Revista médica de Chile
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Revista médica de Chile · Dec 2020
[Implementation of an Objective Structured Clinical Examination (OSCE) for Anesthesiology Certification in Chile].
Anesthesiology became the first Chilean medical specialty certification board to incorporate an objective structured clinical examination (OSCE) into its certification system. The main reason for the introduction of an OSCE is to include an evaluation that allow candidates to demonstrate what they really "do" in clinical practice domains. Inherent in this justification is that the OSCE detects competences that are not well evaluated in current written and oral exams. This article describes the process of implementing an OSCE in Anesthesiology certification and a description of its application after one year of operation.
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Hypopituitarism after moderate or severe traumatic brain injury (TBI) is usually underdiagnosed and therefore undertreated. Its course can be divided in an acute phase during the first 14 days after TBI with 50 to 80% risk of hypopituitarism, and a chronic phase, beginning three months after the event, with a prevalence of hypopituitarism that ranges from 2 to 70%. Its pathophysiology has been addressed in several studies, suggesting that a vascular injury to the pituitary tissue is the most important mechanism during the acute phase, and an autoimmune one during chronic stages. ⋯ Hence, we propose a simple and cost-effective algorithm to detect and treat a potential hypothalamic-pituitary-adrenal axis impairment and alterations of sodium homeostasis, both of which can be life-threatening. In the chronic phase, post-concussion syndrome is the most important differential diagnosis. Given the high prevalence of hypopituitarism, we suggest that all pituitary axes should be assessed in all patients with moderate to severe TBI, between 3 to 6 months after the event, and then repeated at 12 months after trauma by a specialized team in pituitary disease.
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Revista médica de Chile · Dec 2020
[Sociodemographic Patterning of Cardiorespiratory Fitness Derived by Equation in the Chilean Population: Findings from the Chilean Health Survey 2016-2017].
Cardiorespiratory fitness is a strong predictor of mortality and chronic diseases. However, its estimation is costly and time consuming which may limit it broad use in population-based studies. ⋯ This study reports fitness levels in a nationally representative sample of Chile. Fitness levels were higher in men than women however, its decline with age was more pronounce in men than women.
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Revista médica de Chile · Dec 2020
Observed Frequency and Characteristics of Hearing Loss in Osteogenesis Imperfecta.
Osteogenesis imperfecta (OI) is a rare group of genetic disorders affecting connective tissue, with consequent bone fragility, frequent fractures and skeletal deformity. Depending on the type, patients can have blue sclera, dentinogenesis imperfecta, and hearing loss. ⋯ In this group of patients with OI, 30% had hearing loss and among those ears with normal hearing, 13% did not have an acoustic stapedial reflex. Patients with OI should be monitored for hearing loss.