Revista médica de Chile
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Constipation affects 2% to 27% of individuals. It is associated to irritable bowel syndrome in 59% of cases, to a pelvic floor dysfunction in 29% and to a low transit time in 13%. ⋯ An algorithm for the management of chronic idiopathic constipation, that includes a recommendation to increase fiber and liquid intake as an initial approach and an orientation to the use of different laxatives, is presented. The usefulness of biofeedback in patients with pelvic floor dysfunction and without organic cause of constipation, is also discussed.
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Revista médica de Chile · Apr 2008
[Predictors of acute coronary syndrome without ST segment elevation and risk stratification in the chest pain unit].
Nearly 10% of patients with an actual acute coronary syndrome (ACS) are discharged with an inadequate diagnosis. ⋯ Simple clinical findings allow an appropriate identification of patients with a high likelihood of ACS without specialized methods for myocardial ischemia detection.
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Revista médica de Chile · Apr 2008
[Presence of metallo beta-lactamases in imipenem-resistant Pseudomonas aeruginosa].
Metallo-beta-lactamases (MBL) confer high resistance to carbapenems in Pseudomonas aeruginosa (Psae). They are encoded in mobile elements of different genes (VIM, IMP, SMP, GIM), along with other resistance genes. ⋯ The presence of MBL was detected in 19% of imipenem resistant Psae strains.
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The progressive increase of medical negligence law suits requires an updated analysis of the current situation of medical liability in Chile. The application of a new criminal procedure will avoid criminal prosecution of doctors, transferring to the civil courts the pecuniary sanctions for malpractice. Medical negligence and damage inflicted by doctors that require compensation are explained. The most likely evolution of medical liability is proposed, through an increase in civil liability insurance and the necessary standardization of rules applicable to professional liability.
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Despite a better management of the variables that influence the development of diabetic nephropathy there is a progressive increase in the prevalence of terminal renal failure among diabetics, whose cause is not clear. ⋯ There is an inadequate management of blood glucose and blood pressure of diabetic patients before entry to dialysis. They are referred inverted exclamation markate to the nephrologist, the dialysis dose is insufficient and they have a high mortality.