Revista médica de Chile
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Revista médica de Chile · Dec 2019
ReviewIntoxicación por etilenglicol, fisiopatología y enfrentamiento clínico.
Toxic alcohols can produce severe poisoning with multiple organic involvement and even death. The most common form is ethylene glycol. The diagnosis can be extremely difficult if there is no history of its consumption. ⋯ The clinical manifestations are diffuse neurological involvement initially, followed by hemodynamic alterations due to myocardial damage associated with hypocalcemia and acidemia. Subsequently, severe tubular renal damage appears, which may require renal replacement therapy, and finally, focal neurological alterations. To treat this poisoning, it is necessary to inhibit the transformation of alcohol into acids, increase the metabolism of the latter or withdraw them directly with hemodialysis.
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Acute aortic syndromes include a spectrum of life-threatening aortic conditions. A review of the diagnostic aspects of the acute aortic syndrome was made, from the perspective of the imaging techniques available for this purpose. ⋯ Emphasis was placed on the relevance of clinical information as a fundamental tool for suspecting this syndrome and appropriately choosing the imaging technique. Our main objective is to provide information about the diagnosis of this condition, especially in the context of emergency services.
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Revista médica de Chile · Dec 2019
Multicenter Study Observational Study[Response rates to first-line treatment in eligible patients to autologous stem transplantation in Chile].
Background The treatment of choice of newly diagnosed multiple myeloma (NDMM) is an induction with proteasome inhibitors followed autologous stem cell transplantation (HSCT). Since 2013, the treatment of these patients in the public system is based on CTD (cyclophosphamide, thalidomide, and dexamethasone). Aim To evaluate the response rates achieved with CTD, and the results of HSCT in patients with NDMM in the public setting. ⋯ The 5-year Overall Survival (OS) in transplanted patients and non-transplanted patients was 100 and 62% respectively (p < 0.01). Conclusions The response rate achieved by CTD in these patients is suboptimal. The response to CyBorD was better.
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Revista médica de Chile · Dec 2019
[Implementation of diagnosis related groups methodology in a university hospital].
Background The Diagnosis Related Groups (DRG) constitute a method of classifying hospital discharges. Aim To report its development and implementation in a Chilean University Hospital and global results of 10 years Material and Methods We included 231,600 discharges from 2007 to 2016. In the development we considered the physical plant, clinical record flow, progressively incorporated human resources and computer equipment for coding and analysis to obtain results. ⋯ They occupied 40% of bed days. Nine percent had a grade 3 severity with high median hospital stay and accounting for 31.5% of bed days. Conclusions DRG methodology is a valuable information tool for decision making and result assessment in hospital management.
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Revista médica de Chile · Dec 2019
[Performance of sleep questionnaires for the diagnosis of obstructive sleep apnea syndrome].
Background The diagnosis of obstructive sleep apnea syndrome (OSAS) is based on nocturnal records: polysomnography or respiratory polygraphy. However, their high costs limit their use. Aim To examine the predictive value of three sleep questionnaires (STOP, STOP-Bang, Epworth Sleepiness Scale (ESS) in the screening of OSAS in Chilean adults. ⋯ STOP, STOP-Bang and ESS questionnaires classified 64%, 71% and 12% of cases as high risk for OSAS, respectively. The STOP and STOP-Bang questionnaires had the highest sensitivity to predict OSAS (76% and 89%, respectively) while the ESS had the highest specificity (91%). Conclusions The sleep questionnaires allowed to identify the subjects at high risk for OSAS in this sample of adults from the Metropolitan Region.