Revista medica de Chile最新文献

{"title":"[Concerning Projections for Chile and the World: 1.8 Billion People are Physically Inactive].","authors":"Carlos Celis-Morales, Jaime Vasquez-Gómez, Carlos Matus-Castillo","doi":"10.4067/s0034-98872025000100075","DOIUrl":"https://doi.org/10.4067/s0034-98872025000100075","url":null,"abstract":"","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"153 1","pages":"75-77"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031025","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":"[Metaverse in Nursing and Health Professions: The Future of Experiential Learning is Here].","authors":"Jorge Contreras Gutiérrez, Claudia Pérez Acuña, Alejandro Nuñez Nuñez","doi":"10.4067/s0034-98872025000100072","DOIUrl":"https://doi.org/10.4067/s0034-98872025000100072","url":null,"abstract":"","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"153 1","pages":"72-74"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031026","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":"[Lymphangioleiomyomatosis: Update on Pathophysiology, Diagnosis, and Treatment].","authors":"Macarena Lagos Castillo, Felipe Reyes Cartes","doi":"10.4067/s0034-98872025000100063","DOIUrl":"https://doi.org/10.4067/s0034-98872025000100063","url":null,"abstract":"<p><p>Interstitial lung diseases (ILDs) include a group of rare and complex pathologies, among which lymphangioleiomyomatosis (LAM) stands out. LAM is considered a neoplastic disease characterized by abnormal proliferation of smooth muscle cells in the lung, forming cysts and causing severe respiratory alterations. LAM primarily affects women of childbearing age and can present in two forms: sporadic (S-LAM) and associated with tuberous sclerosis complex (TSC-LAM). Although its etiopathogenesis is not fully understood, genetic and hormonal pathophysiological mechanisms have been studied. Genetic alterations in the TSC1 and TSC2 genes lead to uncontrolled activation of the mTOR pathway, resulting in the transformation of smooth muscle cells into abnormal cells known as LAM cells. The activation of hormonal receptors present in LAM cells increases cell proliferation and migration. The perialveolar proliferation of these cells may explain alveolar rupture and cyst formation. There is also matrix remodeling and production of lymphangiogenic growth factors, such as vascular endothelial growth factor-D (VEGF-D), which contributes to the formation of lymphatic vessels in LAM lesions and cystic remodeling of the lung. The most common symptoms are exertional dyspnea and recurrent pneumothorax, along with other extrapulmonary manifestations such as renal angiomyolipomas. Diagnosis is based on characteristic tomographic findings and elevated plasma levels of VEGF-D. Treatment focuses on improving quality of life and halting disease progression. Sirolimus, an mTOR inhibitor, is the first-line therapy and has shown to stabilize lung function and reduce symptoms. In advanced cases, lung transplantation is a viable option. Hormone therapy and some surgical procedures are currently not recommended due to inconsistent results.</p>","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"153 1","pages":"63-71"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065559","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":"[Evolution of the Application of the Concept of Curricular Integration in Clinical Simulation: A Review Focused on Undergraduate Health Professions].","authors":"Francisca Torres Suazo, Marco Bettancourt González, Catalina Atuez Araya, Matías Aravena González, Yenny Plaza Órdenes, Scarlett Vicencio-Clarke, Paulina Ramírez-Delgado, Soledad Armijo-Rivera","doi":"10.4067/s0034-98872025000100045","DOIUrl":"https://doi.org/10.4067/s0034-98872025000100045","url":null,"abstract":"<p><p>Given the importance of simulation in the undergraduate health curriculum and the fact that how we understand the concepts is an essential element when implementing simulation, this review aims to answer the following question: How has the concept of curriculum integration been applied in clinical simulation in the undergraduate health curriculum?</p><p><strong>Material and method: </strong>A focused review was conducted with the help of a librarian. Sixteen articles were obtained and analyzed in extenso, given their low number, using as inclusion criteria that they had implementation results in at least two curriculum levels.</p><p><strong>Results: </strong>Five articles were included in the conceptual synthesis. All the reports analyzed were from North America: three from medical careers, one from technical education, and one from nursing education. A similarity in the articles analyzed is that the curricular insertions reported share the procedural competencies or basic clinical skills with critical thinking in all cases and in a way that is indifferent to the profession being trained. Brauer´s vertical integration concept is a dominant approach to planning complex and progressive simulations in the undergraduate health curriculum.</p><p><strong>Discussion: </strong>The description and analysis of simulation curriculum integration concepts in health careers and their evaluation and continuous improvement over time are educational research areas requiring further information.</p>","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"153 1","pages":"45-52"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047783","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":"[Influence of Remote Work Imposed by COVID-19 Lockdowns on Weight Gain in Adults Across 21 Ibero-American Countries].","authors":"Ingrid Schifferli, Juan José Orellana, Lilia Pedraza","doi":"10.4067/s0034-98872025000100001","DOIUrl":"https://doi.org/10.4067/s0034-98872025000100001","url":null,"abstract":"<p><strong>Aim: </strong>To determine the association between weight gain (WG) and teleworking in 21 Ibero-American countries and to examine the effect WG on sex, age, physical activity (PA), ways of working (WW), mood (M), and eating habits.</p><p><strong>Methods: </strong>Cross-sectional study, non-probability sampling in 21 Ibero-American countries. A biodemographic, eating, PA, M, and WW were obtained. The association between WG and the explanatory variables was studied by bivariate and multivariate analysis.</p><p><strong>Results: </strong>9,698 volunteers, 65.2% women, 34.2% with age from 25 to 34, BMI mean(sd) 26.0 (5.1) kg/m2, WG prevalence: 28.3%, greater prevalence of WG in: women (28.9%); reduced PA (42.6%); lack of positive mood (33.2%); increased the number of meals (54.0%); increased the number of meals and the amount of food (63.7%); increase in consumption of processed and ultra-processed foods (UP), and reduction in non-processed, foods (75.1%). There was no significant link between WG and WW.</p><p><strong>Conclusion: </strong>WG was greater in women. Positive association between WG and reduction in PA, increase in number of meals, amount of food, processed and UP foods, and lack of positive moods.</p>","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"153 1","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056558","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":"[Self-efficacy in Advanced Cardiovascular Life Support among Professionals. Are we overestimating our skills? A multicenter study].","authors":"Sebastián Turner-Pantoja, Nancy Bastías-Vega, Marjorie Baquedano-Rodríguez","doi":"10.4067/s0034-98872025000100053","DOIUrl":"https://doi.org/10.4067/s0034-98872025000100053","url":null,"abstract":"<p><p>Self-efficacy, understood as confidence in one's ability to execute specific tasks successfully, is a key factor in the performance of healthcare professionals in emergency situations. In the context of Advanced Cardiovascular Life Support (ACLS), which requires quick decision-making and the precise execution of technical skills, self-assessment of one's abilities is essential to ensure quality care and patient safety. However, the question arises: could overconfidence compromise actual performance in critical settings?</p><p><strong>Aim: </strong>To evaluate ACLS self-efficacy among healthcare professionals in public hospitals and compare it with their actual performance.</p><p><strong>Methods: </strong>90 healthcare professionals from five public hospitals in a central region of Chile were included. ACLS self-efficacy was measured using an instrument specifically designed for emergency care, while practical ACLS skills were evaluated based on the American Heart Association® guidelines. Additionally, cognitive skills were assessed using a tool developed for this study. Self-efficacy was then compared to actual performance in both practical and cognitive skills.</p><p><strong>Results: </strong>This study identified a significant discrepancy between self-reported confidence and actual ACLS skills. Although many professionals reported high confidence levels in their abilities, their practical and cognitive performance was considerably lower than expected.</p><p><strong>Conclusions: </strong>This study reveals a significant gap between self-efficacy and actual performance in ACLS, suggesting that professionals with lower skill proficiency overestimate their abilities due to metacognitive biases, aligning with the Dunning-Kruger effect - potentially impacting the quality of patient care. Addressing this discrepancy through targeted education and practical simulations is crucial to improving emergency outcomes and patient safety.</p>","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"153 1","pages":"53-62"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036816","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":"[Intercultural Sensitivity in Health Science Head of Faculty to incorporate Intercultural Competence in the Curriculum].","authors":"Debbie Álvarez-Cruces, Alejandra Nocetti-de-la-Barra, Juan Mansilla-Sepúlveda","doi":"10.4067/s0034-98872025000100022","DOIUrl":"https://doi.org/10.4067/s0034-98872025000100022","url":null,"abstract":"<p><p>In Chile, the growth of the migrant population since 1990 has been significant; however, the International Migrant Health Policy was only established in 2017. This policy stresses incorporating interculturality, migration, and health into health science curricula. Heads of Faculty manage the curriculum to address contextual needs. The Intercultural Sensitivity Model outlines the stages for developing empathy essential to meet the cultural needs of others.</p><p><strong>Aim: </strong>To explore the Intercultural Sensitivity of Health Science Heads of Faculty in integrating Intercultural Competence for migrant patients into the curriculum.</p><p><strong>Method: </strong>A qualitative study with an interpretative approach was performed. Key informants, consisting of Heads of Faculty from various health disciplines, were interviewed via Zoom after receiving informed consent via email. Data analysis utilized deductive categories aligned with the stages of Intercultural Sensitivity and inductive subcategories, backed by the ATLAS.ti 24 software.</p><p><strong>Results: </strong>Fifteen Heads of Faculty from three universities participated. The identified categories included: a) Denial, characterized by subcategories of academic isolation and lack of awareness of the International Migrant Health Policy; b) Defense, marked by a lack of trained faculty, rigid curricula, and delegation of practical training; c) Minimization, associated with implicit training and downplaying formative efforts; and d) Acceptance, involving strategies for content inclusion. The code/document analysis revealed that the most frequent stage was Minimization, followed by Defense. The highest stage achieved was Acceptance, though it featured unsystematic educational strategies. The stages of Adaptation and Integration were not reached.</p><p><strong>Conclusion: </strong>The Intercultural Sensitivity of Heads of Faculty in integrating Intercultural Competence for migrant patients into the curriculum is predominantly at the stages of Minimization and Defense, which overlook cultural aspects. This approach impacts and perpetuates universalistic and ethnocentric healthcare practices.</p>","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"153 1","pages":"22-34"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001622","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":"[Attitudes Toward Motherhood and Fertility Preservation Among University Women: A Cross-Sectional StudyTítulo abreviado: Actitud sobre maternidad en universitarias].","authors":"Heidy Kaune G, Martina Yopo D, Fanny Petermann-Rocha, Florencia Herrera O, Fernando Zegers-Hochschild","doi":"10.4067/s0034-98872025000100011","DOIUrl":"https://doi.org/10.4067/s0034-98872025000100011","url":null,"abstract":"<p><p>In Chile, the total fertility rate (TFR) has dramatically decreased from 5,4 children per woman in 1962 to 1,17 in 2021. This decline is associated with delayed childbearing and the decision of many women not to have children. The factors driving this social and demographic transformation remain poorly understood.</p><p><strong>Aim: </strong>To investigate how university women perceive their reproductive future, their intentions to have children, and their willingness to consider oocyte cryopreservation as a means of preserving fertility.</p><p><strong>Methods: </strong>A semi-structured, self-administered survey was conducted among 1.020 female students at Universidad Diego Portales in Santiago, Chile. The survey addressed sociodemographic background, childbearing intentions, fertility knowledge, and attitudes towards oocyte cryopreservation. Data were analyzed using Stata MPV18 software.</p><p><strong>Results: </strong>The average age of participants was 21 years. While most expressed concerns about their future, they also felt empowered to address these challenges. Altogether, 52% of women did not wish to have children, though 37,9% indicated they might reconsider this decision in the future. The key conditions for motherhood included having completed education (84,9%), job stability (91%), and economic autonomy (91,4%). Interestingly, only 30,4% of participants considered having a partner as essential to stablish motherhood and only 10,5% considers matrimony as a condition. Additionally, 47,3% expressed interest in oocyte cryopreservation to safeguard their fertility.</p><p><strong>Conclusion: </strong>Motherhood is not a priority for most university women in Chile today. Most women plan to delay childbearing after age 30, once they have achieved financial and job stability. Fertility preservation is viewed as a valuable option for delaying motherhood. These findings highlight significant changes in young women's priorities and expectations regarding motherhood and reproductive autonomy.</p>","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"153 1","pages":"11-21"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061445","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":"Effectiveness and Toxicity of High-Dose Colistin Treatment in Patients with Multidrug-Resistant Gram-Negative Bacterial Infections.","authors":"Daniela Carrasco, Daniel Muñoz-Pichuante, Felipe Olivares, Alberto Fica, Lorenzo Villa, Gonzalo Carrasco","doi":"10.4067/s0034-98872025000100035","DOIUrl":"https://doi.org/10.4067/s0034-98872025000100035","url":null,"abstract":"<p><p>Hospital-acquired infections by multidrug-resistant Gram-negative bacteria (MDRGN) have become a global public health problem. Colistin is considered one of the last therapeutic options due to its limited clinical effectiveness and high rate of adverse effects. Unfortunately, its use has increase in recent years given the increase of MDRGN-associated infections and narrow therapeutic alternatives. With the aim of improving effectiveness using pharmacokinetic/pharmacodynamic knowledge, higher doses of colistin have been used in recent years but with few reported outcomes.</p><p><strong>Methods: </strong>A retrospective cohort analysis was performed in patients with MDRGN infections treated with high-dose colistin with the aim of evaluating clinical improvement as primary outcome and the incidence of acute kidney injury (AKI) and other adverse events as secondary outcomes.</p><p><strong>Results: </strong>Fifty-five courses of colistin treatment were identified in 50 patients, with 45% applied on intensive care unit. Clinical improvement was achieved in 35 (63.6%) treatments, while extrapulmonary infections were significantly associated with a higher clinical failure rate (OR 10; 95%CI: 1.18-84.5). By multivariate analysis, only the failure to control the infection source influenced significantly for mortality of patients (aOR= 19.6; IC95 3.0-126, p= 0.002). AKI was observed in 30 treatments (54.5%) and was only significantly associated with the use of a loading doses (OR= 6.0, 95%CI: 1.61-22.3). Eosinophilia was frequent (35.7%) and, besides, two respiratory depression events were observed.</p><p><strong>Conclusion: </strong>High doses of colistin could be associated with a favorable clinical improvement in patients with MDRGN infections but has a limited effectiveness in extra-pulmonary infections, especially when a source-control procedure is not performed. AKI is frequently observed and limits its use, while eosinophilia and respiratory depression should be considered also as part of safety monitoring. Prescription of this drug should be judiciously analyzed weighing benefits-to-risk ratio.</p>","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"153 1","pages":"35-44"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001639","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":"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}