Revista médica de Chile
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Revista médica de Chile · Apr 2021
[Challenges in the management of analgesia and sedation in critically ill patients with COVID-19 in Chile].
Approximately 5% of COVID-19 patients will have a severe disease requiring invasive or non-invasive mechanical ventilation. In this conditions, sedatives and analgesics are fundamental to promote tolerance, comfort and synchrony with the mechanical ventilator. ⋯ These factors, added to the progressive shortage of these drugs, a high demand for care and less capacity for personalized attention, have created an adverse scenario for their proper and rational use. This paper proposes different pharmacotherapeutic optimization strategies for a rational management of sedation, analgesia and neuromuscular block in critically ill patients with COVID-19, with the therapeutic alternatives available in Chile.
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Revista médica de Chile · Apr 2021
[Experience with endoscopic submucosal dissection for the treatment of early neoplasms of the digestive tract].
Endoscopic submucosal dissection (ESD) allows en-bloc resection of early gastro-intestinal neoplasms (EGIN) with healing potential. ⋯ ESD allows en-bloc resections with curative potential in selected patients, but with a significant reduction in morbidity and mortality and less impact on quality of life. Our results suggest the feasibility to perform ESD in our country with results comparable to those reported in the literature.
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Screening programs for colorectal cancer (CRC) are standard in most developed countries because they reduce mortality and are cost-effective. Within them, colonoscopy allows to directly visualize the colon and remove neoplastic lesions. However, it is an expensive exam with low adherence in asymptomatic individuals. ⋯ Automated quantitative methods allow objective readings independent of the operator and the reaction reading time, necessary for the analysis of large numbers of samples. The participation rate with immunological FOBTs is higher than with chemical ones, which is why they are preferred by the different countries that have screening programs. The use of quantitative tests allows stratification of symptomatic and asymptomatic patients at higher risk, in the screening programs.
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Revista médica de Chile · Apr 2021
[Socioeconomic determinants and gender gaps in depressive symptoms in Chile].
There are marked differences associated with socio-economic factors in the prevalence of depressive symptoms (DS) in men and women. ⋯ There is a combined effect between socio-economic and gender inequalities on DS. This partially explains the greater vulnerability of poor women and the DS gap between men and women.
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Stroke is the third largest single cause of death in Chile, responsible for 7.3% of all deaths in 2019. Large declines in stroke mortality rates in most Latin American countries in recent decades have been reported. ⋯ Stroke mortality rate decreased significantly between 1980 and 2015 in Chile, mainly in women.