Revista médica de Chile
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Revista médica de Chile · Mar 2021
[Analysis of 4,164 type 1 diabetes antibody profiles in a Chilean health centre].
Previous studies have assessed the role of Type 1 diabetes (DM1) antibodies as predictors of the natural history of disease. ⋯ Forty percent of DM1 antibody tests were positive. Among positive tests, 1, 2, 3 or 4 DM1 antibodies were detected in 48%, 33%, 17% and 3% of cases, respectively. The likelihood of testing positive was inversely related with age for ICA, GAD, IA-2, ZnT8 and directlyproportionalforIAA (p= -0,012; -0,013; -0,014; -0,009; 0,005 respectively). An association between DKA at the onset of the disease and IA-2 positivity was observed (Odds ratio (OR) 5.38 95% confidence intervals (CI) 1.79 - 16.16, P < 0.01). No association was found between IAA positivity and history of insulin therapy (OR 2.25 95%CI 0.63 - 7.90, P = 0.2403). The results obtained from this study represent a novel local profile of DM1 antibody data, highlighting a relationship between antibody positivity and age.
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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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Parathyroid carcinoma is a rare malignant disease that presents as a sporadic or familial primary hyperparathyroidism (PHP). The latter is associated with some genetic syndromes. It occurs with equal frequency in both sexes, unlike PHP caused by parathyroid adenoma that is more common in women. ⋯ Adjuvant therapies with chemotherapy or radiation therapy do not modify overall or disease-free survival. Recurrences are common and re-operation of resectable recurrent disease is recommended. The palliative treatment of symptomatic hypercalcemia is crucial in persistent or recurrent disease after surgery since morbidity and mortality are more associated with hypercalcemia than with tumor burden.
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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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Since the declaration of SARS CoV-2 pandemic, we have witnessed an accelerated increase in new cases, frequently associated with the need for intensive care and mechanical ventilation. In parallel, we have been invaded by many experts in the press and who expose their knowledge on the behavior of epidemics who use concepts that are not always well understood by the medical community. Some concepts should be knowledgeable to understand the epidemic spread. ⋯ Second, a gamma curve describes the period of contagiousness. Third, the contagion magnitude or rate can be calculated and modeled. Explaining these mathematical concepts in a simple and graphic way will allow readers to understand better what is happening with the current pandemic.