Revista médica de Chile
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Colorectal (CRC) is one of the most common types of cancer worldwide. Most tumors develop from an adenoma in a period of 10 to 15 years, but some may appear without previous adenomatous lesions. ⋯ The epidemiological evolution in the recent years in Chile has a worrisome evolution and the treatment costs of advanced stages are a burden for the healthcare system. We herein highlight the main Chilean medical and scientific contributions on the pathogenesis, early diagnosis, and treatment of CRC, which lead to its better understanding, and therefore better management, based on local evidence.
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Revista médica de Chile · Jun 2020
[A new equation to predict urine creatinine values using data from Chilean population].
Evaluation of 24-hour collection accuracy is based on urinary creatinine excretion (UCr), usually using wide ranges indexed by weight. Equations that predict the expected UCr are also available. ⋯ Our equation developed with Chilean values predicts 24-hour UCr values accurately.
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The aim of mechanical ventilation is to substitute physiological respiratory function. The boom of mechanical ventilation came during the XVIII century with the development of Reanimation Societies in Europe, who promoted the use of positive pressure ventilation modes. ⋯ Positive pressure ventilation was relegated to operating rooms until 1952, when it was imposed over negative pressure ventilation during the Copenhagen polio epidemic. Björn Ibsen contributed significantly to this change of ventilation paradigm, which led to the latest ventilation strategies and the development of the actual intensive care units.
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Mediation can approximate opposing positions and reach agreements that offer viable solutions for the problems posed by parties. The favorable results, the statements of the professionals and the welfare of the parties who participate in it are some of the reasons for its growth. ⋯ Mediation allows to dejudicialize health care and improve the relationships that are created in all its services. Its implantation in health organizations will favor a more humanized attention by eliminating conflicts, thus elevating the quality and degree of well-being of all the professionals who participate.
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Telemedicine partially resolved inequalities in access to health care, especially in geographical areas with a low number of doctors and in places with absent or insufficient specialists. Currently, Chile has a National Telehealth Program, but there are no specific laws on digital medicine that recognize remote medical acts and it is uncertain if they really are medical acts. The goal of a medical act is the well-being of a patient, requiring a therapeutic alliance based on the doctor's knowledge of the needs, expectations and fears of such a patient. ⋯ Besio and the main medical and professional associations is analyzed in depth. It is concluded that although direct physical contact between doctor and patient largely supports the therapeutic alliance, telemedicine has been successful, particularly in its synchronous modality. Taking the necessary precautions, in most cases distant medical acts can be carried out allowing a humanized and respectful care of people.