Revista médica de Chile
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Revista médica de Chile · Aug 2020
[Determinants of door to needle time for intravenous thrombolysis in acute ischemic stroke].
Intravenous thrombolysis (IT) in acute ischemic stroke (AIS) is time dependent. The time elapsed from hospital admission to the thrombolytic bolus is named door to needle time (DNT) and is recommend to be of less than 60 min. ⋯ The individual elements that correlated with a DNT longer than 60 min were the failure to detect the AIS during triage and doubts about its diagnosis.
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Revista médica de Chile · Aug 2020
Review[Risk of infections associated with the use of biological medications; a review].
Biological medications are effective for the treatment of cancer and inflammatory diseases. The aim of this review is to summarize the available evidence in systematic reviews or meta-analyses about the risk of infection in patients with cancer, arthritis, psoriasis and inflammatory bowel disease who use biological medications. We included systematic reviews or meta-analyses of controlled clinical trials and case/control studies that analyze infections during and after treatment with FDA-approved biological medications for the treatment of cancer, arthritis, inflammatory bowel disease and psoriasis, both in adults and children. ⋯ In inflammatory bowel disease there is a risk for opportunistic infections. In conclusion, in patients with cancer and inflammatory diseases use biological medications entails a risk of infection. The evidence is different depending on the underlying disease of each patient.
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In the last decades, there has been an increase in life expectancy in the world, with the consequent modification in the proportion of adults over 60 years. This is accompanied by an increase in pathologies for which aging is the main risk factor, such as dementia and hearing loss, which profoundly affect the quality of life of individuals and their family and impact health system costs. Given the lack of disease-modifying treatments for dementia, the study of mechanisms to prevent its occurrence has become a world priority. ⋯ This result undoubtedly has important consequences for the understanding the multifactorial nature of dementia, our daily clinical practice and public policies aimed at its prevention and treatment. In this article, we review the current evidence supporting the association between dementia and hearing loss, discussing the available strategies for prevention, detection and treatment of hearing loss and its possible impact on the natural course of dementia. A flow chart for the clinical management of different subgroups of patients is proposed.
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Revista médica de Chile · Aug 2020
[Mental health problems among health care workers during the COVID-19 pandemic].
COVID-19 has effects on the mental health of health care workers. ⋯ The frequency of mental health problems among these professionals is high and preventive measures should be taken.
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In Chile, 7.1% of people aged over 60 years have some type of cognitive disorder. The frequency of the latter increases to 13% in people between 75-79 years and 36.2% in people over 85 years. The concept of mild cognitive impairment (MCI) and dementia have evolved over time. ⋯ This request has the sole effect of pre-establishing evidence in favor of the notary and not protecting the testator or the vulnerable person. Assessing the ability of older people to care for themselves and their possessions has important implications for them and their families, since there is a serious risk of prejudice when someone is declared as disabled. Thus, considering the epidemiology of cognitive disorders in our country we propose a series of legal and medical discussion points aimed to protect autonomy and to protect individuals and their possessions when they have difficulties to control their decisions.