Revista médica de Chile
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Revista médica de Chile · Sep 2022
Review[Intravenous sodium bicarbonate. When, how and why to use it?].
Severe metabolic acidosis is defined by a pH < 7.2 with HCO3- < 8 mE- q/L in plasma. Its best treatment is to correct the underlying cause. However, acidemia produces multiple complications such as resistance to the action of catecholamines, pulmonary vasoconstriction, impaired cardiovascular function, hyperkalemia, immunological dysregulation, respiratory muscle fatigue, neurological impairment, cellular dysfunction, and finally, it contributes to multisystemic failure. ⋯ However, the calculations are only for reference. More important is to start intravenous NaHCO3 when needed, administer it judiciously, manage its side effects, and continue it to a safe goal. In this review we address all the necessary elements to consider in the administration of intravenous NaHCO3, highlighting why it is the best buffer for the management of severe metabolic acidosis.
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Revista médica de Chile · Sep 2022
Case Reports[Late-onset hereditary transthyretin amyloidosis with polyneuropathy. Report of one case].
Hereditary transthyretin amyloidosis is a multisystemic autosomal dominant genetic disorder characterized by progressive distal sensory-motor polyneuropathy or restrictive cardiomyopathy, secondary to amyloid deposits. Its pathogenesis lies in the TTR gene mutation, and the Val50Met mutation is the most frequent. Patients have significant differences in the onset and severity of clinical presentation according to their country of origin. ⋯ During the etiological study of her polyneuropathy, an increased Kappa/Lambda index of 2.55 mg/L stood out. Therefore, light chain amyloidosis was suspected, and chemotherapy treatment was indicated without favorable response. After 10 years of progressive neurological and ophthalmological involvement, a genetic study confirmed the first case of late-onset hereditary transthyretin amyloidosis Val50Met with polyneuropathy in Chile.
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Revista médica de Chile · Sep 2022
[Risk perception, preventive efficacy and social factors as predictors for COVID-19 preventive behavior in chileans].
Social isolation and hand washing are effective measures to prevent COVID-19 transmission Aim: To evaluate the predictive role of risk perception and preventive efficacy perception, along with sociodemographic and health factors, for adherence to hand washing and isolation behavior of Chilean adults. ⋯ Preventive behaviors are associated with several psychosocial factors, allowing to distinguish groups at higher risk, which should be the focus of COVID-19 preventive interventions.
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Angiomyolipomas (AML) are mesenchymal tumors belonging to the group of perivascular epithelioid cell tumors, which, rarely, can display a malignant behavior. They are composed of adipose tissue, vessels, and muscle tissue in different proportions, and constitute a differential diagnosis for other focal liver lesions. ⋯ During ten years of imaging follow, the size and features of the lesion has not changed. The patient rejected a surgical excision.
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Revista médica de Chile · Sep 2022
[Psychometric properties of two surveys about beliefs towards vaccines in general and SARS-CoV-2 vaccine].
Negative beliefs about vaccines can threaten herd immunity and pandemic control. Although beliefs about vaccines influence vaccination intention, there are no valid instruments that evaluate this in the Latin American population. ⋯ The scales evaluated here are reliable and valid measures that showed associations with vaccination intention in the Chilean population.