Revista médica de Chile
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Revista médica de Chile · Nov 2021
Review[The social impact of physician-assisted death legalization].
The debate on legalization of physician-assisted death (PAD) has focused on its purely individual aspects, leaving aside equally relevant social dimensions such as a progressive expansion of PAD's causes, strains and changes in the doctor-patient relationship, and unreported PADs. The aim of this work was to explore these aspects through an analysis of the experience of Belgium and the Netherlands, countries where PAD is legal since 2002. The results, obtained through a systematic review of the literature, indicate that in both countries, the acceptance of the concept of "psychological suffering" allowed PAD to be performed in psychiatric patients, in persons with dementia and in older people with geriatric conditions. ⋯ Moreover, more than 30% of PADs are not reported. All this information was obtained from physicians not willing to incriminate themselves, after the commission of the PADs, therefore hampering the monitoring of law abiding. These results reveal the existence of a social impact of PAD decriminalization that deserves greater consideration and further studies.
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Revista médica de Chile · Nov 2021
Randomized Controlled Trial[Simulation of tracheal intubation for medical students. The effects of anticipatory study].
Clinical simulation allows the acquisition of procedural skills among medical students. The anticipatory study of these skills may improve the efficiency of simulation sessions. ⋯ Study guides improve practice effectiveness. Our results indicate that the best results are obtained by simulation accompanied with immediate directed feedback and opportunities to repeat the procedures, independent of the type of anticipatory study.
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Revista médica de Chile · Nov 2021
Case ReportsBrain lesions associated with eosinophilia. A useful clue for neurotoxocariasis. Report of one case.
Neurotoxocariasis is uncommon. Its manifestations include events of meningitis, encephalitis and less frequently vasculitis, which manifest as headache, seizures, focalization, confusion, cognitive alterations and /or fever. Peripheral eosinophilia with clinical and neurological imaging elements, allow its early suspicion. ⋯ Lesions reinforced after paramagnetic contrast. Serological studies found specific IgG antibodies by ELISA against antigens of the genus Toxocara, which were confirmed by a positive IgG Western Blot. The patient was treated with albendazole (800 mg/d) for 14 days associated with parenteral and then oral corticosteroids with a favorable response and gradual complete recovery.
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Revista médica de Chile · Nov 2021
Case Reports[Shiga toxin-associated hemolytic uremic syndrome with hypocomplementemia. Report of one case].
The Shiga toxin associated (Stx) hemolytic uremic syndrome (HUS) is an important cause of acute renal failure (ARF) and the most common cause of thrombotic microangiopathy (TMA) in pediatrics. Primary atypical HUS (aHUS) is a rare disease due to a genetic defect in the alternative complement pathway. Both diseases may share clinical and laboratory elements, making differential diagnosis difficult, such as the presence of diarrhea in aHUS or complement alterations in HUS-Stx. ⋯ Alterations in complement factors were observed. Finally, the diagnosis of HUS-Stx was established. The patient evolved favorably with recovery of renal function.
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Revista médica de Chile · Nov 2021
Case Reports[The importance of timely and safe care. Report of one case].
We report a 32-year-old woman with chronic kidney disease on hemodialysis undergoing a nephrectomy for left xanthogranulomatous pyelonephritis with a coralliform calculus and septic shock. Her clinical evolution was torpid, subfebrile, with persistent elevation of inflammatory parameters and with the finding of intra-abdominal collections interpreted as post-surgical. ⋯ Subsequently, she underwent a difficult mechanical ventilation weaning, identifying the abrupt discontinuation of benzodiazepines as a contributing factor to agitation. We report this patient for educational purposes and to reinforce some quality-of-care concepts such as safety and opportunity of healthcare.