the treatment of pituitary tumors (Rev Méd Chile 2006; 134: 989-96). <![CDATA[<B>Screening colonoscopy among first degree relatives of patients with colorectal carcinoma</B>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872006000800008&lng=&nrm=iso&tlng= Background: First degree relatives of patients with colorectal carcinoma are at a higher risk of having the disease than the general population. Therefore, they should be subjected to screening colonoscopy. Aim: To assess the effectiveness of colonoscopy among first degree relatives of patients with colorectal carcinoma. Material and methods: A free colonoscopy was offered to first degree relatives of patients operated on for colorectal cancer between 1998 and 2000. As inclusion criteria, subjects had to be asymptomatic, older than 40 years or less than 10 years younger than the index case. Each subject was contacted twice, inviting him/her to have a colonoscopy performed. Results: Two hundred forty three relatives were contacted for the study and in 76, a colonoscopy was performed. Among the latter, a neoplasm was found in 13 (17%): One adenocarcinoma and 12 adenomas. Three of these lesions were located in the right colon. The main reason given by the 176 subjects that did not agree to have a colonoscopy was lack of interest. Conclusions: Screening colonoscopy is effective to detect adenoma and adenocarcinomaamong first degree relatives of patients with colorectal carcinoma, however only 31% of all potential relatives agreed to undergo a colonoscopy (Rev Méd Chile 2006; 134: 997-1001) <![CDATA[<B>Immunohistochemical expression of the E-cadherin-catenin complex in gastric cancer</B>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872006000800009&lng=&nrm=iso&tlng= Background: The E-cadherin/catenin complex plays an essential role in the control of epithelial differentiation. Abnormal expression in tumors correlates with histological grade, advanced stage and poor prognosis. Aim: To evaluate the expression pattern of E-cadherin/catenin complex in gastric carcinoma and analyze their association with tumor clinicopathological features and patient survival. Material and Methods: Inmunohistochemical staining of E-cadherin, alpha and ß-catenin was performed from paraffin specimens of 65 gastric carcinomas. Results: Abnormal expression of E-cadherin, alpha and ß-catenin was demonstrated in 82%, 85% and 88% of gastric carcinomas, respectively. There was a significant correlation between abnormal expression and Lauren pathological classification and depth of infiltration, but not with tumor stage, positive lymph node metastases and survival. Conclusion: Abnormal expression of E-cadherin, alpha and ß-catenin occurs frequently in gastric carcinoma and correlates with histological grade (Rev Méd Chile 2006; 134: 1002-9). <![CDATA[<b>Brain and spinal cord magnetic resonance imaging in spastic paraparesis associated to human T-lymphotropic virus</b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872006000800010&lng=&nrm=iso&tlng= Background: The spastic paraparesis associated to HTLV-1 causes degenerative pyramidal tract lesions of the spinal cord and affects cortical-nuclear connections in the brain. Aim: To report the findings of magnetic resonance imaging in patients with spastic paraparesis. Material and methods: A magnetic resonance imaging of the brain and spinal cord was performed in 30 patients (24 females), mean age and evolution of 56 and 12 years respectively, with a clinical and virological diagnosis of tropical spastic paraparesis/HTLV-1 associated myelopathy (TSP/HAM). Results: No patient had abnormal signals in the spinal cord parenchyma. However, an atrophy of the dorsal segment was observed in 87% of patients. Patients with the highest degree of atrophy showed a higher degree of functional impairment. Eleven patients had spinal cord conus atrophy, associated to neurogenic bladder or impotency. In 80% of patients, hyperintense subcortical white matter images in DP, T2 and Flair, mostly bi frontal, were detected. In half of them, small rounded and isolated images were observed. In the other half, eight or more images, generally larger and occasionally confluent, were found. Ten of 12 patients with confluent brain lesions showed different degrees of cognitive impairment. No patient had lesions in the corpus callosus, periventricular white matter, pons, medulla oblongata or cerebellum. Conclusions: Most patients with tropical spastic paraparesis have alterations in brain or spinal cord magnetic resonance imaging. The magnetic resonance lesions are concordant with functional impairment. The characteristics of the imaging in TSP/HAM patients can be helpful in the differential diagnosis of patients with paraparesis (Rev Méd Chile 2006; 134: 1011-20). <![CDATA[<B>Ventricular assist device as a bridge to transplant in patients with cardiogenic shock</B>: <B>Report of four patients</B>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872006000800011&lng=&nrm=iso&tlng= Hospitalization and death due to heart failure and cardiogenic shock is frequent and currently is increasing among the adult population. Although cardiac transplantation is the most effective treatment in patients with end-stage heart failure, its availability is limited. While waiting for transplantation, some patients become refractory to treatment and deteriorate progressively. Secondary multi-organ damage could highly compromise the transplant success and also could contraindicate it. Mechanical ventricular assist devices allow reestablishing normal cardiac output and they have been used as a bridge to recovery and transplantation. We report four patients that underwent mechanical ventricular support using the ABIOMED BVS 5000® system as a bridge for transplantation. Two patients were connected to biventricular assistance; a third patient was connected to a left ventricular support and the fourth to a right ventricular support. Three were successfully transplanted and one died of refractory non-cardiogenic shock. There were no complications related to the support system, such as infection, hemorrhage or stroke. In our experience, the ABIOMED BVS 5000® was an effective strategy as a bridge to heart transplant in patients in cardiogenic shock (Rev Méd Chile 2006; 134: 1019-23). <![CDATA[<B>Endoluminal stent-graft placement for acute dissection of the descending aorta complicated with rupture</B>: <B>Report of one case</B>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872006000800012&lng=&nrm=iso&tlng= Acute dissection of the aorta, although not common, has early and highly lethal complications. The type A dissection is treated with surgery. Patients with type B dissections are treated with surgery if they have complications like rupture, growth or visceral ischemia. Surgery, however, has complications such as spinal cord ischemia. Endovascular grafts have less mortality and complications. We report a 59 years old male patient with a type B dissection complicated with rupture. He was treated successfully with the placement of an endoluminal graft. He was discharged five days after the procedure in good conditions. After one year of follow up, the patient remains asymptomatic (Rev Méd Chile 2006; 134: 1024-9). <![CDATA[<B>Streptococcus constellatusas a causative agent of empyema</B>: <B>Report of one case</B>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872006000800013&lng=&nrm=iso&tlng= Streptococcus constellatus is a commensal microorganism in man but may cause infections in different locations. We report a 59 years old male with severe sequelae of a previous cerebrovascular accident that consulted in the emergency room for fever of 15 days of evolution. A right empyema was diagnosed. The bacteriological culture of the effusion disclosed the presence of Streptococcus constellatus and two anaerobic strains (Prevotella intermedia and Fusobacterium urealyticus). The patient was treated with a pleural drainage and received ceftriaxone and clindamycin during six weeks. He was discharged in good conditions and is asymptomatic after eight months of follow up (Rev Méd Chile 2006; 134: 1030-2) <![CDATA[<B>Gut barrier in the critically ill patient</B>: <B>facts and trends</B>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872006000800014&lng=&nrm=iso&tlng= The disturbances of gut barrier in critically ill patients may influence their outcome and prognosis. Experiments in animals show that fasting and stress collaborate to produce intestinal atrophy and translocation of microorganisms and toxins. This fact is one of the main arguments to promote the use of early enteral feeding in critically ill patients. However, the intestinal barrier behaves differently in humans than in animals. The human enteral cells have a good tolerance to fasting and stress, mucosal atrophy is mild and it is not always associated with changes in intestinal permeability. Moreover, the relationship between intestinal permeability with sepsis and bacterial translocation is controversial. This last phenomenon also happens in normal subjects and may be a mechanism to build immunological memory. One of the most important factors that influence bacterial translocation is the microorganism, that under stress conditions can adhere to the intestinal cell and penetrate the intestinal barrier. Splanchnic ischemia and reperfusion is one of the main pathogenic factors in the failure of intestinal barrier. Finally, the fact that the small bowel is an inflammatory target of extra intestinal injuries, explains several clinical situations. The pathophysiology of the intestinal barrier definitely requires more research (Rev Méd Chile 2006; 134: 1033-39). <![CDATA[<B>Wine, fibrinolysis and health</B>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872006000800015&lng=&nrm=iso&tlng= Cardiovascular diseases are the leading cause of death in both men and women in the world. Epidemiological and experimental studies have associated moderate wine consumption (1 to 2 glasses/day) with a decrease in cardiovascular diseases. This decrease is probably due to the effect of ethanol and polyphenols present in the wine. The cardioprotective benefit of wine may be due, in part, to a modulation of the expression of proteins involved in fibrinolysis. Endothelial cells (ECs) play a major role in maintaining normal hemostasis, regulating the balance between the synthesis and interaction of proteins that promote clot formation (thrombosis) and fibrinolytic proteins that facilitate clot lysis. These cells are a major site of synthesis of fibrinolytic proteins, such as tissue type plasminogen activator (t-PA), urokinase-type plasminogen activator (u-PA) and the major inhibitor/regulator of fibrinolysis, PAI-1. EC-mediated fibrinolysis is regulated and localized to the EC surface through specific receptors for u-PA, t-PA and plasminogen. Evidence indicates that ethanol and polyphenols present in wine increase EC localized fibrinolisis. Upregulation of t-PA and u-PA activity and downregulation of PAI-1 may account, at least in part, for this net increase in fibrinolytic activity. The purpose of this review is to cover the main molecular and physiological aspects of moderate wine consumption mediated increase in fibrinolysis and reduction in cardiovascular risk (Rev Méd Chile. 2006; 134: 1040-8). <![CDATA[<B>Recommendations for the nutritional assessment of critically ill patients</B>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872006000800016&lng=&nrm=iso&tlng= Undernutrition affects 30 to 50% of hospitalized patients. The identification of patients with undernutrition or in risk to become undernourished is of utmost importance to prescribe a timely nutritional support. This article performs a critical review of anthropometrical, biochemical and functional parameters used for nutritional assessment. Prognostic indexes and other parameters used for the assessment of nutritional risk are also discussed. Some tools are proposed for the diagnosis of hospital malnutrition (Rev Méd Chile 2006; 134: 1051-8). <![CDATA[<B>Availability of physicians in Chile at the year 2004</B>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872006000800017&lng=&nrm=iso&tlng= Background: The number of physicians available in a given country, their efficiency, quality and specialization is of utmost epidemiological importance. Aim: To evaluate the availability of physicians in Chile. Material and methods: The information about the number of physicians in Chile up to the year 2004, was obtained from the Ministry of Health, national universities and the register of immigrant physicians since 1950. Results: The total number of physicians licensed to practice was 25,542, of whom 2,700 are immigrants. The physician/inhabitant ratio increased from 1/921 in 1998 to 1/612 in 2004. The greater impact in the increment of available physicians was given by the immigration of professionals and by the increase in the number of physicians graduated from national universities, mainly from the new private universities. Forty two percent of physicians work at public services and 61% of these are certified specialists. The regional distribution of general practitioners and basic specialists is adequate. Along the country, the mean physician/beneficiary ratio is 8.45/10,000, the specialist/beneficiary ratio is 4.9/10,000 and the general practitioner/beneficiary ratio is 2.3/10,000. Conclusions: The national information of available physicians, especially in the private sector, should be improved. Immigration of physicians should be regulated, maintaining validation examinations and a National Medical Test to assess medical proficiency should be instituted (Rev Méd Chile 2006; 134: 1057-64). <![CDATA[<B>Valsalva: much more than a simple maneuver</B>: <B>Antonio Maria Valsalva (1666-1723)</B>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872006000800018&lng=&nrm=iso&tlng= Valsalva is a term commonly used to designate a special maneuver, consisting in a forced expiratory effort against a closed airway. We use Valsalva's maneuver many times in our clinical practice and we usually do not think about its origin. Most people do not know that this was originally described by an outstanding anatomist, surgeon and pathologist, Antonio Maria Valsalva, the mentor of another great anatomist, Giovanni Battista Morgagni. Valsalva's contribution was vast and description of Valsalva's maneuver was only a small fraction of the legacy that he left us, almost three hundreds years ago. We render a tribute to a great man, and learn about his life and work (Rev Méd Chile 2006; 134: 1059-62). <![CDATA[<B>Clinical guidelines in ischemic vascular strokes, in Chile</B>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872006000800019&lng=&nrm=iso&tlng= Valsalva is a term commonly used to designate a special maneuver, consisting in a forced expiratory effort against a closed airway. We use Valsalva's maneuver many times in our clinical practice and we usually do not think about its origin. Most people do not know that this was originally described by an outstanding anatomist, surgeon and pathologist, Antonio Maria Valsalva, the mentor of another great anatomist, Giovanni Battista Morgagni. Valsalva's contribution was vast and description of Valsalva's maneuver was only a small fraction of the legacy that he left us, almost three hundreds years ago. We render a tribute to a great man, and learn about his life and work (Rev Méd Chile 2006; 134: 1059-62). <![CDATA[<B>Preliminary validation of a smelling test in a sample of Chilean population and its role in the differential diagnosis of Parkinson´s disease</B>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872006000800020&lng=&nrm=iso&tlng= Valsalva is a term commonly used to designate a special maneuver, consisting in a forced expiratory effort against a closed airway. We use Valsalva's maneuver many times in our clinical practice and we usually do not think about its origin. Most people do not know that this was originally described by an outstanding anatomist, surgeon and pathologist, Antonio Maria Valsalva, the mentor of another great anatomist, Giovanni Battista Morgagni. Valsalva's contribution was vast and description of Valsalva's maneuver was only a small fraction of the legacy that he left us, almost three hundreds years ago. We render a tribute to a great man, and learn about his life and work (Rev Méd Chile 2006; 134: 1059-62). <![CDATA[<b>Crónica</b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872006000800021&lng=&nrm=iso&tlng= Valsalva is a term commonly used to designate a special maneuver, consisting in a forced expiratory effort against a closed airway. We use Valsalva's maneuver many times in our clinical practice and we usually do not think about its origin. Most people do not know that this was originally described by an outstanding anatomist, surgeon and pathologist, Antonio Maria Valsalva, the mentor of another great anatomist, Giovanni Battista Morgagni. Valsalva's contribution was vast and description of Valsalva's maneuver was only a small fraction of the legacy that he left us, almost three hundreds years ago. We render a tribute to a great man, and learn about his life and work (Rev Méd Chile 2006; 134: 1059-62).