Revista médica de Chile
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Revista médica de Chile · May 2024
Review[Workplace Inclusion for Individuals with Psychiatric Disabilities under Law 21.015: A Narrative Review to Understand Its Implications for Healthcare Teams].
Individuals with psychiatric disabilities face significant challenges in achieving workforce inclusion, presenting a critical public health issue. The enactment of Law 21.015 on this matter offers an opportunity for improvement. ⋯ Key elements discussed include the necessity of early support for employment, the effectiveness of supported employment strategies, and the importance of coordinating mental health and employment services. General recommendations for the employability of individuals with psychiatric disabilities are provided. Healthcare teams should be familiar with the legal aspects of employability, as well as the available intersectoral networks, and be prepared to guide individuals with psychiatric disabilities who express a desire to work. They should support these individuals in job placement and maintain open communication channels among the components of the intersectoral network.
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Revista médica de Chile · May 2024
Multicenter Study[Tacrolimus in Difficult to Treat Proteinuria Associated with Lupus Nephritis. Experience of 3 Centers].
The management of proteinuria in patients with lupus nephritis represents a challenge for the specialist. Recently, Calcineurin Inhibitors have been positioned as an effective alternative in these patients, but their use is not widespread in our country. We report the experience of three centers in this regard. ⋯ Tacrolimus alone or in combination with Mycophenolate is a safe and effective alternative in the management of Lupus nephritis-associated proteinuria.
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Revista médica de Chile · May 2024
Practice Guideline[Consensus Recommendations for Lung Cancer Screening in Chile].
Lung cancer is the leading cause of cancer death worldwide, also in Chile, where the main risk factor is smoking. Early detection using low-dose computed tomography has been shown to reduce mortality from this cause, but there are still no formal screening recommendations in Chile. ⋯ Experts expressed concerns about the feasibility and acceptability of implementing screening programs in the local context, noting possible barriers, such as lack of awareness and costs. Local evidence needs to be generated to address the regional particularities and ensure the feasibility and effectiveness of lung cancer screening programs in Chile.
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Revista médica de Chile · May 2024
Comparative Study[Characteristics of Hospitalized Adults with Severe Hyponatremia: A Comparison of Patients with Severe and Very Severe Hyponatremia in Terms of Etiology, Symptoms, Treatment Response, and Mortality].
Hyponatremia is the most common hydroelectrolyte disorder in hospitalized patients. It is unclear whether there are differences between severe hyponatremia (<125 mEq/L) and very severe hyponatremia (<115 mEq/L) in terms of etiology, response to therapy, and mortality. ⋯ Differences related to etiology, response to treatment, and mortality were observed between patients with severe and very severe hyponatremia. These findings may generate hypotheses for prospective studies of hyponatremia in hospitalized patients.
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Revista médica de Chile · May 2024
Case Reports[Case Report: Guillain-Barré Syndrome with Difficult-to-manage Pain and Persistent Urinary Retention].
Guillain-Barré Syndrome (GBS) is an acute inflammatory polyradiculoneuropathy that affects the peripheral nervous system, predominantly impairing motor function. Pain, both somatic and neuropathic, is reported in 89% of cases and is refractory to first-line analgesics in most of these. ⋯ Transdermal fentanyl was administered with good response and tolerance, in addition to tamsulosin and intermittent catheterization, resulting in the successful removal of the catheter after six weeks. Based on this case, individualized evaluation of pain and urinary retention in GBS is suggested, considering the use of transdermal opioids and non-invasive bladder emptying measures, respectively.