Revista medica de Chile最新文献

{"title":"Phase IIa randomized placebocontrolled clinical trial to evaluate the efficacy of bromhexine in combination with standard therapy in the early treatment of COVID-19 in primary care patients.","authors":"David Ramírez, Romina Rojas, Humberto Fierro, Daniela Alejandra Nova, Georgina M Renard, Estibaliz Ampuero, Jorge Fuentealba, Ana Martínez, Carmen Gil, Miguel Reyes-Parada","doi":"10.4067/s0034-98872024001201198","DOIUrl":"10.4067/s0034-98872024001201198","url":null,"abstract":"<p><p>The continuous appearance of SARS-CoV-2 variants with both increased transmission and immune evading potential, in addition to the reluctance of some populations to be vaccinated, supports the search for alternative treatments to protect against the viral infection consequences. Bromhexine is a well-known, over-the counter, expectorant which have garnered interest for the potential prevention and treatment of COVID-19.</p><p><strong>Aim: </strong>To evaluate the efficacy of oral bromhexine in patients with mild to moderate symptomatic active SARS-CoV-2 infection.</p><p><strong>Methods: </strong>A randomized, placebo-controlled clinical trial assessing the effectiveness of oral bromhexine in outpatients with active SARS-CoV-2 infection. Adult patients diagnosed with active SARS-CoV-2 infection (n= 36) were randomly assigned (1:1) to receive bromhexine or placebo, with both groups also receiving standard care. The primary efficacy endpoint was viral load reduction (day 4 vs. baseline), while reductions of a series of COVID-19 clinical symptoms were considered as secondary endpoints.</p><p><strong>Results: </strong>No differences in the viral load at different times after the initiation of treatment were observed. In addition, no differences between groups were detected in most of the clinical symptoms evaluated. Remarkably, a significant decrease in the percentage of patients with cough was observed at days 5-7 in the bromhexine group, an effect that was not apparent in the group receiving a placebo.</p><p><strong>Conclusions: </strong>Since coughing is one of the primary forms of transmission for SARS-CoV-2, the observed reduction of coughing might be highly beneficial, particularly for patients living in crowded, poorly ventilated, or confined environments.</p>","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"152 12","pages":"1198-1208"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Transition of Adolescents with Chronic Kidney Disease: A Critical Challenge in Continuity of Care].","authors":"Hans Müller-Ortiz, Cecilia de La Maza Cariola, Yela Zambrano Coronel, Jaime Muñoz Pérez, Patricia Sánchez Krause","doi":"10.4067/s0034-98872024001201265","DOIUrl":"https://doi.org/10.4067/s0034-98872024001201265","url":null,"abstract":"","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"152 12","pages":"1265-1266"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Development of a Curriculum Innovation Model Competency based for Medical Specialties: Experience of the Radiology Program of a Chilean University].","authors":"Sandra Araya L, Jorge Díaz J, Mónica Espinoza B, Ana María Rojas-Serey","doi":"10.4067/s0034-98872024001201209","DOIUrl":"10.4067/s0034-98872024001201209","url":null,"abstract":"<p><p>The Educational Project (PE) of the University of Chile is framed within a competency-based curriculum (CBC) approach. In 2017, the Radiology Program of the Faculty of Medicine began its transition to this model, in which graduates must demonstrate their competencies in all essential aspects of performance defined for their professional profile.</p><p><strong>Aim: </strong>To describe the experience in the development of the curriculum innovation plan for the specialty program in radiology at the University of Chile.</p><p><strong>Methods: </strong>The work was organized into stages, including identifying educational demands, defining performance areas, drafting competencies, and synthesizing the graduate profile, followed by internal and external validation, dissemination, and creation of course/rotation programs. The guiding principles considered in the process were: advisory and support provided by medical education specialists, transparency, participation, and curricular validity, all developed collaboratively with the academic staff and under the leadership of the program authorities.</p><p><strong>Results: </strong>Key factors for the success of the work included institutional support and backing from program authorities, ongoing advisory, the use of a Gantt chart for guidance, and active participation from faculty members. Weaknesses included the difficulty in engaging the entire academic staff and the limited time of participants. Both issues were addressed through the flexible participation of representatives from each area, support from curriculum advisors, and the use of mass communication systems.</p><p><strong>Conclusions: </strong>In summary, an updated, relevant, and coherent program was successfully developed, aligned with the expected profile and the healthcare needs of our country, and one that can be monitored and adjusted over time.</p>","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"152 12","pages":"1209-1218"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Sociodemographic and Health Characterization of Transgender Individuals Enrolled in the Gender Identity Support Program at a Public Hospital in Chile from 2013 to 2023].","authors":"Pablo Contreras Gálvez, Jacqueline Del Río Valdebenito, Leonardo Lafuente Astroza","doi":"10.4067/s0034-98872024001201185","DOIUrl":"10.4067/s0034-98872024001201185","url":null,"abstract":"<p><p>There are a few publications that quantify the sociodemographic profiles of the \"trans\" population.</p><p><strong>Aim: </strong>To describe the sociodemographic and health profiles of the \"trans people\" who have entered the Gender Identity Support Program in a Public Hospital in the Province of Osorno, Chile.</p><p><strong>Methods: </strong>A descriptive methodology was used. The population included corresponds to the entire universe of people in the statistical registry of the Gender Identity Support Program of the Base Hospital San José de Osorno between 2013 and the first semester of 2023. A univariate statistical analysis was performed.</p><p><strong>Results: </strong>A wide age dispersion between 17 to 77 years old was observed, with an average of 20.4 and a standard deviation of 30.3. An increasing number of incorporations since 2018 to date. The identification with the male gender stands out at 70.00%, with the female gender at 26,66%, and in the remaining 3,33%, those who identify as non-binary. There is a high employment rate (97,96%), and in 80% of the cases, someone is considered a \"significant person/support\" in his/her transition. In 31,66% of the cases, there is a history of self-inflicted injuries, 51,66% have a mental health history, and 34,14% of them have a history of cardiovascular pathologies. All the people admitted to the program requested accompaniment by the mental health team.</p><p><strong>Conclusions: </strong>A sociodemographic and health profile was identified in the population participating in the Osorno Hospital's gender identity support program. Given that only this population was consulted, studies should be conducted in the general population if the aim is to describe more precisely the profile of trans persons in Chile and determine their real demand.</p>","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"152 12","pages":"1185-1197"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effects of Gender Transition on the Mental Health Perception of Transgender People in Chile].","authors":"Marais Del Río Martín, Sarah Paz Martín, Jaime Barrientos Delgado","doi":"10.4067/s0034-98872024001201219","DOIUrl":"10.4067/s0034-98872024001201219","url":null,"abstract":"<p><p>Gender transition is a significant identity milestone in the lives of trans people and serves as a protective factor for their mental health. However, its impact has been insufficiently explored in research on the mental health of this population. Furthermore, the effects of other factors identified by the Minority Stress Model have been evaluated separately, which hinders a comprehensive understanding of the phenomenon.</p><p><strong>Hypothesis: </strong>Indicators associated with gender transition will have a positive effect on the mental health of trans people. The effect of the duration of the transition on mental health will vary according to the level of internalized transphobia.</p><p><strong>Aim: </strong>To examine the impact of the gender transition process on the perception of mental health among Chilean trans people.</p><p><strong>Methods: </strong>A total of 377 participants were recruited. A self-administered questionnaire was used, including measures related to the transition process, internalized transphobia, experiences of discrimination, connection with the trans community, and perception of mental health. The data were analyzed using multiple linear regression.</p><p><strong>Results: </strong>The indicators examined showed a significant correlation with the perception of mental health. When evaluating their contribution in the presence of other variables, the unique contribution of some variables was not significant. Satisfaction with the transition process was associated with a better perception of mental health. Among participants who scored high in internalized transphobia and had been in the transition process for a short time, the perception of mental health was lower. Experiencing discrimination was associated with a worse perception of mental health. People assigned male at birth had a better perception of mental health than those assigned female.</p><p><strong>Conclusions: </strong>The gender transition process, together with indicators of the Minority Stress Model, uniquely impacts the mental health of trans people in Chile. Uderstanding its unique contribution enables healthcare providers to adopt culturally sensitive care tailored to the specific needs of this population.</p>","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"152 12","pages":"1219-1229"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Cannabis Use, Emotional Dysregulation, and Impulsivity: An Analytical Cross-Sectional Study].","authors":"Felipe Moraga, Alejandra Rojo, Ulises Ríos, Marcelo Arancibia","doi":"10.4067/s0034-98872024001201230","DOIUrl":"10.4067/s0034-98872024001201230","url":null,"abstract":"<p><p>The relationship between emotional regulation, impulsivity and cannabis use is complex and has been scarcely studied in Chile.</p><p><strong>Aim: </strong>To analyze the relationship between emotional dysregulation, impulsivity, age of onset and patterns of cannabis use in Chilean adults.</p><p><strong>Methods: </strong>An analytical cross-sectional study was carried out. The DERS-E (emotional dysregulation) and UPPS-P (impulsivity) scales were applied and sociodemographic variables were collected.</p><p><strong>Results: </strong>Sixty-four participants (45% female) were included, with an average age of 34.8 ± 10.8 years. Forty-five percent initiated use before the age of 18 years, a group that showed significantly higher levels of emotional dysregulation and total impulsivity. Forty-four percent had regular cannabis use. Thirty-nine percent of regular users showed scores consistent with emotional dysregulation, versus 14% of intermittent users (p= 0.02). The total score and all dimensions of DERS-E were significantly higher in regular users, but there were no differences in impulsivity dimensions according to use pattern. There were significant and positive correlations between DERS-E and UPPS-P dimensions, with the highest magnitude being the correlation between DERS-E total score and the \"negative urgency\" dimension (r= 0.505).</p><p><strong>Conclusions: </strong>Cannabis users with early onset and habitual pattern present greater emotional dysregulation. Impulsivity is higher in the group that started use before 18 years of age, but there are no differences according to the pattern of use. Prospective studies should clarify the relationship between emotional dysregulation, impulsivity, and cannabis use. We suggest implementing early therapeutic strategies focused on emotional regulation.</p>","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"152 12","pages":"1230-1240"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Percutaneous Aortic Valve Implantation: What Should We Know?]","authors":"Pabla Cataldo, Christian Dauvergne, Jorge Sandoval, Fernando Pineda, Scott Lim","doi":"10.4067/s0034-98872024001201249","DOIUrl":"10.4067/s0034-98872024001201249","url":null,"abstract":"<p><p>In 2002, Alan Cribier revolutionized interventional cardiology by implanting the first transcatheter aortic valve (TAVI) in a man with symptomatic, inoperable severe aortic stenosis (AS).</p><p><strong>Aim: </strong>To generate a didactic review of the current literature on AS and TAVI.</p><p><strong>Method: </strong>Qualitative study through a narrative review of the historical perspective, prevalence, and diagnosis of AS, devices currently available for TAVI, and basic considerations on the technique, evidence-based patient selection, and possible complications.</p><p><strong>Results: </strong>Severe AS and TAVI have a lot of evidence in all the scenarios studied, with evident and explosive growth. The well-established diagnosis by echocardiogram can be supported in certain circumstances by other imaging techniques that can clarify ambiguities. Adequate patient assessment and planning will always be the fundamental pillar for the success of the technique, which has a wide range of devices that must be chosen according to the patient's needs, and implanted by a trained team to ensure quality and safety.</p><p><strong>Conclusions: </strong>22 years after the first TAVI, we have a minimally invasive procedure that has established itself as a safe and effective alternative to surgical valve replacement.</p>","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"152 12","pages":"1249-1261"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Chronic Non-Communicable Diseases: A New Perspective].","authors":"Nicolás Fernández B","doi":"10.4067/s0034-98872024001201262","DOIUrl":"https://doi.org/10.4067/s0034-98872024001201262","url":null,"abstract":"","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"152 12","pages":"1262-1264"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Nutritional Deficiencies in Bariatric Surgery: A Guide for General Practitioners].","authors":"Milenko Grimoldi, María Jesús Irarrazaval, Manuel Moreno, Nicolás Moreno, Fernando Crovari, Nicolás Quezada","doi":"10.4067/s0034-98872024001201241","DOIUrl":"10.4067/s0034-98872024001201241","url":null,"abstract":"<p><p>Obesity is a pandemic that affects nearly a third of the world's population, and its medical treatment has not achieved satisfactory or sustained results over time. Its counterpart, bariatric surgery (BS), has seen significant growth in recent years due to its favorable outcomes in weight loss and the resolution of comorbidities associated with obesity. Changes in diet, associated with the anatomical and physiological alterations resulting from BS, can lead to complications such as protein-calorie malnutrition and micronutrient deficiencies. Therefore, non-specialist physicians must be informed about these potential issues to ensure timely diagnosis and proper treatment. In this literature review, based on our center's years of experience as a national reference in bariatric surgery, we present the main nutritional complications associated with BS.</p>","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"152 12","pages":"1241-1248"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Diversity and Institution: Scopes for Health Sciences Education].","authors":"Javiera Ortega-Bastidas, Olga Matus-Betancourt, Cristhian Pérez-Villalobos, Mary Jane Schilling-Norman, Camila Espinoza-Parçet","doi":"10.4067/s0034-98872024000800847","DOIUrl":"https://doi.org/10.4067/s0034-98872024000800847","url":null,"abstract":"<p><p>With the growing access to higher education, the university population has become increasingly heterogeneous. This situation has forced educational institutions to rethink their work. Health schools, specifically, must not only ensure the acquisition of technical-professional competencies, but also promote comprehensive training in students in this area.</p><p><strong>Aim: </strong>To understand the diversity in health students and the institutional implications for educational training.</p><p><strong>Method: </strong>Qualitative study, based on Grounded Theory. Group interviews and semi-structured interviews were conducted with 11 teachers and 25 students of health careers. An analysis was performed through constant comparison method up to axial coding level, using Atlas-ti 7.5.2.</p><p><strong>Results: </strong>A central phenomenon emerges around the institution's valuation of diversity, which should have didactic and curricular adaptations, as well as the necessary accompaniments for them.</p><p><strong>Discussion: </strong>Institutions must guarantee access, full participation, and meaningful learning for all their students. To this end, a culture that values diversity and translates into institutional policies.</p>","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"152 8","pages":"847-855"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}