Revista médica de Chile
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Revista médica de Chile · Jan 2021
Randomized Controlled Trial[The impact on sample sizes of studies if the significance level is changed from an α of 0.05 to 0.005].
The statistical significance α = 0.05 is the cut-off point used to decide whether a hypothesis is statistically significant. When p-value is less than 0.05, we reject the null hypothesis. Although this criterion has been used for almost a century to generate new knowledge, there is currently an international discussion about the need to decrease the significance to α = 0.005. ⋯ Considering the sample size implications, the change in the level of significance would have important effects on the Chilean science. The cost of a randomized clinical trial could increase by at least 27% to 32%. This increase could be similar for cross-sectional studies. With an investment of less than 0.4% of gross domestic product in science and technology, national scientific research would become more expensive, distributing the few available resources among fewer projects. This effect should be considered in any discussion about national budget for science and technology.
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An increasingly large proportion of clinical trials is being conducted at non-traditional geographic regions such as Latin America. However, concerns have been raised that hosting countries may lack adequate research regulations and that clinical trials may not address local health needs. In this context, Chile has been hosting a relatively large proportion of clinical trials and has introduced new regulatory protections. ⋯ Clinical trials conducted in Chile over the last decade are largely funded by external pharmaceutical companies. Their distribution is partially aligned with local disease burden. The introduction of regulatory protections was followed by changes in the distribution of diseases studied.
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Revista médica de Chile · Jan 2021
Nutritional and behavioral factors related to weight gain after bariatric surgery.
Weight regain (WR) after bariatric surgery is common. Several factors involved in WR have been identified, but there has been little research on specific eating habits such as eating snacks rather than regular meals and being a "sweet-eater". ⋯ Eating more daily calories, being a "sweet-eater", a "grazer", and sedentarism were factors related with a greater risk of regaining weight after surgery.
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Revista médica de Chile · Jan 2021
Case Reports[Percutaneous implantation of an aortic prosthetic valve on a degenerated mitral bioprosthesis. Report of one case].
Reintervention of a mitral degenerated bioprosthesis has a high surgical risk, especially in elderly patients with multiple comorbidities. We report a 74 years old female with two previous cardiac surgical procedures and a new structural mitral bioprosthesis deterioration with severe mitral regurgitation. Considering her high-surgical risk, a fully percutaneous treatment was performed with a balloon-expandable aortic valve in mitral position (valve-in-valve) through a transseptal approach with a favorable outcome. This technique is an attractive and effective option with a relatively low rate of complications that could solve this challenging and complex disease.
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Revista médica de Chile · Jan 2021
Case Reports[Rupture of abdominal aortic aneurysm into the duodenum: uncommon cause of massive gastrointestinal bleeding].
Primary aortoenteric fistula is the spontaneous communication between the lumen of the aorta and a portion of the digestive tract. The most common cause is the erosion of an abdominal aortic aneurysm into the 3rd or 4th portion of the duodenum. It manifests clinically as gastrointestinal bleeding, with or without abdominal pain and a pulsatile abdominal mass on physical exam. ⋯ An 82-year-old male with an abdominal aortic aneurysm presenting with hematochezia. A CAT scan revealed a communication between the aneurysm and the third portion of the duodenum, that was surgically repaired. The patient died in the eighth postoperative day.