Revista médica de Chile
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Revista médica de Chile · Jan 2024
Review[Quaternary prevention in the Cardiovascular Health Program Rational use of complementary exams: A narrative review].
The Cardiovascular Health Program (PSCV), founded by the Ministry of Health of Chile (Minsal), is focused on the global cardiovascular risk of people with the purpose of preventing and reducing morbidity, disability and premature death caused by cardiovascular diseases, in congruence with its sanitary aims. Quaternary Prevention is defined as "actions taken to protect individuals from medical interventions that are likely to cause more harm than good". The PSVC's 2017 technical guidelines establish a battery of 11 complementary exams to request upon entering the program, however, neither the scientific evidence that supports them nor the periodicity of their request was mentioned. The aim of this revision is to evaluate the rationality of exams request, based on updated evidence, as a strategy for quaternary prevention and potential economic savings for the sanitary system. ⋯ It was concluded that the costs of widely requested complementary exams could be reduced through a more efficient management guided by updated evidence. Our proposal entails changes in some processes and in the evaluation of fulfillment of the PSCV, as well as a deeper cost-effectiveness analysis of the recommendations in order to optimize the management of resources in primary health care.
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Revista médica de Chile · Jan 2024
Review Case Reports[Mitochondrial diseases and urolithiasis: Is there an association? Literature review about 2 cases].
Urolithiasis corresponds to the formation of stones in the urinary tract. It is a multifactorial metabolic disorder; its formation is related to oxidative stress and inflammatory processes. The mitochondria, for its part, is an intracellular organelle that plays a role in the regulation of intracellular oxidative stress and intracellular calcium homeostasis, both processes related to urolithiasis. Mitochondrial diseases are diverse pathologies that compromise different organs, including the urinary system. ⋯ Mitochondrial diseases are part of a group of pathologies whose characteristics have not been fully studied. They have a complex relationship with urolithiasis, despite not having been able to demonstrate causality. Studying them in this area would open a door to new treatments and prevention.
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Revista médica de Chile · Jan 2024
Review[Early integration of palliative care; implications for people with chronic diseases].
Globally, there is a growing number of population with noncommunicable and aging diseases that are eligible for palliative care. ⋯ Palliative care is a strategy of care for all people with complex chronic pathologies, which should be integrated early, in an active, multidimensional and safe way, under the wing of a trained and coordinated health team at different levels of care.
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Revista médica de Chile · Jan 2024
Comparative Study[Short-term and long-term mortality comparison between myocardial infarction with and without ST segment elevation undergoing myocardial revascularization by percutaneous coronary angioplasty].
To compare the early and late mortality of patients that have suffered an ST segment elevation myocardial infarction (STEMI) and a non-ST segment elevated myocardialinfarction (NSTEMI). ⋯ This study did not show significant differences in overall mortality during prolonged follow-up of patients with STEMI and NSTEMI. The STEMI group had a higher risk of early death, while the NSTEMI group had higher long-term mortality.