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Thoracic ectopia cordis: A case report. 胸廓脐外翻:病例报告
IF 1.2 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-08-23 DOI: 10.5867/medwave.2024.07.2789
Fabian Andres Merchan Bustos, Isabel Cristina Mesa-Cano, María Graciela Merchán-Coronel, Andres Alexis Ramírez-Coronel, Xavier Rodrigo Yambay-Bautista, Braulio Fernando Álvarez-Loja

Ectopia cordis is a congenital heart malformation of the sternal wall, with a prevalence of 0.1% among heart conditions and an incidence of 5.5 to 7.9 per million births. It is characterized by the heart being located outside the thoracic cavity, and it may be accompanied by other congenital anomalies such as omphalocele, Cantrell´s pentalogy, or Fallot´s tetralogy. We present a case of thoracic ectopia cordis in a male neonate. After birth, we also observed a midline thoracic malformation and respiratory difficulties with clinical and paraclinical features consistent with tetralogy of Fallot. It was decided to provide skin flap coverage, and due to the poor prognosis of the heart condition, palliative care was chosen. Unfortunately, the neonate passed away after seven days. This clinical case study contributes to understanding this rare condition and may help improve diagnosis and treatment of affected patients.

脐外翻是一种胸骨壁先天性心脏畸形,在心脏疾病中的发病率为 0.1%,发病率为每百万新生儿中有 5.5 至 7.9 例。其特点是心脏位于胸腔外,可能伴有其他先天性畸形,如脐带绕颈、Cantrell's 五联症或法洛氏四联症。我们报告了一例男性新生儿胸廓脐带异位。出生后,我们还观察到中线胸廓畸形和呼吸困难,其临床和辅助临床特征与法洛氏四联症一致。我们决定对其进行皮瓣覆盖,由于心脏状况预后不佳,我们选择了姑息治疗。不幸的是,新生儿在七天后去世。这项临床病例研究有助于人们了解这种罕见的疾病,并有助于改善对受影响患者的诊断和治疗。
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引用次数: 0
Epidemiology of high-energy trauma in Chile: An ecological analysis using public registries. 智利高能量创伤的流行病学:利用公共登记簿进行生态分析。
IF 1.2 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-08-21 DOI: 10.5867/medwave.2024.07.2929
Maximiliano Barahona, Anselmo Alegría, Camila Amstein, Marcela Cárcamo, Macarena Barahona

High-energy trauma is defined as severe organic injuries resulting from events that generate a large amount of kinetic, electrical, or thermal energy. It represents a significant public health concern, accounting for 10% of global mortality. This article aims to describe the epidemiology of high-energy trauma in Chile. Specifically, it seeks to compare the mortality rate per 100 000 inhabitants among member countries of the World Health Organization (WHO), provide a descriptive analysis of notifications under the Explicit Health Guarantees (GES) for the health issue of polytraumatized patients, and analyze the trend in the mortality rate due to external causes in Chile. This study employs an ecological design using three open-access databases. First, the WHO database on deaths from traffic accidents in 2019 was used. Then, the GES database was consulted for the "Polytraumatized" issue between 2018 and 2022. Finally, the Chilean Department of Health Statistics database on causes of death between 1997 and 2020 was utilized. In 2019, Chile ranked in the middle regarding the mortality rate per 100 000 inhabitants due to traffic accidents. GES notifications for polytrauma predominantly involved men aged 20 to 40 years and those affiliated with the public health system, highlighting a primary focus for prevention efforts. Mortality from accidents showed a decreasing trend, with significant structural changes identified in 2000 and 2007.

高能创伤是指由产生大量动能、电能或热能的事件造成的严重器质性损伤。它是一个重大的公共卫生问题,占全球死亡率的 10%。本文旨在描述智利高能创伤的流行病学。具体而言,它试图比较世界卫生组织(WHO)各成员国每 10 万居民的死亡率,对多发性创伤患者健康问题的明确健康保障(GES)通知进行描述性分析,并分析智利外部原因导致的死亡率趋势。本研究采用生态学设计,使用了三个开放式数据库。首先,使用了世界卫生组织 2019 年交通事故死亡数据库。然后,就 2018 年至 2022 年期间的 "多创伤 "问题查阅了 GES 数据库。最后,利用了智利卫生统计局关于 1997 年至 2020 年死因的数据库。2019 年,智利因交通事故导致的每 10 万居民死亡率排名居中。GES通报的多发性创伤主要涉及20至40岁的男性和那些隶属于公共卫生系统的人群,这凸显了预防工作的主要重点。事故死亡率呈下降趋势,2000 年和 2007 年出现了显著的结构性变化。
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引用次数: 0
Effects of hypopressive exercise associated with aerobic and muscle strength training on the treatment of fatigue, urinary incontinence symptoms, sexual function, and quality of life in women treated for gynecologic cancer: A randomized clinical trial protocol. 与有氧运动和肌肉力量训练相关的低压运动对治疗妇科癌症妇女的疲劳、尿失禁症状、性功能和生活质量的影响:随机临床试验方案。
IF 1.2 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-08-13 DOI: 10.5867/medwave.2024.07.2906
Lily Berríos-Contreras, Luz Alejandra Lorca, Mariana Arias Avila, Francisco Ortega, Ivana Leao Ribeiro

Introduction: Therapeutic exercise has an important role in the population living with cancer as it improves function and quality of life and reduces the symptoms of cancer treatment. There is little clinical evidence on the effects of hypopressive exercise in women with gynecological cancer.

Objective: Evaluate the effects of 4 weeks of hypopressive exercise associated with muscle strength training and aerobic exercises on fatigue, urinary incontinence symptoms, sexual function, and quality of life in women treated for gynecological cancer compared to a group that will perform conventional training.

Methods: This randomized, single-blinded clinical trial study is set in the Clinical Research Laboratory, Department of Kinesiotherapy, at a Chilean University. Patients will be randomly assigned to an experimental group of hypopressive exercises associated with muscle strength training and aerobic exercises or a control group of muscle strength training and aerobic exercises. Twelve tele-rehabilitation sessions will be performed. Women over 18 years of age with gynecologic cancer who have been prescribed radiotherapy or chemotherapy will participate. Fatigue, quality of life, urinary incontinence symptoms, and sexual function will be assessed before and after the intervention.

Expected results: The results of this clinical trial have important implications for specific treatment for the cancer population and generate new techniques in the practice of oncology-specialized kinesiologists. Hypopressive exercise is expected to reduce incontinence symptoms due to neuromuscular activation of the pelvic floor muscles. However, more studies are needed to confirm the beneficial effects of hypopressive exercises in face-to-face or remote rehabilitation.

简介治疗性运动可改善癌症患者的功能和生活质量,减轻癌症治疗的症状,因此在癌症患者中发挥着重要作用。关于低压运动对妇科癌症女性患者的影响,目前还没有什么临床证据:与进行常规训练的组别相比,评估与肌肉力量训练和有氧运动相关的为期 4 周的低压运动对妇科癌症女性患者的疲劳、尿失禁症状、性功能和生活质量的影响:这项随机、单盲临床试验研究在智利一所大学的运动疗法系临床研究实验室进行。患者将被随机分配到与肌力训练和有氧运动相关的低压运动实验组或肌力训练和有氧运动对照组。将进行 12 次远程康复治疗。年龄在 18 岁以上、接受过放疗或化疗的妇科癌症患者将参与其中。干预前后将对疲劳、生活质量、尿失禁症状和性功能进行评估:这项临床试验的结果将对癌症患者的具体治疗产生重要影响,并为肿瘤专业运动学专家的实践提供新技术。由于骨盆底肌肉的神经肌肉激活作用,低压运动有望减轻尿失禁症状。然而,还需要更多的研究来证实低压运动在面对面或远程康复中的有益效果。
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引用次数: 0
[Public policies and right to sexuality of the elderly in Chile]. [智利的公共政策和老年人的性权利]。
IF 1.2 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-08-07 DOI: 10.5867/medwave.2024.07.2786
Pedro Enrique Villasana López, María Mireya Abarca Castillo, Martín Patricio Vargas Matamala

People over 65 years of age will constitute the majority of the world's population in the short term, but in precarious living conditions: more years in a worse condition of vulnerability and fragility. Societies and development models would not be prepared, generating high personal, family and collective costs. In Chile, fragility would be highly prevalent in this population, impacting the full development of their lives; with sexuality as one of the aspects that are invisible and little studied. This work makes a critical approach, based on the review and analysis of context, public policies and legislation in force in Chile, evidencing atomization and biomedical orientation of public policies, collaborating in the understanding of the relationship between fragility and sexuality in old people; and revealing pending training and research tasks for the generation of public policies for an active and healthy life.

65 岁以上的人口在短期内将占世界人口的大多数,但他们的生活条件将岌岌可危:他们将有更多的时间处于更加脆弱和易受伤害的状态。社会和发展模式将无法做好准备,从而导致个人、家庭和集体付出高昂的代价。在智利,脆弱性在这一人群中非常普遍,影响了他们生活的全面发展;性问题是其中一个被忽视和很少被研究的方面。这项工作在审查和分析智利的背景、公共政策和现行立法的基础上,提出了一种批判性的方法,证明了公共政策的原子化和生物医学取向,有助于理解老年人脆弱性与性行为之间的关系;并揭示了在制定促进积极健康生活的公共政策方面有待开展的培训和研究任务。
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引用次数: 0
Medical education for undergraduate research: Proposals from the experience of two national student conferences of the Universidad de Valparaíso. 医学教育促进本科生研究:瓦尔帕莱索大学两次全国学生大会的经验建议。
IF 1.2 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-30 DOI: 10.5867/medwave.2024.06.2959
Carlos Cabrera-Ubilla, Sebastián Almarza Santander, Marcelo Arancibia, María Elizabeth Guerra-Zúñiga

Introduction: Scientific research promotes the development of essential skills for medical practice. However, student participation in research projects is low, with multiple limitations and students' perceptions of deficient research skills. This study aims to describe the organization of the two medical student conferences held by the Scientific Society of Medical Students of the Universidad de Valparaíso and to analyze the papers presented. Finally, we make recommendations for promoting scientific research among medical students.

Methods: An analytical cross-sectional study was conducted, including all the presentations given at the conferences.

Results: The conferences comprised four phases: registration, evaluation, selection, and presentation. A total of 399 papers were received. A total of 157 case reports and 12 cross-sectional studies were presented, including 797 authors (56.7% women) from 21 universities. Most of the first authors were women in the internship cycle at public universities. The specialties with the highest representation were internal medicine (32.5%), pediatrics (18.3%) and surgery (13%). In the case reports, the best-evaluated section was the title (6.66 ± 0.76), and the worst-evaluated section was the discussion (6.17 ± 0.84). The case reports from private universities scored significantly higher in six of the eight items assessed.

Conclusions: Greater participation was represented by students in their internship cycle presenting case reports. The worst evaluated section was the discussion, which could reflect difficulties in the research process. It is crucial to increase student participation from the first years of the career and encourage their involvement in research. More studies are needed to evaluate student participation and barriers to scientific research.

引言科学研究可促进医学实践基本技能的发展。然而,学生对科研项目的参与度却很低,存在多种局限性,而且学生认为自己的科研技能不足。本研究旨在介绍瓦尔帕莱索大学医科学生科学协会举办的两次医科学生会议的组织情况,并对会议提交的论文进行分析。最后,我们提出了促进医学生科学研究的建议:方法:我们进行了一项横断面分析研究,包括在会议上发表的所有论文:会议包括四个阶段:注册、评估、遴选和演讲。共收到 399 篇论文。共有 157 篇病例报告和 12 篇横断面研究报告,包括来自 21 所大学的 797 位作者(56.7% 为女性)。第一作者大多是公立大学实习周期内的女性。所占比例最高的专业是内科(32.5%)、儿科(18.3%)和外科(13%)。在病例报告中,评价最好的部分是标题(6.66 ± 0.76),评价最差的部分是讨论(6.17 ± 0.84)。在 8 个评估项目中,私立大学的案例报告在 6 个项目上得分明显更高:结论:学生在实习周期内提交病例报告的参与度更高。评价最差的部分是讨论,这可能反映了研究过程中的困难。至关重要的是,要从职业生涯的最初几年开始提高学生的参与度,并鼓励他们参与研究。需要进行更多的研究,以评估学生的参与情况和科学研究的障碍。
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引用次数: 0
Comparative analysis of leukemia and risk estimation in working age population between provinces of Ecuador. 厄瓜多尔各省劳动适龄人口白血病比较分析及风险估计。
IF 1.2 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-26 DOI: 10.5867/medwave.2024.06.2903
Antonio Ramón Gómez-García, Esteban Fernandez-Moreira, Xavier García-León, Manuel Gómez Del Moral

Leukemia is associated with exposure to radiation, benzene derivatives, and pesticides. Previous research has documented an increase in work-related leukemia in the Latin American Andean region. To date, there are only few studies in Ecuador on the impact of oil exploitation on adjacent indigenous communities. Our study aims to show the impact of leukemia on the working-age population. For the calculation of morbidity and mortality rates, we used hospital discharge and death records from the National Institute of Statistics of Ecuador. These data were collected and adjusted to the corresponding province's population for further analysis. Large differences were observed between provinces in adjusted rates of leukemia mortality and morbidity in the working-age population. The variations in altitude among different areas in Ecuador give the provinces a distinct geographic identity. Likewise, the provinces with the highest morbidity and mortality rankings, such as Azuay, Loja, Imbabura, and Tungurahua, have an average altitude above 2000 meters. As a result, there are variations in the average temperature, exposure to solar and cosmic radiation, and mining and farming methods. The observed differences warrant the future collection of geolocation data for affected individuals. This could help to better understand how leukemia cases have demogrpahic hotspots in the country, identify possible risk factors associated with the disease in each region, and design more effective prevention and control strategies.

白血病与暴露于辐射、苯衍生物和杀虫剂有关。以前的研究记录了拉丁美洲安第斯地区与工作有关的白血病增加的情况。迄今为止,厄瓜多尔关于石油开采对邻近土著社区影响的研究很少。我们的研究旨在说明白血病对劳动适龄人口的影响。在计算发病率和死亡率时,我们使用了厄瓜多尔国家统计局的出院和死亡记录。我们收集了这些数据,并根据相应省份的人口数量进行了调整,以便进一步分析。在调整后的劳动适龄人口白血病死亡率和发病率方面,各省之间存在巨大差异。厄瓜多尔不同地区的海拔差异使各省具有不同的地理特征。同样,发病率和死亡率排名最高的省份,如阿苏艾、洛哈、因巴布拉和通古拉瓦,平均海拔都在 2000 米以上。因此,各省的平均气温、太阳辐射和宇宙辐射以及采矿和耕作方式都存在差异。根据观察到的差异,今后有必要收集受影响个体的地理位置数据。这有助于更好地了解白血病病例在该国的人口热点,确定每个地区与该疾病相关的可能风险因素,并设计更有效的预防和控制策略。
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引用次数: 0
The postmodern subject from a psychopolitical perspective: An analysis from logotherapy. 从心理政治角度看后现代主体:逻辑疗法的分析。
IF 1.2 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-15 DOI: 10.5867/medwave.2024.06.2799
Julio Cesar Suarez Luna

From a hermeneutic interpretation, this article analyzed the new psychic pandemic configuring a typology of psychopolitical man, provided by digital swarms and mass psychology, that, from logotherapy, can be perceived as a postmodern collective neurosis. We also analyze a self's hyper-reflection as a social phenomenon of psychopolitics, suffering as repression, and the love of narcissistic consumption. Consolidating a sense of life as a social ethos is the answer to finding compromises and responsibility for the individual mission that every human being has as a member of a community and society.

En este ensayo se abordó la nueva pandemia psíquica desde una interpretación hermenéutica. Esta pandemia configura una tipología de persona psicopolítica, dada por enjambres digitales y una psicología de masas que, desde la logoterapia, se puede percibir como neurosis colectivas postmodernas. También se puede analizar como fenómenos sociales de la psicopolítica. Esta es una hiperreflexión del propio yo, el sufrimiento como represión y el amor de consumo narcisista. El consolidar un sentido de vida como ethos social, es la respuesta para hallar compromisos y responsabilidad ante la misión personal que tiene cada ser humano como miembro de una comunidad y sociedad.

本文从诠释学的角度,分析了由数字蜂群和大众心理学提供的心理政治人类型学所构成的新的心理流行病,从逻各斯疗法的角度,可将其视为后现代的集体神经症。我们还分析了作为心理政治社会现象的自我超反思、作为压抑的痛苦以及对自恋消费的热爱。本文从诠释学的角度探讨了新的精神流行病。这种流行病是由数字蜂群和从逻各斯疗法中可被视为后现代集体神经症的大众心理所赋予的一种心理政治人格的类型。它也可以被分析为心理政治的社会现象。这是对自我的过度反思,是作为压抑和自恋的消费者之爱的痛苦。巩固作为社会精神的生命意识,是找到每个人作为社区和社会成员对个人使命的承诺和责任的答案。
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引用次数: 0
Effective geriatric management strategies for fatal non-Hodgkin lymphoma: Insights from a case report. 致命非霍奇金淋巴瘤的有效老年管理策略:病例报告的启示。
IF 1.2 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-09 DOI: 10.5867/medwave.2024.06.2747
Deysi Cristina Páez-Calvopiña, Alberto Bustillos, Elena Vicenta Hernández-Navarro, Estefania Carolina Salazar-Garcés, Luis Fabián Salazar-Garcés

This case report delves into the intricate medical history of an 85-year-old male who experienced a myriad of health challenges throughout his years. With a medical history full of conditions, such as stroke, sinus bradycardia, chronic obstructive pulmonary disease, severe pulmonary hypertension, and chronic gastritis, the patient´s health profile is further complicated by prostatic hypertrophy, persistent dorsalgia and lumbalgia, the presence of a thyroid nodule, and a recent onset of hypothyroidism. Among the diverse medical conditions of this patient, our narrative is primarily centered on his latest diagnosis: non-Hodgkin´s lymphoma. Non-Hodgkin´s lymphoma is not just a mere addition to his already complex medical history; it is a malignant neoplasm that shapes worldwide patterns of cancer mortality. The first indicators that led to this discovery were the patient´s complaints of persistent pain in the left lateral neck region associated with dysphagia. This was not an isolated symptom; the patient also reported a month-long history of asthenia, myalgias, weakness around the pelvic girdle, fatigue, and hyporexia, depicting a concerning clinical picture. Advanced diagnostic tools, namely ultrasound and computed tomography, shed light on submaxillary and cervical adenopathies. To corroborate such findings and get a definitive diagnosis of malignancy, a fine-needle aspiration was advised. Through this case, we aim not only to describe a clinical scenario but to highlight the challenges involved in the diagnosing and treatment of non-Hodgkin ´s lymphoma, especially in elderly patients. The overlap of multiple comorbidities adds further complexity to the scene, demanding meticulous care and expertise. This report serves as an educational tool for oncology experts, as well as testimony to the complexities of patient care in the oncology diagnostic and treatment setting.

本病例报告深入探讨了一名 85 岁男性患者的复杂病史,该患者多年来经历了各种健康挑战。患者的病史充满了各种疾病,如中风、窦性心动过缓、慢性阻塞性肺病、严重肺动脉高压和慢性胃炎,而前列腺肥大、持续性背痛和腹痛、甲状腺结节的存在以及最近出现的甲状腺功能减退症使其健康状况更加复杂。在该患者的各种病症中,我们主要围绕他的最新诊断:非霍奇金淋巴瘤进行叙述。非霍奇金淋巴瘤并不仅仅是对他已经很复杂的病史的简单补充;它是一种恶性肿瘤,影响着全球癌症死亡率的模式。导致这一发现的最初迹象是患者主诉左侧颈部持续疼痛并伴有吞咽困难。这并不是一个孤立的症状;患者还报告了一个月的气喘、肌痛、骨盆周围无力、疲劳和厌食病史,描述了令人担忧的临床症状。先进的诊断工具,即超声波和计算机断层扫描,揭示了颌下腺和宫颈腺病。为了证实这些发现并明确诊断为恶性肿瘤,建议进行细针穿刺。通过这个病例,我们不仅要描述一个临床病例,还要强调非霍奇金淋巴瘤诊断和治疗过程中的挑战,尤其是老年患者。多种合并症的叠加进一步增加了现场的复杂性,需要细致入微的护理和专业知识。本报告可作为肿瘤专家的教育工具,也是肿瘤诊断和治疗过程中病人护理复杂性的见证。
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引用次数: 0
Proceedings of the VII Chilean Congress of Public Health, IX Chilean Congress of Epidemiology. 第七届智利公共卫生大会、第九届智利流行病学大会论文集。
IF 1.2 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-06-26 DOI: 10.5867/medwave.2024.S1
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引用次数: 0
Factors associated with suicide risk and attempts in healthcare students: A cross-sectional study. 医学生自杀风险和自杀未遂的相关因素:一项横断面研究。
IF 1.2 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-06-25 DOI: 10.5867/medwave.2024.05.2756
Simón Castro, Clara Pastene, Nicolás Vásquez, Pía Galleguillos, Marcelo Salas, Ruben Alvarado

Introduction: Suicide deaths in young people have been increasing in recent decades and are considered a major public health problem worldwide, being a partially preventable event. The prevalence of suicidal ideation is high among university students, especially in health careers. The objective of this study was to measure the prevalence of high suicidal risk in this specific group and to identify associated factors, aiming to provide empirical evidence for the construction of effective suicide prevention strategies.

Methods: A cross-sectional study was conducted based on an online survey directed to healthcare students near the end of the first year of the COVID-19 pandemic to learn about the frequency of suicidal risk and its associated factors. The sample consisted of 477 students (70.8% female, mean age 21.7 ± 2.5 years) from eight healthcare majors. The data were collected in January 2021.

Results: 22.6% of the young people reported a high suicide risk on the Okasha scale, and 3.4% made a suicide attempt in the previous year. Factors associated with high suicidal risk were having a non-heterosexual orientation, an irregular academic trajectory, experiences of physical and/or psychological violence, higher levels of depressive and anxious symptomatology, as well as lower levels of social support from friends and family.

Conclusions: Suicide risk and attempt levels are high in this group of students, and there is a group of factors that could guide more effective actions, such as support for higher-risk groups and screening to identify and provide support to young people at high suicidal risk and with mental health conditions.

导言:近几十年来,年轻人自杀死亡的人数不断增加,被认为是世界范围内的一个重大公共卫生问题,是可以部分预防的事件。在大学生中,尤其是从事健康职业的大学生中,自杀意念的发生率很高。本研究旨在测量这一特殊群体的高自杀风险发生率,并找出相关因素,从而为制定有效的自杀预防策略提供经验证据:方法:在 COVID-19 大流行的第一年即将结束时,我们对医学生进行了一次在线调查,在此基础上开展了一项横断面研究,以了解自杀风险的发生频率及其相关因素。样本包括来自八个医疗保健专业的 477 名学生(70.8% 为女性,平均年龄为 21.7 ± 2.5 岁)。数据收集于 2021 年 1 月。结果显示:22.6% 的年轻人在奥卡沙量表中报告有较高的自杀风险,3.4% 的年轻人在过去一年中有过自杀企图。与高自杀风险相关的因素包括:非异性恋取向、不正常的学业轨迹、身体和/或心理暴力经历、较高水平的抑郁和焦虑症状以及较低水平的亲友社会支持:这部分学生的自杀风险和自杀未遂率都很高,有一组因素可以指导采取更有效的行动,如为高风险群体提供支持,进行筛查以识别高自杀风险和有心理健康问题的青少年并为其提供支持。
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引用次数: 0
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