Revista medica de Chile最新文献_第10页

[Use of Artificial Intelligence in Diabetic Retinopathy Screening: Experience in a Health Service in Santiago, Chile]. [人工智能在糖尿病视网膜病变筛查中的应用：智利圣地亚哥卫生服务的经验]。

Revista medica de Chile Pub Date : 2024-11-01 Epub Date: 2025-02-03 DOI: 10.4067/s0034-98872024001101148

María C Ibañez-Bruron, Andrea Cruzat, Gonzalo Ordenes-Caviere, Marcelo Coria

{"title":"[Use of Artificial Intelligence in Diabetic Retinopathy Screening: Experience in a Health Service in Santiago, Chile].","authors":"María C Ibañez-Bruron, Andrea Cruzat, Gonzalo Ordenes-Caviere, Marcelo Coria","doi":"10.4067/s0034-98872024001101148","DOIUrl":"10.4067/s0034-98872024001101148","url":null,"abstract":"Early detection of diabetic retinopathy is critical for preventing vision loss.Aim: To evaluate the use of artificial intelligence (AI) for screening sight threatening diabetic retinopathy (DR) in a public Hospital in Chile.Material and methods: The mydriatic retinal photographs of 366 participants were uploaded for analysis by EyeArt, a cloud-based AI software developed by Eyenuk (Los Ángeles, USA). Diagnostic accuracy was calculated by comparing its results with the clinical evaluation of the fundus by an ophthalmologist. Participants with severe non-proliferative DR or worse were considered as positive cases.Results: Twenty four percent of participants had DR, including 33 (9%) who had sight threatening DR in at least one eye. The sensitivity and specificity of EyeArt were 100% (95% confidence intervals (CI): 89-100%) and 84% (95% CI: 80-88%), respectively.Conclusions: EyeArt was highly sensitive for sight threatening DR and it may be a cost-effective method to improve DR screening in the Chilean public health system.","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"152 11","pages":"1148-1153"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574757","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

[Functional Assessment Tool Based on Hand Grasp in the Chilean Adult Population]. [基于智利成人握手功能的评估工具]。

Revista medica de Chile Pub Date : 2024-11-01 Epub Date: 2025-02-03 DOI: 10.4067/s0034-98872024001101183

Daniel Patiño-García, Margarita Ibáñez González

引用次数: 0

[Neurocognitive Performance in Patients with End-Stage Chronic Kidney Disease: Differences Between Conservative Medical Management and Hemodialysis]. [终末期慢性肾病患者的神经认知表现：保守治疗与血液透析的差异]。

Revista medica de Chile Pub Date : 2024-11-01 DOI: 10.4067/s0034-98872024000800856

Luna Sánchez, Bárbara Lanis, Nicolás Meza, Gustav Rohde

{"title":"[Neurocognitive Performance in Patients with End-Stage Chronic Kidney Disease: Differences Between Conservative Medical Management and Hemodialysis].","authors":"Luna Sánchez, Bárbara Lanis, Nicolás Meza, Gustav Rohde","doi":"10.4067/s0034-98872024000800856","DOIUrl":"10.4067/s0034-98872024000800856","url":null,"abstract":"No consensus has been reached about how cognitive performance evolves in patients receiving hemodialysis (HD).Aim: to analyze the cognitive performance of patients with end-stage chronic kidney disease (CKD) undergoing conservative medical management or HD.Methods: We conducted a cross-sectional study. The cognitive performance of both groups was assessed through the INECO Frontal Screening (IFS) instrument.Results: 6 patients were analyzed in each group (n= 12). A significant difference was observed for the total IFS score, with 14.4±6.29 points in the HD group and 21.5±3.96 points in the conservative management group (p<0.05). Regarding the specific domains of the IFS, a significant difference was found in the domain of verbal inhibitory control, with an average of 1.83±1.17 points in the HD group and 4±0.89 points in the conservative management group (p<0.05). No associations were elucidated on the abbreviated MMSE, ACE-III, TMT-A and B, Grober and Buschke Test, Stroop Test and Boston Test Nomination Test.Conclusion: Patients with terminal CKD on HD (even those with a normal MMSE result) show an impairment in their executive functions compared to those who underwent conservative management.","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"152 8","pages":"856-866"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034943","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

[Risk Profile for Preventable Hospitalizations in Older Adults: Challenges for the Interoperability of Health Networks]. [老年人可预防住院的风险概况：健康网络互操作性的挑战]。

Revista medica de Chile Pub Date : 2024-11-01 Epub Date: 2025-02-03 DOI: 10.4067/s0034-98872024001101111

Melisa A Münzenmayer, Claudio A Méndez, Antonio Tejeda Altamirano, Victoria Espinosa F

{"title":"[Risk Profile for Preventable Hospitalizations in Older Adults: Challenges for the Interoperability of Health Networks].","authors":"Melisa A Münzenmayer, Claudio A Méndez, Antonio Tejeda Altamirano, Victoria Espinosa F","doi":"10.4067/s0034-98872024001101111","DOIUrl":"10.4067/s0034-98872024001101111","url":null,"abstract":"Health research teams routinely face difficulties processing clinical data to determine risk profiles in susceptible populations.Aim: Generate a risk profile of avoidable hospitalizations in older adult patients using integrated healthcare networks of the Southern Metropolitan Health Service (SSMS) of the Metropolitan Region of Chile from 2019-2021.Methods: The present research has a retrospective longitudinal descriptive design of anonymized clinical database records from four Family Health Centers and a high-complexity South Metropolitan Health Service (SMHS) hospital. The information available in TRACKCARE and RAYEN records for 2019-2021 was cleaned and filtered, considering only the ICD-10 diagnoses of interest. Demographic and clinical data analysis was performed with descriptive and inferential statistics using GraphPad Prism v5.0.Results: 57.2% of older adults are women with an average age of 74.2 ± 7.2 (P= 0.0352). There is a different distribution profile of the FONASA section between men and women (P= 0.0002) even when 74% of the total sample is affiliated with FONASA-B. 62.7% have a single ICD-10 diagnosis, the majority being high blood pressure and heart failure (I10-I11), reaching 34% of diagnoses.Conclusions: Despite the evident lack of interoperability between the available clinical registry bases, it was possible to identify a sociodemographic and clinical profile of people aged 65 years and more prone to avoidable hospitalizations. This is through a process of collection and cleansing from different sources of information available in the South Metropolitan Health Service and involved communities.","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"152 11","pages":"1111-1119"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574317","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

[Duties of the Physician in Relation to the Use of Alternative and Complementary Medicines by Their Patients]. [医生在患者使用替代和补充药物方面的职责]。

Revista medica de Chile Pub Date : 2024-11-01 DOI: 10.4067/s0034-98872024000800901

Rodrigo Salinas R, Carlos Echeverría B, Alberto Rojas O, Paulina Taboada R, Hernán Borja R, Anamaría Arriagada U, María A Rodríguez S, Gonzalo Ruiz-Esquide S, María Alejandra Florenzano V

{"title":"[Duties of the Physician in Relation to the Use of Alternative and Complementary Medicines by Their Patients].","authors":"Rodrigo Salinas R, Carlos Echeverría B, Alberto Rojas O, Paulina Taboada R, Hernán Borja R, Anamaría Arriagada U, María A Rodríguez S, Gonzalo Ruiz-Esquide S, María Alejandra Florenzano V","doi":"10.4067/s0034-98872024000800901","DOIUrl":"10.4067/s0034-98872024000800901","url":null,"abstract":"In the prevailing medical pluralism of contemporary society, alternative and complementary medicine occupy a relevant place, comprising a heterogeneous group of practices with different values depending on tradition and social acceptance. Their scarce regulation and growing use, facilitated by promotion through social networks and distrust of the dominant biomedical model, have generated interest among medical organizations and health authorities in their use and consequences. Appreciations vary from outright rejection to interest in its adoption by public health systems as part of their services. Its growing use, however, contrasts with an incipient development of the scientific evidence supporting its use and, consequently, a scarce representation of its curricular teaching in our medical schools. The use of CAM by patients cannot be ignored in the therapeutic encounter. Physicians must be prepared to discuss their possible benefits and risks with their patients and to make recommendations in accordance with the principles of medical professionalism: the good of the patient must take precedence over other interests, taking into account the scarce scientific evidence of their efficacy and safety, the imperfect regulation to which they are subject and the lack of pharmacovigilance on their effects. The patient's autonomy over his or her health care, considerations regarding the use of scarce health care resources, and the due compassion and empathy owed to the patient as a suffering being cannot be ignored.","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"152 8","pages":"901-908"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034941","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

[A General Approach to the Diagnosis and Management of Chronic Liver Damage in Primary Health Care]. [初级卫生保健中慢性肝损害诊断和管理的一般方法]。

Revista medica de Chile Pub Date : 2024-10-01 Epub Date: 2025-02-03 DOI: 10.4067/s0034-98872024001001067

Nicolás Ortiz-López, Sofía Ponce-Arancibia, Larissa Aleman, Juan Pablo Roblero, Álvaro Urzúa, Máximo Cattaneo, Jaime Poniachik

{"title":"[A General Approach to the Diagnosis and Management of Chronic Liver Damage in Primary Health Care].","authors":"Nicolás Ortiz-López, Sofía Ponce-Arancibia, Larissa Aleman, Juan Pablo Roblero, Álvaro Urzúa, Máximo Cattaneo, Jaime Poniachik","doi":"10.4067/s0034-98872024001001067","DOIUrl":"10.4067/s0034-98872024001001067","url":null,"abstract":"Chronic liver disease (CLD) is one of the leading causes of morbidity and mortality in Chile. The progression of the disease generally involves a prolonged asymptomatic phase, during which there is an opportunity for early diagnosis and interventions to prevent progression to advanced disease and its complications. Although risk factors are well-characterized today, and access to diagnostic tests has significantly improved, CLD is not yet included in long-term condition management programs in primary health care (PHC). In this context, it is essential for PHC to focus on primary prevention and early detection of liver diseases, aiming to reduce the socio-health burden of liver cirrhosis, and prevent its progression to decompensated cirrhosis, end-stage liver disease, and hepatocellular carcinoma.Aim: To define the initial management of chronic liver diseases in adults in primary care.Methods: narrative review.Results: We provide an overview of the initial management of chronic liver diseases in adults in PHC, including aspects focused on prevention, identification of patients with liver disease, appropriate application of diagnostic tests, delivery of proper counseling, and timely referrals to specialists.","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"152 10","pages":"1067-1080"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575068","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

[Transcarotid Artery Stenting with dynamic flow reversal. First case and one year follow up]. 动态血流逆转经颈动脉支架植入术。第一例和一年随访]。

Revista medica de Chile Pub Date : 2024-10-01 Epub Date: 2025-02-03 DOI: 10.4067/s0034-98872024001001097

Diego Soto V, Gabriel Cassorla J, Gabriel Seguel S, Paulo Cassis C, Sebastián von Mühlenbrock H, Camila Hevia S, Melissa Pavez K, Francisco Goyenechea M, Cristian Marín O, Sebastián Morales Z

引用次数: 0

[Gallbladder Cancer: Is It Time to Modify the Explicit Health Guarantees (GES) Program?] 胆囊癌：是时候修改明确健康保障（GES）计划了吗？］

Revista medica de Chile Pub Date : 2024-10-01 Epub Date: 2025-02-03 DOI: 10.4067/s0034-98872024001001028

Camila P Samaniego, Xabier de Aretxabala, Felipe Castillo, Álvaro Paredes, M Trinidad González

{"title":"[Gallbladder Cancer: Is It Time to Modify the Explicit Health Guarantees (GES) Program?]","authors":"Camila P Samaniego, Xabier de Aretxabala, Felipe Castillo, Álvaro Paredes, M Trinidad González","doi":"10.4067/s0034-98872024001001028","DOIUrl":"10.4067/s0034-98872024001001028","url":null,"abstract":"Chile currently has one of the highest mortality rates from gallbladder cancer in the world. In 2006, the Chilean Ministry of Health included cholelithiasis (patients aged 35-49) and treatment with cholecystectomy within the Explicit Health Guarantees (GES) program.Aim: To evaluate the results of the GES Preventive Cholecystectomy Program for Gallbladder Cancer as to consider the need to propose changes to the model.Methods: retrospective analysis of official data from the Chile Ministry of Health and National Statistics Institute.Results: Since the program's inception in 2006, 284.139 notifications have been issued to patients aged between 35 and 49 with gallstones. Notifications can be correlated with the number of cholecystectomies performed under the program. Gallbladder cancer standardized mortality has shown a decrease over the last two decades, even before the program was implemented. High and low incidences are observed throughout the country. Regarding notifications, there are areas with a high incidence that are not always correlated with the areas with high notifications.Conclusion: The decrease in the standardized mortality of GBC in Chile requires modifying the present GES Preventive Cholecystectomy program for Gallbladder Cancer. Resources should be oriented to patients living in high-incidence areas with known risk factors.","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"152 10","pages":"1028-1037"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575075","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

[Organizing Pneumonia: Analysis of 10 Years Registers in a Chilean Center]. [组织肺炎：智利某中心10年登记资料分析]。

Revista medica de Chile Pub Date : 2024-10-01 Epub Date: 2025-02-03 DOI: 10.4067/s0034-98872024001001060

Miljenko Lolas, Juan Pablo Cuevas, Mauricio Salinas

{"title":"[Organizing Pneumonia: Analysis of 10 Years Registers in a Chilean Center].","authors":"Miljenko Lolas, Juan Pablo Cuevas, Mauricio Salinas","doi":"10.4067/s0034-98872024001001060","DOIUrl":"10.4067/s0034-98872024001001060","url":null,"abstract":"Organized pneumonia (OP) is an uncommon disease included in the group of idiopathic interstitial pneumonias. It can be cryptogenic (COP) or secondary to various etiologies. Its diagnosis is complex and not standardized. There are no published Chilean series. We present a cohort of patients with pneumonia in organization treated at the National Thoracic Institute (INT).Aim: To describe the characteristics of patients with OP in a Chilean center.Methods: Pathological registries from the INT were reviewed between 2013 and 2022. Clinical and radiological information was obtained from hospital records. Each case was reviewed by the research team. Data are described by means, absolute and relative frequencies.Results: From an initial list of 203 biopsies, 69 were obtained with clinical/radiological symptoms compatible with OP. The mean age of these subjects was 62 years, of which 33 (47.8%) were men and 36 (52.2%) women. Biopsies were obtained by transbronchial biopsy in 49 (71%) cases and surgical biopsy in 19 (27.5%) cases. In terms of etiology, 37 (53.6%) of them were considered cryptogenic, 12 (17.4%) secondary to the use of medication / drugs and 11 (15.9%) cases associated with connective tissue disease. Regarding treatment, 36 (52.2%) patients received oral steroids and 10 (14.5%) were treated with a mix of corticosteroids and immunosuppressors. In the long-term follow-up, there were 23 deaths in just over 6 years.Conclusions: The reported series has similar characteristics to those reported in the literature. Most of the cases described in this series were classified as COP. The most common underlying etiologies were connective tissue diseases and medications. The most used treatment was corticosteroid alone or mixed with immunosuppressors.","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"152 10","pages":"1060-1066"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575081","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

[Measurement of Protective Psychosocial Factors for Healthy Ageing]. [健康老龄化的保护性心理社会因素的测量]。

Revista medica de Chile Pub Date : 2024-10-01 Epub Date: 2025-02-03 DOI: 10.4067/s0034-98872024001001106

Claudia Troncoso-Pantoja, Antonio Amaya-Placencia, Jorgelina Ricchezza

引用次数: 0