Revista médica de Chile
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Revista médica de Chile · Jun 2020
Review[Unsafe abbreviations in medical prescriptions and their association with medication errors: a review].
The prescription of medications is a weak link in the therapeutic chain of a drug. Medication errors can be associated with the use of so-called unsafe abbreviations in medical prescription. When they are mistakenly interpreted by the person who reads the prescription, error becomes imminent. ⋯ One of the causes for the use of acronyms the limited time that doctors have at the time of prescription. One way to reduce the use of these abbreviations, is to remind constantly about those that may have the greatest risk in each health institution. A list of unsafe abbreviations, to be used by Chilean health services, is proposed.
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Revista médica de Chile · Jun 2020
Cytomegalovirus infection in AIDS patients. An illustrative case series.
Cytomegalovirus (CMV) is an opportunistic infection (OI) in immunosuppressed patients. However, there are no clear cut-off values available for quantitative plasmatic CMV measures (viral load [VL]) to discriminate those with CMV illness from those infected suffering a transient viral reactivation. ⋯ The predominant clinical manifestation in our series was gastrointestinal. A CMV VL cutoff level of CMV VL of 3,800 copies / mL is useful to discriminate infected patients from those with CMV related disease.
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Revista médica de Chile · Jun 2020
Adherence to levothyroxine prescription in patients with hypothyroidism.
Hypothyroidism occurs in 1-2% of the general population, is associated with significant morbidity and requires continuous treatment with levothyroxine. ⋯ In a large proportion of these patients, TSH levels were controlled, and most patients were adherent to levothyroxine therapy.
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Revista médica de Chile · Jun 2020
[Evaluation of HIV epidemic in Chile. A statement of the Chilean Academy of Medicine].
The Chilean Academy of Medicine convened a commission to evaluate the status of HIV epidemic and the national response to it, regarding its achievements, gaps and challenges, aiming to recommend actions to optimize assessment quality and national response. This publication summarizes the agreed upon opinion of its members. The epidemic is overwhelmingly sexually transmitted, predominant in homo/bisexual men. ⋯ Despite these clear achievements, insufficient, occasionally inadequate public policies and certain rigid regulations thwart optimal effectivity and efficiency of the programs, contributing to the slow and incomplete compliance with international commitments. Shortcomings worth highlighting are: suboptimal educational and preventive programs directed to youngsters, vulnerable and general population; persistent underdiagnosis of infected population; cumbersome requirements to request and inform diagnostic tests, thus discouraging testing; excessive centralization and long latency of diagnosis confirmation and monitoring tests; incomplete epidemiologic analysis and public reporting of findings; non flexibility and slow updating of therapeutic guidelines; insufficient adaptation of care and drug delivery modalities to patients' needs; excessive administrative requirements at care centers and restrictive legislation for outcome and interventional clinical research. Recommendations to deal with these issues were proposed.
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Revista médica de Chile · Jun 2020
Case Reports[Stress induced ketoacidosis in spinal muscular atrophy. Report of one case].
Spinal muscular atrophy is an uncommon cause of ketoacidosis, where there is a decrease in muscle mass, an abnormal metabolism of glucose and fatty acids, and changes in neuroendocrine function. These conditions favor the accumulation of keto acids and the development of metabolic acidosis. We report a 26-year-old female, with a history of spinal muscular atrophy type III, consulting for abdominal pain and vomiting lasting one week. ⋯ She had a pH of 6.98, HCO3- of 3.8 mmol/L, pCO2 of 16.4 mmHg, BE of -26 mmol/L, delta ratio of 1.05, anion gap of 31 mEq/L, creatinine of 0.37 mg/dL, sodium of 147 mEq/L, potassium of 3.7 mEq/L, chloride of 112 mEq/L, lactate of 1.2 mmol/L, glucose of 108 mg/dL, albumin of 4.2 g/dL, ketonemia +++, ketonuria +, measured plasma osmolality of 322 mOsm/kg, estimated osmolality of 314 mOsm/kg, toxilab negative, salicylate levels < 3 µg/mL, acetaminophen levels < 1.2 µg/mL. Intravenous hydration and bicarbonate were started, without satisfactory response. Interpreting the clinical picture as a ketoacidosis induced by stress in a patient with spinal muscular atrophy, it was handled with glucose, amino acids, vitamins and trace elements, with a favorable response.