Medwave最新文献

{"title":"Time to treat the climate and nature crisis as one indivisible global health emergency.","authors":"Kamran Abbasi, Parveen Ali, Virginia Barbour, Thomas Benfield, Kirsten Bibbins-Domingo, Stephen Hancocks, Richard Horton, Laurie Laybourn-Langton, Robert Mash, Peush Sahni, Wadeia Mohammad Sharief, Paul Yonga, Chris Zielinski","doi":"10.5867/medwave.2023.11.2900","DOIUrl":"10.5867/medwave.2023.11.2900","url":null,"abstract":"","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"23 11","pages":""},"PeriodicalIF":1.2,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138830452","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":"SARS-CoV-2 humoral immune response in patients with cardiovascular risk factors: The COmmunity Cohort Study.","authors":"Vivienne C Bachelet, Ignacio Silva-Ayarza, María S Navarrete","doi":"10.5867/medwave.2023.11.2787","DOIUrl":"https://doi.org/10.5867/medwave.2023.11.2787","url":null,"abstract":"<p><p>Based on the recommendations of the Vaccine Advisory Committee and the National Immunization Program, Chile implemented an early vaccination process of the population with vaccines from different laboratories. The study of neutralizing antibody levels in different population subgroups contributes to the establishment of correlates of protection against SARS-CoV-2 infection. In 2022 and 2023 we set up a community cohort of 914 adults with cardiovascular risk factors. In this cohort we are measuring the humoral immune response to exposure to SARS-CoV-2 antigens, either by vaccines or infection, as well as the incidence of COVID-19 and other adverse events. This cohort, which we call The COmmunity Cohort, is providing us with valuable information on the levels of neutralizing antibodies in these individuals and their degree of protection against COVID-19.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"23 11","pages":"e2787"},"PeriodicalIF":1.2,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138830451","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":"Education on pain disciplines in physical therapy in Chile: In need of change.","authors":"José Alfredo Órdenes-Mora, Laiza Moura Almeida-Terassi, Manuel Ahumada Wartemberg, Felipe J J Reis","doi":"10.5867/medwave.2023.11.2713","DOIUrl":"https://doi.org/10.5867/medwave.2023.11.2713","url":null,"abstract":"<p><p>Pain is a major public health concern associated with emotional disorders and physical disability and generates increased sick leave and healthcare expenditures. However, despite its social impact and the high pain-related costs, the training of healthcare professionals, such as physical therapists, in pain management is insufficient, leading to an inadequate therapeutic approach. This study aimed to determine the existence of a specific program on pain within the curricula of physical therapy careers in accredited universities in Chile. Out of 40 physical therapy careers, we analyzed 38 curricula. None of them had a specific discipline on pain management in their curricula. Although there is no concrete definition of the best modality for pain education in undergraduate students, it has been shown that following the International Association for The Study of Pain curricula improves students' knowledge and awareness of pain management.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"23 11","pages":"e2713"},"PeriodicalIF":1.2,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138805220","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":"Oral atenolol compared to oral propranolol for infantile hemangioma","authors":"Victor Meza Viteri, Ligia Aranibar","doi":"10.5867/medwave.2023.11.2753","DOIUrl":"https://doi.org/10.5867/medwave.2023.11.2753","url":null,"abstract":"Introduction Infantile hemangioma is the most frequent benign vascular tumor in childhood, with an incidence of 3 to 10%. When patients require treatment, oral propranolol, a non-selective lipophilic beta-blocker, is usually considered the therapy of choice. However, its use has been associated with several adverse events related to its β-2 action and its ability to cross the blood-brain barrier. Because of this, oral atenolol, a hydrophilic β-1 receptor-selective beta-blocker, may represent a valid treatment alternative. Nonetheless, there is still controversy regarding the efficacy and safety of atenolol when compared with propranolol as monotherapy for this condition. Methods We searched Epistemonikos, the largest database of systematic reviews in health science, which is maintained by screening multiple sources of information, including MEDLINE/PubMed, EMBASE, and Cochrane, among others. Data were extracted from the identified reviews, data from the primary studies were analyzed, a meta-analysis was performed, and a summary table of the results was prepared using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method. Results Nine systematic reviews were identified, including 10 primary studies and three randomized trials. The three randomized trials were included in the analysis of this investigation. Conclusion The use of oral atenolol compared with oral propranolol as monotherapies may result in little or no difference in terms of likelihood of complete remission, decrease in Hemangioma Activity Score, likelihood of post-treatment relapse, and risk of adverse events and severe adverse events, in infantile hemangioma (low certainty of evidence).","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"33 8","pages":""},"PeriodicalIF":1.2,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138590310","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":"Community-acquired pneumonia: Epidemiology, diagnosis, prognostic severity scales, and new therapeutic options.","authors":"Paulo Guilherme Oliveira E Silva, Luiz Alberto Cerqueira Batista Filho, Pérez Flores Ismael, Vilins E Silva Victoria, Toledo Maciel Alexandre, Seraphim Medeiros Larissa","doi":"10.5867/medwave.2023.11.2719","DOIUrl":"https://doi.org/10.5867/medwave.2023.11.2719","url":null,"abstract":"<p><p>This narrative review article explores the current scientific knowledge on the definition, epidemiology, diagnostic criteria, microbiology, treatment, and prevention of severe community-acquired pneumonia (SCAP) in immunocompetent adults. At present, despite major scientific advances in diagnostic evaluation, clinical management, antimicrobial therapy, and prevention, severe community-acquired pneumonia remains a major cause of morbidity and mortality, as well as having a major economic impact in terms of increased healthcare expenditure worldwide. This pathology is considered one of the leading causes of sepsis/septic shock, with an extremely high overall mortality rate, which justifies all the effort in early diagnosis, proper management, and prompt initiation of antimicrobial therapy. Including biomarkers (isolated or in combination) associated with applying diagnostic criteria and prognostic severity scales in clinical practice helps identify patients with severe community-acquired pneumonia, defines immediate admission to the intensive care unit, and, thus, minimizes the adverse outcomes of this serious pathology.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"23 11","pages":"e2719"},"PeriodicalIF":1.2,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138805218","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":"General aspects of the use of mixed methods for health research.","authors":"Francisco Pérez Peña, Matías Cobaisse Ibáñez, Sebastián Villagrán Pradena, Ruben Alvarado","doi":"10.5867/medwave.2023.10.2767","DOIUrl":"https://doi.org/10.5867/medwave.2023.10.2767","url":null,"abstract":"<p><p>Traditionally, research has been divided according to its methodology into quantitative and qualitative. Mixed research methodology combines both methods and has established itself as a third approach, allowing to comprehensively address high-complexity research problems. Although there are various definitions of mixed methods research, they all share aspects such as the collection and analysis of both quantitative and qualitative data and the integrated interpretation of the results within the same research. This type of research is an important tool to address the complexity of health sciences, allowing the understanding and integration of quantitative data with experience-based aspects. In this way, a broad and deep perspective of health problems is achieved, providing a solution to sanitary policies and services. During the development of mixed methods research, there are key stages where both approaches can be integrated depending on the objectives set by the investigators. Although mixed methods studies may differ widely, general models have been identified to guide the development of a single specific design. These models are classified according to the priority of each approach, the sequence in which each approach will be executed, the level and timing of data integration, and the purpose of integrating the data for the study.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"23 10","pages":""},"PeriodicalIF":1.2,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71483599","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":"Clinical simulation training for the adequate management of obstetrics emergencies: A narrative review.","authors":"Najat Boucetta,&nbsp;Mustafa El Alaoui","doi":"10.5867/medwave.2023.10.2712","DOIUrl":"10.5867/medwave.2023.10.2712","url":null,"abstract":"<p><p>Obstetric emergencies are critical situations that jeopardize the health of both the mother and the baby during pregnancy or childbirth. This study aimed to validate the effectiveness of clinical simulation training in managing these situations. We conducted a narrative review of studies published between 2008 and 2022, collected from databases including Scopus, Sciencedirect, PubMed, Springer, Scielo, and Google Scholar. Data from studies that met our inclusion criteria were meticulously gathered and summarized. Our findings strongly emphasize that clinical simulation emerges as a highly effective tool in the training of healthcare professionals. This training translates into substantial improvements in various aspects, including performance, knowledge, confidence, satisfaction, attitudes, self-efficacy, teamwork abilities, and the skills necessary to confront critical obstetric situations such as postpartum hemorrhage, eclampsia, shoulder dystocia, maternal cardiac arrest, umbilical cord prolapse, and cesarean sections. Importantly, this training reduces the inherent risks associated with learning on real patients and aligns with the highest ethical standards. Additionally, our results underscore that interdisciplinary collaboration in the management of obstetric emergencies proves to be an effective strategy for providing comprehensive patient care. However, it is crucial to highlight that, in order to ensure patient safety and promote a teamwork approach, it is imperative for healthcare professionals to receive adequate training and be duly qualified. Although we acknowledge that implementing clinical simulation training can entail significant costs and require substantial resources, we firmly believe that this strategy continues to hold immeasurable value in the education of professionals in this field. Ultimately, we anticipate that future high-quality research will further fortify the evidence base regarding best practices in clinical simulation training for obstetric emergencies, thus contributing to enhanced patient outcomes and the overall quality of healthcare in this critical domain.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"23 10","pages":""},"PeriodicalIF":1.2,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71434400","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":"Progressive multiple organ dysfunction syndrome in adolescent pregnancy: Case report.","authors":"Jennifer Rodrigues Boock,&nbsp;Alexis Strickler,&nbsp;María Teresa Silva Elgueta,&nbsp;Loreto Twele Montecinos,&nbsp;Carolina Lizama Deluchi","doi":"10.5867/medwave.2023.09.2716","DOIUrl":"10.5867/medwave.2023.09.2716","url":null,"abstract":"<p><strong>Introduction: </strong>Adolescent pregnancy is a physiological process, but it can evolve with premature delivery, severe obstetric or clinical pathologies, mortality, or sequelae for mother and child. We aim to report the progressive multiple organ dysfunction syndrome secondary to pyelonephritis and sepsis during prepartum, delivery, and puerperium of adolescent pregnancy and its sequelae.</p><p><strong>Case report: </strong>A 14-year-old adolescent with a pregnancy of 27 weeks of gestation controlled from 8 to 25 weeks. She was urgently admitted to the high-risk obstetric unit due to signs of preterm labor, pyelonephritis, and acute renal injury. Treatment was started with intravenous cefazolin and betamethasone for lung maturation, oral nifedipine, and magnesium sulfate to prevent preterm labor and fetal neuronal protection, evolving with sustained hypotension and septic shock. At 13 hours after admission, she was transferred to the intensive care unit, where she evolved with persistent and progressive multiple organ failure for 28 days, progressively affecting the cardiovascular, hematologic, respiratory, and gastrointestinal systems. She was treated with vasoactive drugs, antibiotics, invasive mechanical ventilation, ultrafiltration, hemodialysis, pleural drainage, and cholecystectomy. Twenty-four hours after admission to intensive care, preterm vaginal delivery occurred. She developed chronic kidney disease stage KDIGO 5 (Kidney Disease Improving Global Outcomes V) and is awaiting renal transplantation. On the other hand, the preterm newborn presented severe neonatal asphyxia, bronchopulmonary dysplasia, and hypoxic-ischemic encephalopathy.</p><p><strong>Conclusion: </strong>Complicated adolescent pregnancy is a health emergency. Avoiding delays in the diagnosis and treatment of pyelonephritis, septic shock and the progressive multiple organ dysfunction syndrome can prevent mortality and permanent sequelae, both maternal and neonatal.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"23 9","pages":""},"PeriodicalIF":1.2,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41205101","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":"Population analysis of the CLOCK rs3749474T-rs4864548A haplotype and its relationship with obesity.","authors":"Sergio Flores Carrasco,&nbsp;Mariela Olguín-Barraza,&nbsp;Angel Roco-Videla","doi":"10.5867/medwave.2023.09.2735","DOIUrl":"https://doi.org/10.5867/medwave.2023.09.2735","url":null,"abstract":"<p><p>It has been suggested that the rs3749474T/rs4864548A haplotype of the CLOCK gene increases the risk of obesity, but the population variability of these alleles and the haplotype is unknown. This research aims to determine the linkage between the rs3749474T and rs4864548A alleles from the database of 1000Genomes to confirm the existence of the TA haplotype polymorphisms of these alleles and their frequency in five macro populations. Linkage disequilibrium and haplotype frequencies for 2504 individuals from 26 populations were analyzed using the r statistic and Fisher's exact test. There is a high frequency of the TA haplotype in Latin America (44.8%), a high linkage disequilibrium (r2= 0.92) worldwide between these alleles, a high differentiation between macro populations, and a high homogeneity. The evidence warrants further studies on the association between this haplotype and the risk of obesity and overweight in Latin American populations.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"23 9","pages":""},"PeriodicalIF":1.2,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41122507","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":"Burnout levels and associated factors among Intensive Care Unit workers during the first wave of the COVID-19 pandemic in Chile: A cross-sectional study.","authors":"Felipe Ponce-Fuentes,&nbsp;Jenny Collipal-Cayún,&nbsp;Jaime Sepúlveda-Cisternas,&nbsp;Ivan Cuyul-Vásquez,&nbsp;Antonio Roberto Zamuner,&nbsp;Jorge Fuentes-Contreras","doi":"10.5867/medwave.2023.08.2720","DOIUrl":"https://doi.org/10.5867/medwave.2023.08.2720","url":null,"abstract":"<p><strong>Introduction: </strong>The COVID-19 pandemic resulted in an unpredictable healthcare crisis with a high psychological burden on healthcare workers.</p><p><strong>Objective: </strong>To evaluate burnout levels and their associated demographics and occupational factors among intensive care unit healthcare workers during the COVID-19 pandemic in a single hospital in the city of Temuco, Chile.</p><p><strong>Methods: </strong>A cross-sectional design in which a sociodemographic questionnaire and the Maslach Burnout Inventory for Human Services were sent to health care workers in a single Chilean Intensive Care Unit during the pandemic COVID-19. Burnout levels, demographic, and occupational factors are reported using descriptive statistics; correlations between burnout levels and demographic-occupational factors were analyzed using Spearman's and rank-biserial correlation coefficients; and multiple linear stepwise regression was used to assess the contribution of demographic and occupational factors to participants' burnout levels.</p><p><strong>Results: </strong>A total of 84 participants (46 women and 38 men) were included in the analysis. Depersonalization and low personal accomplishment were evidenced in 95.2% and 98.8% of the intensive care unit healthcare workers, respectively. Emotional exhaustion was positively correlated with having children ( = 0.72; < 0.01). Age ( = 0.79; < 0.05), sex ( = 0.30; < 0.05), and prior experience in intensive care unit facilities ( = 0.71; < 0.05) were correlated with depersonalization. Feeling of personal accomplishment was positively correlated with with sex ( = 0.70; < 0.05) and type of work shift ( = 0.29; < 0.01).</p><p><strong>Conclusions: </strong>The intensive care unit healthcare workers in this study reported high levels of depersonalization and low feelings of personal accomplishment during an advanced stage of the COVID-19 pandemic. Older age, being female, having children, having intensive care unit experience, and working at 4th shift were factors related to burnout dimensions.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"23 8","pages":""},"PeriodicalIF":1.2,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41136167","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}