Revista médica de Chile
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Biomarkers in inflammatory bowel disease are an essential tool in clinical practice. They allow a non-invasive evaluation of patients and thus guide decision-making at different stages of the disease, including diagnostic suspicion, severity assessment, relapse prediction, and treatment response. ⋯ Fecal calprotectin is the most commonly used marker. This review discusses the advantages and disadvantages of biomarkers in inflammatory bowel disease, as well as their clinical applications and new biomarkers currently under research.
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Revista médica de Chile · Mar 2020
Review[With regard to COVID-19 contingency. ECMO in adults. Extracorporeal Membrane Oxygenation). To whom, how and when].
ECMO (Extracorporeal Membrane Oxygenation) is an extracorporeal life support system in catastrophic lung failure, shock and cardiopulmonary resuscitation, in different age groups, with multiple physiologic features. When the candidate to be submitted is too unstable to be transported to a hospital with ECMO, cannulation before transfer allows stabilization and subsequent transport. The aim of this article is to review the current concepts of extracorporeal support, its indications, national and international experience, and its possible role in the SARS-Cov2 pandemic.
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Revista médica de Chile · Mar 2020
[Ethical guidelines for medical decision-making during COVID-19 pandemic in Chile].
The catastrophic emergency experienced by many countries with the COVID-19 pandemic emphasized the importance of bioethics for decision-making, both at the public health (equitable and effective policies) and at the clinical level. At the clinical level, the issues are the fulfillment of medical care demand with adequate health care teams, infrastructure, and supplies, and to cover critical care demands that surpass the available resources. Therefore, ethically correct approaches are required for the allocation of life sustaining resources. ⋯ A successful assignment effort will require everyone's trust and cooperation. Decision making should be planned and discussed in advance, since in-depth deliberation will be extremely complex during the disaster. Our goal is to help the health care teams to wisely allocate resources in shortage periods.
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Revista médica de Chile · Mar 2020
Penicillin desensitization in allergic pregnant women with syphilis. Report of two cases.
Syphilis during pregnancy has a high risk of congenital transmission with disastrous fetal consequences. Penicillin (PNC) is the only effective antimicrobial for the treatment of pregnant women with syphilis. Chilean guidelines do not consider desensitization to PNC in these women. ⋯ An electronic survey was conducted among approximately 100 Clinical Pharmacists (CP) in the country. Of these, 16 answered and 13 reported having experience in drug desensitization, in at least five cases with PNC and none reported deaths or cardiorespiratory arrest. Desensitization to PNC can be carried out safely and in Chile, this alternative should be incorporated to the management of pregnant women with syphilis and immediate allergy to PNC, instead of using erythromycin.