Revista médica de Chile
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Revista médica de Chile · May 2022
Review[Liver transplantation for non-resectable colorectal liver metastases: A review].
In Chile, colorectal cancer ranks third in incidence and fifth in mortality. Half of these patients have liver metastases at the diagnosis, and only 30% of them are resectable. Despite the development of many complex hepatobiliary procedures to achieve the total resection of metastases, the long-term survival with these techniques is not good. ⋯ These patients have better overall and disease-free survival after liver transplantation. The use of immunosuppressive treatment doesn't increase recurrence, and even the pattern of tumor growth is slower in liver transplant recipients. The purpose of this review is to summarize the current evidence in this topic and to highlight the need for a formal protocol for liver transplantation for unresectable colorectal liver metastases, using living donors or marginal grafts to avoid competition with the rest of the national waiting list.
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Revista médica de Chile · Apr 2022
Review[Dialogue between bioethics and evidence- based medicine, a narrative ethics perspective].
Evidence-Based Medicine (EBM) is the methodological paradigm of Western medicine today. EBM is expected to reduce the use of intuition and to promote the use of scientific evidence, in the clinical decision-making process. ⋯ All the above could lead to several bioethical conflicts. This work consists in a literature review that examines the interaction between EBM and Bioethics in a reciprocity frame, in order to approach possible ethical conflicts that emerge with the use of EBM, and later analyze them from the perspective of the Narrative Ethics model, proposed by the philosopher Paul Ricoeur.
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Revista médica de Chile · Apr 2022
Review[Pulmonary manifestations of anti-neutrophil cytoplasmic antibody associated vasculitis].
This article reviews the pulmonary manifestations of anti-neutrophil cytoplasmic antibody associated vasculitis (AAV). Its frequency in the different phenotypes of the disease, clinical manifestations and updated therapeutic recommendations are reviewed, aiming to alert the medical community about the existence of these diseases. We pretend to stimulate a timely suspicion, diagnostic precision, and the implementation of effective therapies, to reduce the eventual sequelae derived from a diagnostic omission or an inappropriate treatment for the different clinical scenarios in which these diseases appear.
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Revista médica de Chile · Apr 2022
[Performance of EuroSCORE II in Latin America: a systematic review].
EuroSCORE II is a mortality risk score for cardiac surgery in adults. This version is widely validated and compared with other scores in Europe, North America, and Asia. ⋯ In these studies, EuroSCORE II underestimated mortality in cardiac surgery.
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Revista médica de Chile · Apr 2022
[A systematic review of standardized instruments to measure the doctor-patient relationship].
The current health situation caused by the COVID-19 pandemic has prompted a reconfiguration of the doctor-patient relationship. We performed a systematic review to comparatively evaluate the instruments most used to study communication in the doctor-patient relationship. ⋯ Most of these instruments contemplate a unidirectional design and address similar dimensions of the doctor-patient relationship, particularly in the Latin American context where the relationship is mostly studied in a unidimensional way. We propose recommendations for the development, revision, or refinement of instruments that measure communication in the doctor-patient relationship.