Articles: ninos.
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Revista médica de Chile · Dec 2020
Case Reports[Methemoglobinemia caused by dapsone. Report of one case].
Methemoglobinemia is a rare condition with serious consequences if not diagnosed. We report the case of a 64-year-old woman with a history of allergy to sulfa drugs and a recent diagnosis of a small vessel vasculitis (ANCA-p) who started induction therapy with corticosteroids and rituximab. Due to the need for infectious prophylaxis, and considering her history, dapsone was administered instead of cotrimoxazole after ruling out glucose-6-phosphate dehydrogenase deficiency. ⋯ The arterial gasometric study by direct potentiometry revealed an O2 saturation of 98%, with a saturation gap > 5%. Considering the use of dapsone, a methemoglobinemia was suspected and confirmed by co-oximetry (methemoglobinemia 9%). Dapsone was suspended and one week later, her methemoglobinemia was absent.
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Revista médica de Chile · Dec 2020
Case Reports[Aseptic meningitis caused by brucellosis. Report of one case].
Aseptic meningitis represents a diagnostic challenge for the clinician. Cytological and chemical parameters are key in the differential diagnosis. Hypoglycorrhachia is a strong predictor of a bacterial origin for aseptic meningitis. ⋯ The CSF was inflammatory with low glucose levels. Serology for brucellosis was positive. The patient was treated with ceftriaxone and rifampicin with a good clinical response.
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Revista médica de Chile · Dec 2020
Case Reports[Inferior vena cava agenesis presenting as deep vein thrombosis. Report of one case].
Abnormalities of the inferior vena cava are rare. Its embryological development occurs between the sixth and eighth week of gestation and depends on the persistence or regression of three pairs of veins: the posterior cardinal veins, the subcardinal veins and the supracardinal veins. The type of congenital alteration depends on the moment that embryogenesis is altered. ⋯ An abdominal CAT scan showed an agenesis of the supra and infra-adrenal inferior vena cava, with multiple collaterals. The study for thrombophilia was negative. The patient was treated with vitamin K antagonists with a good clinical response.
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Revista médica de Chile · Dec 2020
[Implementation of an Objective Structured Clinical Examination (OSCE) for Anesthesiology Certification in Chile].
Anesthesiology became the first Chilean medical specialty certification board to incorporate an objective structured clinical examination (OSCE) into its certification system. The main reason for the introduction of an OSCE is to include an evaluation that allow candidates to demonstrate what they really "do" in clinical practice domains. Inherent in this justification is that the OSCE detects competences that are not well evaluated in current written and oral exams. This article describes the process of implementing an OSCE in Anesthesiology certification and a description of its application after one year of operation.
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Social frailty is a seldom explored concept in older people. There is dissent if it should be considered a multidimensional syndrome or it should be limited to the physical sphere. ⋯ One exposes the concept of social frailty, nine operationalize social frailty using questions or items on social behavior and two use scales or measuring instruments to classify older people as "socially frail". It is concluded that social frailty is a new concept in gerontology: there are divergences as to whether it should be considered as another dimension of frailty or as an independent concept with a predictive capacity by itself to detect risk among older people.