Revista médica de Chile
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Revista médica de Chile · May 2022
Review[Transitional care for people with chronic health conditions].
People with chronic conditions and elderly frequently use different levels of health care. If those are not coordinated, patients are exposed to complications and adverse effects. To avoid this, the implementation of transitional care (TC) is proposed, which includes the coordination and follow-up of users through the different care settings. ⋯ A search of articles published between 2012 and 2019 in Google Scholar, MEDLINE, CINAHL and Cochrane Library databases was conducted looking for articles related to the concept of transitional care, characteristics, and impact on people with chronic conditions. Several models of TC have been formulated and the literature identifies common interventions, namely telephone follow-up, outpatient clinics and home visits for self-management support. Reports show that TC reduces re-hospitalizations, care costs, increases quality of life and user satisfaction with the health system.
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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 · May 2022
Clinical Trial[Use of anticoagulants in patients with atrial fibrillation undergoing transcatheter aortic valve implantation].
Transcatheter Aortic Valve Implantation (TAVI) is beneficial in patients with symptomatic severe Aortic Stenosis (AS). There is no consensus about the best anticoagulation strategy for patients with a recent TAVI and with atrial fibrillation (AF). Direct oral anticoagulants (DOACs) are effective to prevent embolic events with a significant lower incidence of bleeding. There is scarce evidence about the use of these drugs in patients undergoing TAVI. ⋯ In the absence of randomized data, interventional cardiologists prescribe DOACs at discharge to patients with AF and TAVI, without following current guidelines in most cases.
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Revista médica de Chile · May 2022
Case Reports[Spontaneous non-traumatic splenic rupture as a presentation form of light chain amyloidosis. Report of one case].
We report a 35-year-old sportive man who was admitted to the emergency department for worsening of acute spontaneous abdominal pain appearing at rest. He only referred having lifted a tree trunk the day before, but he was used to perform such physical efforts. ⋯ The patient benefited from total splenectomy. Laboratory data showed hypogammaglobulinemia, proteinuria and the anatomopathological examinations of both spleen and kidneys were consistent with light chain amyloidosis.
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Acute myeloid leukemia (AML) is the most common leukemia in adults. ⋯ Our results are comparable to those reported in developed countries. Improving the survival of patients 60 years and older is our main challenge.