Revista medica de Chile最新文献

[Association between pain and depression in chilean older adults. Reality that requires an immediate approach]. [智利老年人疼痛与抑郁之间的关系。需要立即解决的现实问题]。

Revista medica de Chile Pub Date : 2024-01-01 DOI: 10.4067/s0034-98872024000100069

María Del Pilar Ureta Fernández, Lydia Lera, Cecilia Albala

{"title":"[Association between pain and depression in chilean older adults. Reality that requires an immediate approach].","authors":"María Del Pilar Ureta Fernández, Lydia Lera, Cecilia Albala","doi":"10.4067/s0034-98872024000100069","DOIUrl":"https://doi.org/10.4067/s0034-98872024000100069","url":null,"abstract":"ABASTRACT Background: To study the association between pain and depression, its characteristics and related factors in chilean older adults.Methods: Cross-sectional analytical study of the National Survey of Dependence in Chilean older adults 2009, with a sample of 4766 people aged 60 years and older. Pain was described using a Likert scale from \"no pain\" to \"very much pain\". Depression was measured using the GDS-15 scale. Adjusted logistic regression analyses were performed to identify the association between pain and depression.Results: 70% of the sample reported pain, 21.6% of high intensity. The screening was positive for depression in 23% of the sample, and 5% suspected severe depression. Both conditions were more frequent in women, subjects with low levels of schooling and rural residence. There was an association between pain and depression OR 3.46. The greater the intensity of pain, the greater the association OR 5.2 (95% CI 4.1-6.7) for depressive symptoms and OR 13.9 for suspected severe depression (95% CI 8.1-23.9).Conclusion: The association between pain and depression is high and is related to pain intensity, being higher in people with less education and physical dependency. The high frequency of both conditions in Chilean elderly people and their serious consequences make it an urgent public health problem, aggravated as a consequence of the prolonged isolation due to the COVID-19 pandemic.","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305567","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}

引用次数: 0

[Intercultural characterization of the empathetic physician: Experiences of chronic patients of the chilean public health system]. [移情医生的跨文化特征：智利公共卫生系统慢性病患者的经历]。

Revista medica de Chile Pub Date : 2024-01-01 DOI: 10.4067/s0034-98872024000100019

Grimanessa González-Tapia, Mariana Lazzaro-Salazar, Teresa Margarita Torres-López

{"title":"[Intercultural characterization of the empathetic physician: Experiences of chronic patients of the chilean public health system].","authors":"Grimanessa González-Tapia, Mariana Lazzaro-Salazar, Teresa Margarita Torres-López","doi":"10.4067/s0034-98872024000100019","DOIUrl":"https://doi.org/10.4067/s0034-98872024000100019","url":null,"abstract":"Background: Empathy is a fundamental element of the physician-patient relationship for treatment and therapeutic adherence that has had to face significant changes due to the migrations of the health system in Chile.Aim: Characterize the empathetic physicians according to the perceptions of chronic patients during the encounter with national and foreign doctors in the public health system in the Maule Region.Methods: Qualitative study of exploratory-descriptive type. Twenty chronic patients from public health services in the Maule region were interviewed remotely using the free listing technique. A thematic processual qualitative analysis of the content and a descriptive quantitative analysis were carried out where the frequency and salience of the Smith index assisted by the Anthropac 4.98 software were obtained.Results: Seven categories of empathetic care were identified in the physicians-patient relationship: Affectivity (37%), Communication (19%), Attention (13%), Respect (12%), Research (9%), Knowledge (5%) and Efficiency (5%).Conclusions: The affective and psychoemotional aspects were more valued than the cognitive aspects of empathetic care. No differences were observed in assessing the empathetic care of patients seen by Chilean physicians and those treated by foreign physicians.","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305582","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}

引用次数: 0

[Early integration of palliative care; implications for people with chronic diseases]. [姑息关怀的早期整合；对慢性病患者的影响]。

Revista medica de Chile Pub Date : 2024-01-01 DOI: 10.4067/s0034-98872024000100102

Paula Vega Vega, Rina González Rodriguez, Moyra López Ramirez, Claudia Miranda Castillo

引用次数: 0

[Quaternary prevention in the Cardiovascular Health Program Rational use of complementary exams: A narrative review]. [心血管健康计划中的四级预防合理使用辅助检查：叙述性综述]。

Revista medica de Chile Pub Date : 2024-01-01 DOI: 10.4067/s0034-98872024000100088

Martín Plaza, Francisca Dabed, Sebastián Manzanares, Sebastián Lenz R

{"title":"[Quaternary prevention in the Cardiovascular Health Program Rational use of complementary exams: A narrative review].","authors":"Martín Plaza, Francisca Dabed, Sebastián Manzanares, Sebastián Lenz R","doi":"10.4067/s0034-98872024000100088","DOIUrl":"https://doi.org/10.4067/s0034-98872024000100088","url":null,"abstract":"Introduction: The Cardiovascular Health Program (PSCV), founded by the Ministry of Health of Chile (Minsal), is focused on the global cardiovascular risk of people with the purpose of preventing and reducing morbidity, disability and premature death caused by cardiovascular diseases, in congruence with its sanitary aims. Quaternary Prevention is defined as \"actions taken to protect individuals from medical interventions that are likely to cause more harm than good\". The PSVC's 2017 technical guidelines establish a battery of 11 complementary exams to request upon entering the program, however, neither the scientific evidence that supports them nor the periodicity of their request was mentioned. The aim of this revision is to evaluate the rationality of exams request, based on updated evidence, as a strategy for quaternary prevention and potential economic savings for the sanitary system.Methods: A narrative review was conducted through searches on databases, updated clinical guidelines and international recommendations about 11 complementary exams on the follow-up of Type 2 Diabetes and Hypertension.Results: Based on the data analysis, recommendations were made according to the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system.Conclusion: It was concluded that the costs of widely requested complementary exams could be reduced through a more efficient management guided by updated evidence. Our proposal entails changes in some processes and in the evaluation of fulfillment of the PSCV, as well as a deeper cost-effectiveness analysis of the recommendations in order to optimize the management of resources in primary health care.","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305588","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}

引用次数: 0

[Mitochondrial diseases and urolithiasis: Is there an association? Literature review about 2 cases]. [线粒体疾病与泌尿系统结石：有关联吗？关于 2 个病例的文献综述]。

Revista medica de Chile Pub Date : 2024-01-01 DOI: 10.4067/s0034-98872024000100111

Renato Navarro Capone, Alvaro Bofill, Lucas López, Gastón Astroza Eulufi

{"title":"[Mitochondrial diseases and urolithiasis: Is there an association? Literature review about 2 cases].","authors":"Renato Navarro Capone, Alvaro Bofill, Lucas López, Gastón Astroza Eulufi","doi":"10.4067/s0034-98872024000100111","DOIUrl":"10.4067/s0034-98872024000100111","url":null,"abstract":"Urolithiasis corresponds to the formation of stones in the urinary tract. It is a multifactorial metabolic disorder; its formation is related to oxidative stress and inflammatory processes. The mitochondria, for its part, is an intracellular organelle that plays a role in the regulation of intracellular oxidative stress and intracellular calcium homeostasis, both processes related to urolithiasis. Mitochondrial diseases are diverse pathologies that compromise different organs, including the urinary system.Materials: Two cases of patients with mitochondrial diseases under study are presented who debuted with urinary symptoms with septic shock caused by a ureterolithiasis complicated by urinary infection.Results: Different pathophysiological mechanisms have been proposed in the literature that relate the different mitochondrial diseases with the presence of urolithiasis. We divide them into direct damage mechanisms, that is, the dysfunctional mitochondria would act actively in the formation of urolithiasis, and indirect damage, in which the consequences of mitochondrial diseases in the urinary organs would be responsible for the lithiasis.Discussion: There are various reports of patients who have been studied for urolithiasis in the context of mitochondrial diseases. Among them, the possible pathophysiological associations reported are collected.Conclusion: Mitochondrial diseases are part of a group of pathologies whose characteristics have not been fully studied. They have a complex relationship with urolithiasis, despite not having been able to demonstrate causality. Studying them in this area would open a door to new treatments and prevention.","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305584","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}

引用次数: 0

[Portal vein embolization prior to major hepatectomy: A multidisciplinary approach for advanced liver tumors in Chile]. [肝大部切除术前的门静脉栓塞术：智利治疗晚期肝肿瘤的多学科方法]。

Revista medica de Chile Pub Date : 2024-01-01 DOI: 10.4067/s0034-98872024000100028

Sergio Riveros, María Jesús Irarrázaval, Antonio Peñailillo, Joaquín Hevia, Pablo Achurra, Eduardo Briceño, Eduardo Viñuela, Patricia Rebolledo, Nicolás Jarufe, Jorge Martínez, Luis Meneses, Martin Dib

{"title":"[Portal vein embolization prior to major hepatectomy: A multidisciplinary approach for advanced liver tumors in Chile].","authors":"Sergio Riveros, María Jesús Irarrázaval, Antonio Peñailillo, Joaquín Hevia, Pablo Achurra, Eduardo Briceño, Eduardo Viñuela, Patricia Rebolledo, Nicolás Jarufe, Jorge Martínez, Luis Meneses, Martin Dib","doi":"10.4067/s0034-98872024000100028","DOIUrl":"https://doi.org/10.4067/s0034-98872024000100028","url":null,"abstract":"Background: One of the main limitations to achieving a complete tumor resection in patients with technically resectable liver tumors is the presence of a small future liver remnant (FLR). Portal vein embolization (PVE) allows hypertrophy of the non-embolized lobe, reducing the risk of postoperative liver failure.Aim: To describe the experience of portal embolization prior to hepatectomy and its effectiveness in converting advanced unresectable liver tumors into resectable tumors.Methods: Non-concurrent cohort study. All patients who underwent PVE before hepatectomy between 2016 and 2020 in our center were included. Demographic and diagnostic variables, pre and post-PVE volumes, perioperative variables, and global and disease-free survival were analyzed.Results: Nineteen patients were included. Median age 66 (54-72) years and 57.9% (n= 11) were women. Bilateral metastases were present in 78.9% (n= 15). Sixteen patients (84.2%) received neoadjuvant chemotherapy. One patient (5.3%) had a complication after PVE. The median time between embolization and volumetry was 5.3 weeks (4.7-7.1). Median FLR before and after PVE were 19.8% (16.2-27.7) and 30% (25.2-40.5), respectively. The median percentage of hypertrophy was 48% (40.4-76.5). Fifteen patients (78.9%) underwent hepatectomy. Significant complications occurred in 26.6% (n= 4); among them, three patients (20%) presented postoperative liver failure.Conclusions: PVE is safe and effective in promoting FLR hypertrophy in the presence of chemotherapy, allowing patients with advanced liver tumors to undergo surgery with curative intent.","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305586","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}

引用次数: 0

[Comorbidity of obesity and smoking and their association with cardiometabolic risk factors: Results from the 2016-2017 National Health Survey]. [肥胖与吸烟的共病及其与心脏代谢风险因素的关联：2016-2017年全国健康调查的结果]。

Revista medica de Chile Pub Date : 2024-01-01 DOI: 10.4067/s0034-98872024000100007

Rodrigo Santis, Francisco Del Río, Claudia Bambs, Paula Margozzini, Marcela Babul, Florencia Santis, Sofía Herrera

{"title":"[Comorbidity of obesity and smoking and their association with cardiometabolic risk factors: Results from the 2016-2017 National Health Survey].","authors":"Rodrigo Santis, Francisco Del Río, Claudia Bambs, Paula Margozzini, Marcela Babul, Florencia Santis, Sofía Herrera","doi":"10.4067/s0034-98872024000100007","DOIUrl":"https://doi.org/10.4067/s0034-98872024000100007","url":null,"abstract":"Background: The comorbidity between obesity and smoking and its association with cardiometabolic risk factors has been little explored.Objectives: Describe the prevalence of such comorbidity and to explore its association with cardiometabolic risk factors.Methods: The study was based on the 2016-2017 Chilean National Health Survey and included 6,233 participants. The independent variables were general obesity according to Body Mass Index (BMI), central obesity measured by Waist-to-Height Ratio (WTHR) and Waist Circumference (WC), and daily tobacco consumption (DTC). The dependent variables were blood lipids, fasting glucose and blood pressure. The association analysis was performed by multivariate logistic regression and excluded subjects with a medical record of hypertension, diabetes mellitus and dyslipidemia to avoid reverse causality.Results: The prevalence of General obesity-DTC comorbidity was 7.7%, WTHR risk-DTC was 10.8% and elevated WC-DTC was 13.2%. A total of 3,132 participants were included in logistic regressions. General obesity alone, and DTC-general obesity comorbidity had statistically significant association with elevated triglycerides, decreased HDL, elevated non-HDL and total cholesterol, elevated fasting glucose, and elevated blood pressure. The comorbidities DTC-risk WTHR and DTC-increased WC were associated with increased triglycerides and non-HDL cholesterol. DTC alone was associated with elevated systolic blood pressure.Conclusion: DTC-general obesity comorbidity is more frequently associated with the cardiometabolic risk factors explored than DTC-central obesity comorbidity. Smoking cessation can be a cost-effective intervention in this risk comorbidity.","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305568","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}

引用次数: 0

[Evaluation of the state and implementation of the Hospital Clinical Forensic Units in Chile]. [评估智利医院临床法医室的状况和实施情况]。

Revista medica de Chile Pub Date : 2024-01-01 DOI: 10.4067/s0034-98872024000100128

Francisca Ortiz, Vivian González, Francisca Crispi

{"title":"[Evaluation of the state and implementation of the Hospital Clinical Forensic Units in Chile].","authors":"Francisca Ortiz, Vivian González, Francisca Crispi","doi":"10.4067/s0034-98872024000100128","DOIUrl":"https://doi.org/10.4067/s0034-98872024000100128","url":null,"abstract":"Background: Sexual violence has a several negative impact on women's health. Thus, the health system is a gateway for the multisector response to victims. In 2018, the Clinical Forensic Hospital Units (UCFH) in Chile were launched for this purpose.Objective: To evaluate the state of implementation of the UCFH in the health services (HS) in Chile.Method: This is a quantitative descriptive, cross-sectional study. A survey was designed and applied through the Google Forms platform to the managers of the care and prevention network for victims of sexual violence (VSV) of each SS. The contact of each manager was requested by each HS in three ways: transparency law, lobby law, and telephone. Each HS was classified according to the existence or not of UCFH and for each unit the availability of resources was evaluated according to the recommendations of the Technical Standard of Attention to VSV of the Ministry of Health. Also, the functioning of each unit during the pandemic was evaluated.Results: Twenty-four of the 29 HSs responded, of which 12 reported having UCFH. Of the 12 units, 50% had complete infrastructure, 58.3% had complete instruments, none had full human resources, 50% had partial HR, 50% had sampling complete, and 58. 3% had full health benefits. The function during the pandemic was affected in 25% of the units.Conclusion: Challenges persist in the implementation of the UCFH, with special limitations in the availability of human resources.","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305581","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}

引用次数: 0

[Management of pregnant women with deficiency of factor VII. Report of one case]. [孕妇 VII 因子缺乏症的管理。一例报告]。

Revista medica de Chile Pub Date : 2024-01-01 DOI: 10.4067/s0034-98872024000100119

Miguel López, Matías Fica, Verónica Soto, Francisco Samaniego

引用次数: 0

[Dying during the pandemic: Experiences of relatives of patients who died during the COVID-19 pandemic in Chile]. [在大流行期间死亡：智利 COVID-19 大流行期间死亡病人亲属的经历]。

Revista medica de Chile Pub Date : 2024-01-01 DOI: 10.4067/s0034-98872024000100036

Patricia Olivares, Victoria Lermanda, Paula Bedregal, Ignacio Neumann, Álvaro Lavín, Joaquín Márquez, Susana Muñoz

{"title":"[Dying during the pandemic: Experiences of relatives of patients who died during the COVID-19 pandemic in Chile].","authors":"Patricia Olivares, Victoria Lermanda, Paula Bedregal, Ignacio Neumann, Álvaro Lavín, Joaquín Márquez, Susana Muñoz","doi":"10.4067/s0034-98872024000100036","DOIUrl":"https://doi.org/10.4067/s0034-98872024000100036","url":null,"abstract":"Introduction: The COVID-19 pandemic marked a milestone in the history of medicine worldwide. Together with the humanitarian drama it represented, the problems that arose are promoting lines of research in multiple fields. One of these fields is the aspects related to medical communication and end-of-life care. This paper reports the experiences and perceptions of relatives of patients who died during the pandemic with a psychospiritual support intervention in a public hospital in the Metropolitan Region, Chile, called \"farewell\".Methods: A qualitative study was conducted with a phenomenological approach based on in-depth interviews. From this, categories were derived that allowed a systematization of the observation of the experiences.Results: Among the results, the impact of the circumstances and the communication provided by the medical team on grief should be highlighted. The use of the word \"farewell\" emerges as a useful, albeit ambiguous, communicative tool when it comes to adequately framing an end-of-life process.Conclusions: It is argued that the end of life is an area that requires physical and psychospiritual spaces, and adequate training at all levels to do justice to a highly relevant moment in the care of people.","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305579","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}

引用次数: 0