Revista médica de Chile
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Revista médica de Chile · Jul 2023
[Phenomenology of moral distress: implications for the humanization of medical education and practice].
In the healthcare context, moral distress (MD) refers to the negative emotions that arise when a person knows the correct course of action in a given situation but is not able to follow it due to personal, hierarchical or institutional impediments. MD has been related to various professional problems, such as vocational disorientation, low work motivation, depersonalized treatment of patients, abandonment of duties, and changes of specialty or profession. ⋯ Accordingly, this article has the objectives, firstly, to promote the phenomenological study of MD in our country, considering the importance of preventing its potential adverse impact on the mental health of future professionals, and, secondly, to highlight the need to include narrative approaches in medical education, in order to develop a more holistic approach to understanding patients and their condition of vulnerability. Ultimately, it is expected that addressing the implications of MD in medical education and practice will contribute to its humanization, optimizing the quality of healthcare.
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Revista médica de Chile · Jul 2023
Review Case Reports[First Case report of Lawsonella clevelandensis Infection in Latin America and literature review].
Lawsonella clevelandensis is a gram-positive anaerobic bacillus, partially acid-fast, belonging to the order Corynebacteriales and is considered commensal of the skin and oral cavity. In recent years, few cases of infection by this microorganism have been reported, generally in immunosuppressed patients, with the most reported clinical presentation being the generation of abscesses. The isolation of this bacterium is difficult since it does not grow in traditional cultures, so its identification usually requires the use of molecular biology. ⋯ Sequencing of the gene that codes for the 16s RNA of the bacterial ribosome was performed from a urine sample, obtaining a sequence compatible with Lawsonella clevelandensis. After the result, therapy with amoxicillin-clavulanic acid was indicated with resolution of the leukocyturia and negative smear microscopy, and immunosuppression could be indicated without inconvenience. To the authors' knowledge, this is the twelfth case of Lawsonella clevelandensis infection described in the medical literature in the world and the first to report the isolation of the pathogen in urine.
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Revista médica de Chile · Jul 2023
Review[Endomyocardial biopsy in current practice: Technical Aspects, Indications and complications].
Endomyocardial biopsy (EMB) is an invasive procedure and a diagnostic tool used mainly on the follow-up of post-heart transplant rejection in the past years. Currently, it has an important role in the diagnosis of non-ischemic cardiomyopathies. ⋯ Diagnostic performance has improved with advances in pathology analysis. Its complications risk, close to 1% in high-volume interventional centers, can be justified considering the potential benefit of an accurate diagnosis and prognosis.
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the International Agency for Research on Cancer included the occupational and environmental exposure of firefighters, in the list of carcinogens for humans. ⋯ Identifying associations between firefighters' occupational exposures and cancer risk is a challenging task mainly due to the multifactorial origin of cancer. The best way to reduce exposure is to implement preventative measures.