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 · Aug 2022
Review[Handgrip strength as a predictor of adverse health outcomes].
Muscle strength can be measured through different methods and handgrip strength is one of the most used techniques in epidemiological studies. Given its easy application, high reliability, and low cost, it is considered an important health biomarker. ⋯ There is a paucity of evidence in Chile about the association of handgrip strength with these health outcomes limiting its visibility and implementation in clinical settings. Therefore, this narrative review summarizes the scientific evidence about the association of grip strength with non-communicable chronic diseases and mortality in middle age and older adults.
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Revista médica de Chile · Aug 2022
Review[Benefits of green spaces and physical activity for the well-being and health of people].
Physical environment can influence well-being, quality of life and health and population health in several ways. Exposure to green spaces improves the physical and mental health of individuals. Chile has privileged conditions for outdoor activities that could benefit millions of people. However, a small percentage of the Chilean population is exposed to green spaces in the recommended amounts to promote health. ⋯ This review supports strategies for improving access to green spaces in urban areas coupled with physical activity promotion in these settings. Health and urban planning stakeholders should consider these aspects in future programs.
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Revista médica de Chile · Jul 2022
Review[Instruments to assess functional capacity and the presence of frailty in older people].
The evaluation of functional capacity and the presence of frailty is an essential prognostic indicator in older people. ⋯ The main instruments to assess CFI and frailty in older people cared in PHC in Chile are the EFAM, and the Fried and FTI criteria, respectively.
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Drug dosing according to renal function is a globally accepted practice whose main purpose is to avoid drug associated toxicity when renal clearance is decreased. Renal function is usually estimated based on creatinine clearance or an estimated glomerular filtration rate (GFR) obtained from one of the available equations based on serum biomarkers. In this review we will analyze the different available methods to adjust the dose of drugs based on GFR, with emphasis on their comparative performance for this objective. Based on this, we will provide some recommendations for drug dosing in chronic and acute renal dysfunction.