Revista médica de Chile
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Revista médica de Chile · Dec 2020
Case Reports[Inferior vena cava agenesis presenting as deep vein thrombosis. Report of one case].
Abnormalities of the inferior vena cava are rare. Its embryological development occurs between the sixth and eighth week of gestation and depends on the persistence or regression of three pairs of veins: the posterior cardinal veins, the subcardinal veins and the supracardinal veins. The type of congenital alteration depends on the moment that embryogenesis is altered. ⋯ An abdominal CAT scan showed an agenesis of the supra and infra-adrenal inferior vena cava, with multiple collaterals. The study for thrombophilia was negative. The patient was treated with vitamin K antagonists with a good clinical response.
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The prevalence of inflammatory bowel disease (IBD) increased in the last decades. Thus, the number of pregnant women with the condition is also increasing. ⋯ Patients can undergo vaginal delivery in most forms of IBD. However, cesarean delivery is still preferable in women with a history of ileal pouch-anal anastomoses (IPAA) or active perianal disease.
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Revista médica de Chile · Dec 2020
[Survival analysis of patients starting hemodialysis in Chile between 2013 and 2019].
Renal replacement therapies, especially hemodialysis (HD) in end-stage kidney disease, avoid an inevitable death caused by the disease. However, in elderly patients with multiple comorbidities, this therapy could derive in a comparable survival than conservative management. Considering that HD represents a high cost for the health system, it is worth analyzing the effects of HD on survival. ⋯ The median survival of patients on HD is dependent on age and the presence of comorbidities, among other factors. We performed an analysis to determine if starting HD in older patients with comorbidities has a real benefit over conservative management in terms of survival.
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Social frailty is a seldom explored concept in older people. There is dissent if it should be considered a multidimensional syndrome or it should be limited to the physical sphere. ⋯ One exposes the concept of social frailty, nine operationalize social frailty using questions or items on social behavior and two use scales or measuring instruments to classify older people as "socially frail". It is concluded that social frailty is a new concept in gerontology: there are divergences as to whether it should be considered as another dimension of frailty or as an independent concept with a predictive capacity by itself to detect risk among older people.
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Revista médica de Chile · Dec 2020
[A survey among patients about physician virtues that they value].
Theoretically, the exercise of good medicine requires physicians who possess and practice virtues. There are good reasons to believe that virtue ethics would be highly appreciated by patients. ⋯ These results support the theoretical argument that, for patients, the practice of virtue ethics is essential for a good medical practice.