Revista médica de Chile
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Atrial Fibrillation (AF) is the most common sustained arrhythmia and is highly prevalent in elderly patients. It confers a higher risk for ischemic stroke, heart failure and death. The diagnosis and treatment of AF has been extensively studied and remain under constant revision. ⋯ This new family of drugs has clear benefits in terms of efficacy and safety compared with traditional vitamin K antagonists. Treatment of most common comorbidities in patients with AF such as advanced age, heart failure, diabetes, renal failure, and others are also analyzed. New therapies for AF will be shortly available.
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Revista médica de Chile · Nov 2022
Review[Academic residents fellowship program at the University of Chile Clinical Hospital].
The mission of the University of Chile Clinical Hospital is to be the main University Hospital in the country. Along with training of health professionals in clinical practice and research, the Hospital provides comprehensive health solutions to the community. Since its foundation, it played an important role in the training of health professionals and specialists. ⋯ These regulations allow the financing of training programs in basic or primary specialties (such as internal medicine, surgery, obstetrics and gynecology, among others) or in specialties derived from them (such as cardiology, gastroenterology and reproductive medicine, among others.) The different clinical departments and the Hospital Direction define each year how many places will be offered and in which specialties. The Faculty of Medicine Graduate School carries out the formal selection of the applicants. This article reviews the results of this program between 2013 and 2021, analyzing in detail the traceability of each graduate over the years.
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Revista médica de Chile · Oct 2022
Review[Biological effects due to exposure to different concentrations of oxygen from hypo to hyperoxemia].
The systemic effects of oxygen deficiency or excess are not thoroughly described. Knowledge is evolving towards the description of beneficial and detrimental effects of both extremes of partial pressure of oxygen (PaO2). The cellular and tissue mediators derived from the modulation of the oxidative tone and the production of reactive oxygen species (ROS) are widely characterized biochemically, but the pathophysiological characterization is lacking. ⋯ On the other hand, the modulation of the hypoxic response associated with exposure to high altitude environments (hypobaric), favors Chile and its highlands as a natural laboratory to determine certain cardiovascular, cerebral and metabolic responses in the resident population. Also, the consequences of the intermittent exposure to high altitudes in workers also deserves attention. This review discusses the physiopathological response to hypo and hyperoxemia, associated with environments with different oxygen concentrations, and brings back the concept of oxygen as a pharmacological mediator in extreme environments such as high altitudes and hyperbaric medicine in divers, decompression sickness, osteonecrosis associated with radiotherapy and sudden sensorineural hearing loss.
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Despite recent initiatives and efforts, gender inequality still exists in medicine and academia. There is a higher proportion of male authors in international scientific publications. ⋯ There are fewer female authors in scientific publications. Chile is one of the countries with a high rate of gender gap in the world. The underrepresentation of women in academia is an example of this.
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Revista médica de Chile · Sep 2022
Review[Challenges for training medical professionalism values in times of COVID-19 and social crisis].
The essence of professional education not only involves transmitting knowledge, but also values and attitudes for a practice that allows us to face changing global and national scenarios. Physicians are currently facing new challenges derived from the impacts of the pandemic as well as the social crisis. Increased workload, limited access to health systems, economic uncertainty, and increased public scrutiny hamper physicians to fulfill their responsibilities to patients and society. ⋯ Medical professionalism acts as a stabilizing and morally protective social force. Thus, it is critical to fathom essential values of professionalism that characterize medical practice today. Indeed, the explicit incorporation of these values in undergraduate and postgraduate programs will undoubtedly allow the training of better professionals for the practice of medicine. (Rev Med Chile 2022; 150: 1248-1255).