Revista médica de Chile
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Revista médica de Chile · Mar 2020
[Ethical guidelines for medical decision-making during COVID-19 pandemic in Chile].
The catastrophic emergency experienced by many countries with the COVID-19 pandemic emphasized the importance of bioethics for decision-making, both at the public health (equitable and effective policies) and at the clinical level. At the clinical level, the issues are the fulfillment of medical care demand with adequate health care teams, infrastructure, and supplies, and to cover critical care demands that surpass the available resources. Therefore, ethically correct approaches are required for the allocation of life sustaining resources. ⋯ A successful assignment effort will require everyone's trust and cooperation. Decision making should be planned and discussed in advance, since in-depth deliberation will be extremely complex during the disaster. Our goal is to help the health care teams to wisely allocate resources in shortage periods.
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Revista médica de Chile · Mar 2020
Penicillin desensitization in allergic pregnant women with syphilis. Report of two cases.
Syphilis during pregnancy has a high risk of congenital transmission with disastrous fetal consequences. Penicillin (PNC) is the only effective antimicrobial for the treatment of pregnant women with syphilis. Chilean guidelines do not consider desensitization to PNC in these women. ⋯ An electronic survey was conducted among approximately 100 Clinical Pharmacists (CP) in the country. Of these, 16 answered and 13 reported having experience in drug desensitization, in at least five cases with PNC and none reported deaths or cardiorespiratory arrest. Desensitization to PNC can be carried out safely and in Chile, this alternative should be incorporated to the management of pregnant women with syphilis and immediate allergy to PNC, instead of using erythromycin.
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Revista médica de Chile · Mar 2020
Biography Historical Article[Ernestina Pérez Barahona (1865-1951). Her medical attempt to rescue the chilean race].
This article analyzes some publications of Ernestina Pérez Barahona (1865-1951), the second Chilean and Latin American female physician. It exposes her concern for the public health and, more precisely, for the problem of the Chilean race. She constantly refers to hygiene in her conferences, articles and books published between 1887 and 1920. Thus, the aim of this review is to recover her production and to inform the readers about her intervention as a medical professional.
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Revista médica de Chile · Mar 2020
Case Reports[Combined use of left ventricular assist devices in cardiogenic shock. Report of one case].
We report a 55-year-old woman with a history of hypothyroidism and type 2 diabetes mellitus who consulted at the emergency room because of intermittent oppressive chest discomfort. At admission, electrocardiogram showed a complete atrioventricular block. A transthoracic echocardiogram disclosed severe left ventricular dysfunction. ⋯ Despite successful primary angioplasty, she persisted with refractory shock and progressive hypoxemia. A concomitant connection to the extracorporeal membrane oxygenation system (ECMO) was decided. The support of both devices allowed the stabilization of the patient and the improvement of perfusion parameters.
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Primary cardiac tumors have a low incidence, and their presentation form and clinical course are not well known. ⋯ Most PCTs in this group of patients were benign neoplasms and the most common tumors were myxomas. The main diagnostic method is echocardiography and the prognosis of surgical treatment is excellent when the tumors are benign. (Rev Med Chile 2020; 148: 327-335).