Medwave最新文献

{"title":"Temporal analysis of the administration of encephalic reperfusion therapies during the COVID-19 pandemic in a Chilean hospital: An analytical cross-sectional study.","authors":"Keren Zambrano, Marcelo Arancibia, Catalina Soto, Julio Riquelme","doi":"10.5867/medwave.2025.08.3081","DOIUrl":"https://doi.org/10.5867/medwave.2025.08.3081","url":null,"abstract":"<p><strong>Introduction: </strong>The COVID-19 pandemic had a major impact on emergency services, including stroke care. Changes in the administration times of brain reperfusion therapies for stroke have been little explored in Chile. The aim of this study was to analyze the impact that the pandemic had on critical stroke treatment times, the number of patients treated, clinical severity, and the presence of major vessel occlusion.</p><p><strong>Methods: </strong>We performed a retrospective analysis of patients undergoing encephalic reperfusion therapy in a hospital in Valparaíso, Chile. Two groups of patients treated one year before (pre-pandemic group) and one year after (pandemic group) the start of health restrictions were compared.</p><p><strong>Results: </strong>104 patients were included, with a mean age of 67.4 ± 13 years and a clinical severity of 13.5 ± 6.5 in the NIHSS. 91.5% received thrombolytic therapy. No significant intergroup differences were found in the metrics of treatment time, number of patients treated, clinical severity, or presence of major vessel occlusion. Although there was a non-significant trend towards delayed institutional therapeutic times, a significant correlation was found suggesting that the shorter the time from symptom onset to door, the shorter the time to access therapy (r = 0.84).</p><p><strong>Conclusions: </strong>There were no significant differences in the therapeutic times of stroke in the period prior to the COVID-19 pandemic and the pandemic period, showing similarities to the experience reported in Chile and highlighting the adaptation of the health system during the health crisis. Studies with more complex epidemiological designs analyzing larger samples of patients will allow us to complement these results.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"25 8","pages":"e381"},"PeriodicalIF":0.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993245","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":"Characterization of the expressed and effective demand for oncology services under the explicit health guarantees of the Chilean public health system.","authors":"Carolina De la Fuente, Paula Bedregal, Paula Zamorano, Oscar Arteaga, Cristian Rebolledo, Camilo Oñate, Pedro Zitko","doi":"10.5867/medwave.2025.07.3070","DOIUrl":"https://doi.org/10.5867/medwave.2025.07.3070","url":null,"abstract":"<p><strong>Introduction: </strong>Efficient and effective cancer management is a priority for the Chilean healthcare system. In recent years, significant progress has been made through public policies integrating management at different levels (micro, meso, and macro). However, gaps between the population's needs, service availability, and effective demand may impact health outcomes.</p><p><strong>Objective: </strong>To describe the national effective demand for prioritized cancer services within the Chilean public healthcare system.</p><p><strong>Methods: </strong>A descriptive comparative analysis was conducted using data from the public sector Health Guarantees Management Information System between 2018 and 2022. The rates of new cases granted health guarantees by intervention type and the analysis of delayed guarantees were performed.</p><p><strong>Results: </strong>A total of 3.8 million new cases of explicit health guarantees and 3.9 million fulfilled opportunity guarantees were included. The rates of primary treatment opportunity guarantee by tracer intervention declined in 2020 and 2021, while delayed guarantees showed an increasing trend throughout the entire period. Effective demand varied across cancer types. Breast cancer, preventive cholecystectomy, and gastric cancer exhibited the largest sex-based differences in new cases and primary treatment. Delayed guarantees were similar between sexes, except for breast cancer.</p><p><strong>Conclusions: </strong>This study provides valuable insights into the demand for cancer services in Chile and the performance of the public healthcare system concerning sex and cancer type, highlighting the impact of the COVID-19 pandemic. The findings emphasize the need to strengthen the public system's response capacity to reduce gaps and improve equity in oncological care.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"25 7","pages":"e3070"},"PeriodicalIF":0.8,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144961055","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":"Implementation of a forensic psychiatry seminar using case-based learning methodology: protocol for a film-supported educational intervention.","authors":"Humberto Pizarro, Silvio Cuneo, Julio Michelotti","doi":"10.5867/medwave.2025.07.3080","DOIUrl":"10.5867/medwave.2025.07.3080","url":null,"abstract":"","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"25 7","pages":"e3080"},"PeriodicalIF":0.8,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144874147","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 of a multicomponent physical exercise program in synchronous telerehabilitation mode: A systematic review with meta-analysis protocol.","authors":"Igor Cigarroa, Gustavo López-Alarcón, Felipe Vargas-Rios, Sergio Jara-Aceituno, Daniel Reyes-Molina, Cristobal Riquelme-Hernández, Rafael Zapata-Lamana, María Antonia Parra-Rizo","doi":"10.5867/medwave.2025.07.3069","DOIUrl":"10.5867/medwave.2025.07.3069","url":null,"abstract":"<p><strong>Introduction: </strong>Telerehabilitation has been proposed as an innovative, safe, and effective method of intervention to prevent or improve frailty. This rehabilitation modality facilitates access to opportunities and reduces gaps in healthcare. The advantages and challenges of implementing synchronous telerehabilitation programs in older people should be explored.</p><p><strong>Objective: </strong>This protocol describes the methodology to analyze the effects of a multicomponent physical exercise program in synchronous telerehabilitation modality compared to a multicomponent physical exercise program in face-to-face modality in terms of quality of life of frail older people.</p><p><strong>Methods: </strong>A systematic review will be performed in the following databases: Medline/PubMed, Scopus, Web of Science, CINAHL, Central, PeDRO, Lilacs, and Epistemonikos. To identify randomized clinical trials that meet the proposed eligibility criteria. The primary outcomes are quality of life and functionality, and the secondary outcomes are strength, balance, and cardiorespiratory capacity. In addition, the risk of bias will be assessed using the ROB-2 tool, and the certainty of the evidence will be assessed using the GRADE system. A meta-analysis will be performed if the procedures used to determine the results of the study are homogeneous; mean differences with a 95% confidence interval will be calculated. Otherwise, standardized mean differences will be used to determine the effect sizes.</p><p><strong>Expected: </strong>results The main findings of this review and meta-analysis will contribute to clarifying the effectiveness of physical therapy applied in a synchronous remote modality. It will also identify the variables on which it has a positive effect.</p><p><strong>Prospero registration: </strong>CRD42024605527.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"25 7","pages":"e3069"},"PeriodicalIF":0.8,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822047","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":"Next-Generation sequencing in a Native American patient with sea-blue histiocytosis: A case report and genomic analysis.","authors":"Ana Karina Zambrano, Viviana A Ruiz-Pozo, Elius Paz-Cruz, Mateo Antonio Rodríguez, Santiago Cadena-Ullauri, Rafael Tamayo-Trujillo, Patricia Guevara-Ramírez, Daniel Simancas-Racines, Francisco Cevallos, Aníbal Gaviria","doi":"10.5867/medwave.2025.07.3051","DOIUrl":"10.5867/medwave.2025.07.3051","url":null,"abstract":"<p><p>This study presents a case of a 25-year-old Native American woman from Otavalo, Ecuador, diagnosed with sea-blue histiocytosis and myelodysplastic syndrome. Bone marrow aspiration revealed sea-blue histiocytes, and next-generation sequencing identified a likely pathogenic stop-gain mutation in the SAMD9 gene, associated with myelodysplastic syndrome. Additionally, variants of uncertain significance were found in the ALB and SRI genes. Ancestral analysis showed a predominantly Native American composition, suggesting a potential genetic predisposition specific to Andean communities. The report underscores the importance of understanding genetic and ancestral backgrounds in diagnosing and managing hematological disorders.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"25 7","pages":"e3051"},"PeriodicalIF":0.8,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804430","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":"Time from arrival in Chile to tuberculosis diagnosis in migrants treated at primary care centers in two Metropolitan Region municipalities, Chile.","authors":"Alejandra Puga-Arriagada, Jhonatan Castro Horna, Marinella Mazzei Pimentel, Gabriel Cavada Chacón, Guillermo Sequera, Javiera Varela-Torres, Olivia Horna-Campos","doi":"10.5867/medwave.2025.07.3088","DOIUrl":"https://doi.org/10.5867/medwave.2025.07.3088","url":null,"abstract":"<p><strong>Introduction: </strong>In Chile, the number of migrants affected by tuberculosis has experienced a significant increase from 7.1% in 2014 to 29.7% in 2023, ranking as the first group at risk. The objective was to estimate the time to diagnosis of tuberculosis from arrival in Chile in a series of migrants undergoing treatment between January 2021 and March 2022.</p><p><strong>Methods: </strong>We analyzed a cohort of migrants over 18 years of age with a diagnosis of tuberculosis treated in the communes of Recoleta and Independencia. Those who agreed to participate and signed the informed consent form were included. Cases with non-tuberculous mycobacteria and residents outside the Metropolitan Region were excluded. Sociodemographic, clinical, and arrival dates, as well as symptoms and diagnoses, were recorded. Proportional hazards models in STATA v.18 were used to analyze times according to independent variables. A p value < 0.05 was considered significant.</p><p><strong>Results: </strong>The median time to diagnosis was 93.5 months, varying by subgroup. The recent migration subgroup without Chilean documentation had a hazard ratio of 13.1, which indicates that, at any time after arrival, these individuals have a 13-fold increased risk of tuberculosis diagnosis compared to the reference subgroup (traditional migration with Chilean identity documents). This hazard ratio is reduced by 2.4 times when these types of migrants have documentation from Chile (95% confidence interval: 1.2 to 4.5).</p><p><strong>Conclusions: </strong>There is a wide range of time from arrival in Chile to the diagnosis of tuberculosis. Factors such as the type of migration and the type of identity document have an impact on the development of this disease. It is necessary to expedite the legal administrative process for migrants and implement timely screening policies, along with follow-up and improved access to healthcare, to reduce exposure and risk of tuberculosis.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"25 7","pages":"e3088"},"PeriodicalIF":0.8,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794898","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":"Geriatrics-gerontology training and negative stereotypes towards older adults among physiotherapy students in Chile: A cross-sectional study.","authors":"Gonzalo Bravo-Rojas, Ignacio Castellucci, Gabriela Yévenes, Crihsna Marín, María Fernanda Arriagada","doi":"10.5867/medwave.2025.07.3094","DOIUrl":"10.5867/medwave.2025.07.3094","url":null,"abstract":"<p><strong>Introduction: </strong>Ageism refers to the set of stereotypes, prejudices, and discrimination based on age, which negatively affects healthcare for older adults. In Chile, there is limited evidence on this phenomenon among physiotherapy students.</p><p><strong>Objective: </strong>To determine the presence of negative stereotypes towards older adults among physiotherapy students at a private university in the Valparaíso region, and to compare these stereotypes according to the level of knowledge in geriatrics and gerontology.</p><p><strong>Methods: </strong>A cross-sectional observational study was conducted using an online survey of physiotherapy students. The Questionnaire of Negative Stereotypes Towards Ageing was administered, and knowledge in geriatrics and gerontology was assessed based on the completion of specific modules. Descriptive analyses, Student's t-test, and multiple linear regression adjusted for age and sex were performed.</p><p><strong>Results: </strong>A total of 96 students participated in the study. The average score for negative stereotypes towards ageing was 38.8 (SD = 5.8), classified as a low level, although it was close to the threshold for a high level. 42.7% of students presented high levels of negative stereotypes. Students who had passed both modules scored on average 4.3 points lower in negative stereotypes than those who had passed neither (95% CI: -7.4 to -1.3; p = 0.006).</p><p><strong>Conclusions: </strong>Physiotherapy students exhibit negative stereotypes towards ageing, especially those without specific training in geriatrics and gerontology. Including these modules in professional education could contribute to improving future healthcare and reducing ageism towards older adults.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"25 7","pages":"e3094"},"PeriodicalIF":0.8,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784842","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":"Thrombotic thrombocytopenic purpura: Description and analysis of 23 cases treated in Chile between 2017 and 2022.","authors":"Daniel Cathalifaud, Jean-Paul Manríquez, Benjamín Rodríguez, Gonzalo Eymin, Benjamín Sanfuentes, Joel Castellano, Andrés Valenzuela","doi":"10.5867/medwave.2025.06.3002","DOIUrl":"https://doi.org/10.5867/medwave.2025.06.3002","url":null,"abstract":"<p><strong>Introduction: </strong>Since the first description of Thrombotic Thrombocytopenic Purpura, caused by a severe deficiency of ADAMTS13, plasma exchange and immunosuppression have become standard treatments, allowing to decrease its high mortality rate. Prospective records of Thrombotic Thrombocytopenic Purpura have provided valuable information on its pathophysiology, clinical presentation, and outcomes. The objective of this study is to update the local Chilean experience in the diagnosis and management of this disease, through a case series of patients treated between 2017 and 2022.</p><p><strong>Methods: </strong>Case series study that included patients over 18 years old diagnosed with Thrombotic Thrombocytopenic Purpura, treated between June 2017 and August 2022 at Hospital Clínico UC Christus. Information was collected from clinical records, which were used for cohort description and statistical analysis. Accepted definitions from the literature were used to describe the outcomes. The study was approved by the local ethics committee (ID 220524001).</p><p><strong>Results: </strong>Our series had higher age and prevalence of comorbidities compared to those reported in the literature. The most important clinical manifestations included constitutional, gastrointestinal, hemorrhagic, and neurological symptoms, with different presentation frequencies than those described internationally. We found a lower capacity of the PLASMIC Score for the detection of Thrombotic Thrombocytopenic Purpura in our series. The predominant therapeutic strategy was a combination of glucocorticoids and plasma exchange (61% of the patients). There was a high mortality rate (56.5%) and adverse events related to plasma exchange, especially of infections related to its use.</p><p><strong>Conclusions: </strong>This study highlights the diagnostic and therapeutic challenges of Thrombotic Thrombocytopenic Purpura in the local context and the need to improve our management strategies through standardizing care and better application of clinical guidelines to reduce the high mortality rate in these patients.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"25 6","pages":"e3002"},"PeriodicalIF":1.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682790","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":"Motor skills in Peruvian preschool children: A cross-sectional study.","authors":"Joel Figueroa-Quiñones, Karem Julissa Pariona Espino, Ashley Oliveros Marquez, Cesar Ortiz Huamán, Kiara Saravia Huamán, Kerrily Fiorell Fernández Castilla","doi":"10.5867/medwave.2025.06.3056","DOIUrl":"10.5867/medwave.2025.06.3056","url":null,"abstract":"<p><strong>Introduction: </strong>Motor skills encompass a series of movements essential for daily activities and have been associated with well-being and child development. However, there are various external and internal conditions that can affect children's motor development. Therefore, the purpose of our study was to analyze the motor skills of Peruvian children aged three to six years and compare differences based on region, sex, age, and type of educational institution.</p><p><strong>Methods: </strong>An observational study was conducted with a sample of 265 children aged three to six years from public and private institutions in three regions of Peru: the central region (Metropolitan Lima), the jungle region (Tarapoto), and the southern region (Chincha Alta). The Test of Gross Motor Development, Third Edition (TGMD-3) was applied. Data were processed and analyzed using descriptive statistics and non-parametric tests such as the Mann-Whitney U test and Kruskal-Wallis test (p<0.05). Additionally, a multiple linear regression analysis with robust standard errors was conducted.</p><p><strong>Results: </strong>The results revealed significant differences between regions. Children from the Selva (Tarapoto) and Sur (Chincha) regions of Peru reported higher scores than those from the central region. In addition, girls reported higher scores than boys in locomotor skills. Also, it was found that motor performance usually reaches better performance after five years and six months of age.</p><p><strong>Conclusions: </strong>It is concluded that infant motor performance varies by region, age and sex. Therefore, future interventions adjusted for these variables are required to strengthen and improve these skills.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"25 6","pages":"e3056"},"PeriodicalIF":1.2,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659606","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":"Global cost of silencing science: editors and publishers have a duty to resist.","authors":"Frank Frizelle, Kamran Abbasi, Vivienne C Bachelet, Christopher Baethge, Sabine Kleinbert, Hong Yoo Jin, Lilia Zakhama","doi":"10.5867/medwave.2025.06.6876","DOIUrl":"https://doi.org/10.5867/medwave.2025.06.6876","url":null,"abstract":"","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"25 6","pages":"e6876"},"PeriodicalIF":1.2,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608751","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}