Revista médica de Chile
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Revista médica de Chile · May 2023
Review[MALA: Lactic acidosis associated with the use of metformin, review of clinical cases].
Metformin is the preferred medication for the initial management of type 2 diabetes mellitus (T2DM). Although its use is widely recommended, caution should be exercised when prescribing it to populations susceptible to systemic hypoperfusion conditions, as it can lead to accumulation in the body and metabolic disturbances that may result in metformin-associated lactic acidosis. ⋯ To promote a better understanding of this topic, the present review focuses on the analysis of the clinical, pathophysiological, diagnostic, and management aspects of metformin-associated lactic acidosis, with particular attention to management through renal replacement therapies. The analysis will be based on the experience of a series of cases of metformin-associated lactic acidosis treated at a hospital clinical center in Chile.
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Revista médica de Chile · May 2023
Case Reports[Langerhans histiocytosis and panhypopituitarism in adults. Case report].
Langerhans-cells Histiocytosis (LCH) is a rare disease characterized by the clonal proliferation of immature dendritic cells that locally or diffusely infiltrate different systems, mainly affecting children. We present the case of a 38-year-old man with a long-standing history of multiple tooth loss without association with trauma, smoking, or poor dental hygiene. Skull computed tomography (CT) showed multiple lytic jaw lesions. ⋯ The patient evolved with polyuria, polydipsia, and nocturia, confirming the presence of diabetes insipidus and panhypopituitarism through hormonal studies. Magnetic resonance imaging (MRI) of the brain shows a hypothalamic neoplasm with infundibular involvement and an image suggestive of a pituitary granuloma. The treatment consisted of maxillobuccofacial defocusing, hormonal supplementation, chemotherapy, and radiotherapy with favorable evolution.
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To know the experience of first-year medical students at Universidad Austral de Chile regarding virtual Problem-Based learning (PBL) tutorials carried out by peer tutors during the second semester of 2021. ⋯ Although the preparation of peer tutors for PBL tutorials is essential, it is even more critical in virtual mode since they face challenges such as managing virtual platforms and achieving effective communication that allows learning collaboratively.
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Revista médica de Chile · May 2023
[Developing a Self-Instruction Tool for Respectful Care in Healthcare: Design and Validation Process].
Respectful care is a relationship between professionals and patients based on deep respect and assessment of the person's dignity. ⋯ The results of this study show that Respectful care requires professionals responsible for their work who have achieved competencies to provide respectful health care. In that sense, HBT can be understood as a proposalfor continuous improvement in the clinical training of students and health professionals.
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Revista médica de Chile · May 2023
Observational Study[Obesity and risk of relapse in patients with Acute Lymphoblastic Leukemia: A retrospective study].
Obesity has been associated with a low-grade proinflammatory state, and it has been related to the development of cancer in general, including hematologic cancer. ⋯ Obesity is not an independent risk factor for the prognosis of adult patients with Acute Lymphoblastic Leukemia B-lineage.