Revista medica de Chile最新文献

Up to 40% of Pheochromocytoma/paraganglioma syndromes are associated with germline mutations. Therefore, they are considered familial and heritable. We report a 65 year old woman with hypertension, bilateral adrenal nodules found in the CT scan and elevated urinary metanephrines. Her genetic testing showed a c.117_120delGTCT TMEM127 gene mutation. She was subjected to a laparoscopic bilateral adrenal excision. After five years of follow up, no recurrence of the disease has been recorded.

Background: Chronic stress has short and long-term consequences during child and adolescent development if the stress is not mediated by adult care-giving.

Aim: To assess the perceptions of parental responsiveness, demand, and monitoring among seventh grade students.

Material and methods: We applied the Brief Parental Scale (developed and validated locally) asking 12 items about three dimensions, namely responsiveness, demand, and monitoring to 524 seventh grade students aged 12 years, 48% females, from eight public and private schools at Santiago.

Results: The overall response rate was 85%. While the scores were higher for mothers, a significantly constant gradient for the same dimensions (demand > responsiveness > monitoring) was verified for both parents.

Conclusions: The main hypothesis emerged from our study is that adolescents seem to perceive a discrepancy in terms of a relatively high demand and lower monitoring from parents/guardians towards them. The differences between fathers and mothers in adolescent care and the different perceptions by gender of adolescents about parental caregiving, require a further analysis.

Background: Suicidal behavior is a public health problem, and adolescents are one of the main risk groups.

Aim: To analyze the association among suicidal behavior, consumption of psychoactive substances, and Health Related Quality of Life (HRQoL) in adolescents attending schools in Valparaiso, Chile.

Material and methods: Five hundred-fifty adolescents enrolled in a public school participated in the study. HRQoL was evaluated through KIDSCREEN-27, while suicidal behavior and the consumption of psychoactive substances were measured with the Global School-based Student Health Survey (GSHS).

Results: The prevalence of suicidal behavior was higher in women and in those who used tobacco or marijuana in the last month. Respondents with a bad perception of physical well-being reported a higher frequency of suicidal ideation than those with a good perception (Odds ratio (OR): 2.24; 95% confidence: 1.49-3.36). Likewise the frequency of suicidal ideation was higher in those with a bad perception of psychological well-being (OR: 3.87; 95%CI: 2.09-7.71), and a bad perception of autonomy and relation with parents (OR:2.46; 95%CI: 1.34-4.54). Suicide planning was also associated with dimensions of autonomy and relation with parents (OR: 2.32; 95% CI: 1.23-4.38) and dimensions of friends and social support (OR: 1.86; 95%CI:1.05-3.28). Suicide attempt was associated with the dimensions of friendship and social support (OR: 1.83; 95%CI: 1.02-3.28) and school environment (OR: 1,92; 95%CI: 1,23-3,01).

Conclusions: Suicide ideation is associated with worse physical and psychological well-being. Suicide planning and suicide attempt is associated with a worse perception about the relation with parents or friends, social support, and school environment.

Background: COVID-19 impacted all areas of our society, and we took advantage of new technologies such as telemedicine to deliver information. Peer education is another tool that can be used.

Aim: To report the experience of peer education among residents using a digital platform.

Material and methods: A digital educational program was devised in which third year residents exposed different relevant topics in internal medicine to their first year peers using Zoom. The educational process was evaluated using a Likert scale.

Results: A high level of satisfaction was found among the respondents according to the scale.

Conclusions: There was a high level of satisfaction with the used methodology among first-year residents. A more exhaustive evaluation of this educational program should be worthwhile.

Background: Chile is currently updating the Comprehensive Policy on Positive Aging, which establishes a positive association between Subjective Well-being, Self-perceived Health, Functional status, and Social Participation in older people.

Aim: To study the relationship between Subjective Well-being, General Health, Functional status, and Social Participation in older people in Chile.

Material and methods: In a cross-sectional observational study, 2.031 people aged 60 years and over were included in the National Health Survey 2016-2017 (ENS). The study included analysis of correlations between the relevant variables, in addition to binomial logistic regression with Subjective Well-being as a response variable, as well as the application of structural equation techniques (SEM).

Results: Subjective Well-being had a positive association with Self-perceived Health (Rho = 0.370), functional status (Rho = 0.360), and Social Participation (Rho = 0.290). However, in the logistic regression analysis only Self-perceived Health (OR = 0.293) and Functional status (OR = 0.932) had predictive capacity for Subjective Well-being.

Conclusions: The relevance of Self-perceived Health and Functionality in the sensation of Well-being among older people, reinforces the need to improve health care within a framework of a comprehensive policy for this age group.

We report 67-year-old woman with a sinus node dysfunction and diffuse conduction system disease, with a history of recurrent paroxysmal atrial fibrillation. She was admitted to the Hospital due to palpitations, dizziness, and vertigo, attributing the symptoms to the rhythm disorder described, for which the implantation of a pacemaker was indicated. With a history of tracheal cancer treated with radio and chemotherapy, and chronic steroid therapy for rheumatoid arthritis, she had an important limitation in vascular access for a conventional pacemaker, so, added to a high risk of infection, a decision was made to implant a leadless pacemaker. We discuss the electrocardiographic and clinical manifestations of sinus node disease, its relationship with oncological treatment and the indication for a permanent pacemaker, highlighting the characteristics of this new modality of artificial cardiac stimulation, for a special type of patients.

Background: Both perfectionism and social anxiety have been described in patients with eating disorders (ED) and medical students. Academic stress also can increase the risk of developing ED.

Aim: To analyze the dimensions of perfectionism, social anxiety, and academic stress associated with the risk of developing ED in female medical students.

Material and methods: The Multidimensional Perfectionism Scale, the Liebowitz Social Anxiety Scale, the SISCO academic stress inventory and the Eating Attitudes Test-26, were applied to 163 female medical students from all levels of the career. The groups with and without risk of ED were compared according to these variables.

Results: Twenty-four percent of respondents were at risk of ED. There were significant differences between scores of perfectionism, social anxiety, and academic stress between respondents with and without risk for ED. In general, there was a significant correlation among the variables. In a multivariate analysis, the predictors of ED risk were the perception of academic stress (Odds ratio (OR) 1.09; 95% confidence intervals (CI) 1.03-1.16) and personal standards in the context of perfectionism (OR 1.16; 95% CI 1.06-1.27).

Conclusions: A substantial proportion of female medical students were at risk for ED. The risk of ED was determined mainly by academic stress and personal standards in the context of perfectionism. In this sample, social anxiety did not play a relevant role.

In the last decade, medical students stood out as active agents in their training, which implies their involvement in the design, implementation, evaluation, and curricular co-governance. This article describes a model of active undergraduate student participation from 2014 to 2021 and compares the face-to-face and synchronous online modalities, later brought forward by the SARS-COV-2 pandemic. Annually, a call was made to UC School of Medicine undergraduate students to establish the topics and areas to be addressed during self-managed seminars. Then, medical students located in Chile were invited to attend the activity. Psychiatry was established as a priority topic in six out of eight years. Five seminars were conducted, the last two in synchronous online mode. The number of people enrolled in the online modality increased by 251% compared to the face-to-face modality (face-to-face mean = 133 ± 33 SD; online mean = 336 ± 24SD), with no significant differences in rates of attendance between modalities (Odds ratio (OR) = 1,12; 95% CI= 0,82 - 1,55; p = 0,45). The online modality was associated with a higher proportion of enrollees belonging to an institution outside the Metropolitan Region (OR 12,63; 95% CI = 8,64 - 18,46; p < 0,01). The self-managed psychiatry seminars correspond to a model of active undergraduate student participation, with the synchronous online modality representing an opportunity to massify it throughout the national territory.