Revista médica de Chile
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Revista médica de Chile · Jul 2023
Review[Update in diagnosis and management of Clostridioides difficile].
Clostridioides difficile (C. difficile) is one of the leading causes of infection associated with health care with high morbidity and mortality, especially among hospitalized older adults. The increase in the use of antibiotics has been associated with a higher number of cases and greater virulence. Its clinical presentation ranges from asymptomatic carriers to toxic megacolon. ⋯ Fidaxomicin, fecal microbiota transplant, and new therapies such as monoclonal antibodies have been incorporated into the therapeutic arsenal, with a higher level of evidence. Nevertheless, the severity, patient comorbidity, recurrence risk factors, and the economic cost of each therapeutic option must be considered. This review aims to update the last guidelines proposed by the Chilean Societies of Gastroenterology and Infectious Diseases published in 2016, providing the latest recommendations regarding prevention, diagnosis, and treatment of C. difficile infection.
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the International Agency for Research on Cancer included the occupational and environmental exposure of firefighters, in the list of carcinogens for humans. ⋯ Identifying associations between firefighters' occupational exposures and cancer risk is a challenging task mainly due to the multifactorial origin of cancer. The best way to reduce exposure is to implement preventative measures.
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Revista médica de Chile · Jul 2023
Case ReportsBeyond the Recommendations of the Clinical Guidelines for Medullary Thyroid Cancer - A Case Report.
Medullary thyroid cancer (MTC) is a rare disease from parafollicular C cells. Calcitonin has been suggested as a screening; its levels are proportional to the tumor size and predictive of metastatic disease. We present a case where an early action was taken with lower cut-off points. ⋯ Surgery was done, and a biopsy confirmed metastases. Conclusions: The clinical guidelines may allow the management of cases; however, they should be used considering each case context. In our patient, if the guidelines had been strictly followed, it would not have been possible to detect liver metastases to achieve a surgical resection with curative intent.
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Revista médica de Chile · Jul 2023
Controlled Clinical Trial[Metabolic and cardiorespiratory fitness changes in women undergoing a physical exercise program assisted by a mobile application. A non-randomized controlled study].
Metabolic syndrome (MetS) is prevalent in our population. The purpose of this study is to evaluate the effect of physical exercise, assisted by a mobile application (m-Health), on cardiorespiratory fitness (ACR) and cardiovascular risk markers in women with metabolic disorders typical of MetS, and to compare it with the effect of exercise monitored face to face in women with similar characteristics. ⋯ A physical exercise program via m-Health improved ACR and anthropometric parameters in women with cardiometabolic disorders.
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Revista médica de Chile · Jul 2023
[Health-Related Quality of Life in Heart Transplant Recipients: A Review].
Organ transplantation is a therapeutic alternative for patients with end-stage organ failure resulting from chronic or acute disease. In this context, health-related quality of life is an important multidimensional concept to evaluate the benefits of transplantation. ⋯ Heart transplantation represents a successful therapeutic alternative that not only prolongs life but also makes it possible to achieve an adequate health-related quality of life. Family and social support are crucial elements that impact adjustment and quality of life during the pre- and post-transplant process.