Revista médica de Chile
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Revista médica de Chile · Mar 2021
[Communication and empathy skills among health care workers of an emergency department of a general hospital].
Communication gaps are common in emergency medicine. ⋯ The health care team is not trained in communication skills, crisis intervention and empathy. Empathy and good communication are essential for users and family members to perceive health care as satisfactory and safe and to comply with indications. The lack of protocols to inform family members about the death of a patient is the finding that most clearly accounts for the observed communication deficiencies.
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Revista médica de Chile · Mar 2021
[Perspectives of physicians who work in public hospitals about ethical problems in medical practice].
The recognition of ethical problems in medical practice and the potential harmful effects that they may have on patients, underscores the importance of the ethical training of professionals as well as the development of Ethics Committees in Healthcare institutions. However, there is a paucity of national studies about the type of problems faced by professionals and the role of Ethics Committees in hospitals. ⋯ Human resources and an adequate institutional environment are required to promote the discussion about ethical issues such as the relationship between physicians and patient, the role of teaching in health care and institutional decisions.
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The evaluation of renal function in older adults is usually carried out with a creatinine clearance or an estimation of glomerular filtration rate using formulas such as Cockcroft-Gault, MDRD or CKD-EPI. The results obtained with these formulas are often regarded as equivalent. However, in adults older than 70 years, the Cockcroft-Gault formula frequently underestimates the glomerular filtration rate with respect to reference methods and the MDRD formula overestimates it. ⋯ Also, when kidney function is overestimated, CKD patients are prevented from receiving the treatments appropriate for their condition. In recent years, new formulas have been proposed (FAS, BIS) with a greater accuracy to estimate glomerular filtration rate in older adults. This review describes the behavior of these formulas in a significant number of older adults, from various countries, and proposes using those equations with the best performance in older adults.