Revista médica de Chile
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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.
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Revista médica de Chile · May 2024
[Experience in Implementing an Integrated Cardiometabolic Practice Unit in a Private Healthcare Provider: A Value-Based Care Model].
Cardiovascular diseases, in addition to being a health problem for Chile, ranking as the second leading cause of death, also impose a significant economic burden on the country. Aiming to reduce these diseases' health and economic impact, we decided to structure a Cardiometabolic Integrated Practice Unit (UPI) at the FUSAT Clinical Hospital. Unlike the current organization of healthcare systems in Chile, a UPI is structured throughout the entire cycle of care (from promotion and prevention to rehabilitation), with a multidisciplinary team (both clinical and administrative) organized around closely related medical conditions or a set of health conditions. ⋯ After 6 months of collaborative work, we successfully implemented the UPI at the FUSAT Clinical Hospital. This achievement demonstrates that projects of this nature can be carried out through a defined organization and governance, a strategic definition and prioritization of objectives, and an adaptation of the methodology to the local reality. The successful implementation of the UPI inspires confidence in its potential impact on healthcare in Chile.
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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.