Revista médica de Chile
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Revista médica de Chile · Dec 2023
Review[The Evolution of Hemodialysis in Chile: Is Hemodiafiltration the Next Step?].
Hemodialysis began in Chile during the latter half of the 20th century, primarily targeting individuals with acute renal failure. With time, dialysis facilities emerged across diverse regions of the nation, covering hospitals and private centers. This expansion widened dialysis access to chronic patients, culminating in universal coverage through the AUGE plan. ⋯ Despite advancements, complications linked to dialysis persist, significantly affecting patients' overall quality of life. Heightened rates of hospitalization and mortality are, in part, ascribed to the inherent technical limitations of hemodialysis in efficiently clearing uremic toxins. Therefore, superior purification modalities such as high-volume hemodiafiltration need to be progressively adopted to effectively address the persistent clinical needs in the care of dialysis patients within the Chilean context.
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Revista médica de Chile · Dec 2023
[Analysis of Clinical-Scientific Research on Diabetes Mellitus in Chile: A 13-Year Study].
Chile has one of the highest prevalences of Diabetes Mellitus (DM) in Latin America. Therefore, it is relevant to conduct a scientific analysis to identify national scientific productivity in this field objectively and determine if the research efforts are directed toward clinical priorities. ⋯ These results highlight the need to promote research in academic and/or clinical institutions, emphasizing reducing the incidence of DM2 due to the low number of articles with this type of design and the more prevalent complications.
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Revista médica de Chile · Dec 2023
Review[Barriers to access treatment for eating disorders: Literature review].
Eating disorders (EDs) are disabling, potentially fatal, and costly mental disorders. According to recent data, Chile has the highest prevalence of both anorexia nervosa (AN) and bulimia nervosa (BN) in Latin America. However, there is no published data regarding the barriers experienced by patients with EDs in Chile until they start treatment. ⋯ The national context calls for discussing access problems in patients with EDs in Chile. The barriers found in this study should be considered when designing public policies, although the role of the cost of treatment should be more emphasized in Chile.
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Revista médica de Chile · Dec 2023
Case ReportsGastroparesis associated to isoniazid. First description.
Isoniazid, a central compound in the treatment of active or latent tuberculosis, is associated with various adverse reactions, including hepatitis and polyneuropathy. The latter is due to functional pyridoxine depletion and can be avoided by appropriate doses and supplementation with pyridoxine. We present the case of a patient with several previous treatment abandonments for active pulmonary tuberculosis who evolved with late postprandial vomiting due to gastroparesis documented by nuclear medicine gastric emptying tests after a new treatment onset. ⋯ The association of gastroparesis with isoniazid was considered definitive when applying at least two causality protocols. Gastroparesis associated with isoniazid should be added to the list of adverse effects associated with this drug, even in patients receiving pyridoxine supplementation. Its recognition is initially clinical, can be confirmed with nuclear medicine studies, and affects the eradication of Mycobacterium tuberculosis.
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Revista médica de Chile · Dec 2023
Case ReportsSuccessful use of daptomycin and cefazolin in a case of persistent bacteremia caused by community acquired-methicillin resistant Staphylococcus aureus in a pregnant woman. Case report.
We present the case of a pregnant woman with community-acquired methicillin-resistant Staphylococcus aureus bacteremia who required combined treatment with daptomycin and cefazolin for control after failure of an initial treatment with vancomycin. She had a favorable evolution, and the study of family contacts revealed a phenotypic and genetically similar isolate in a nasal sample from his mother. ⋯ This case reveals that bacteremia caused by methicillin-resistant Staphylococcus aureus can affect pregnant women, and that the use of combined therapies may be necessary for its control. Sometimes, family contacts can carry this agent, and an eradication treatment is suggested..