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Productive catch associated with high-quality real-world info upon treating glaucoma: the battle Glaucoma Blindness! Registry.
This could be explained, considering that having adequate clinical skills is the minimal necessary requisite to become a clinical teacher, but does not make a difference in how their performance is perceived, contrary to the generic and pedagogical dimensions.Clinical pathways or structured multidisciplinary care plans are a tool to standardize clinical practice. The aim of this article is to describe and propose a methodology for the development of clinical pathways in a highly complex health institution. We used the guidelines of the European Quality of Care Pathway, which are based on a 4-stage model definition and diagnosis, development, implementation and continuity. To make this process operational, we incorporated the project management methodology (PMO). The implemented methodology contemplates the generation of an institutional governance structure responsible for the coordination of the project and the prioritization of the clinical processes to be standardized. The implementation of each clinical pathway was carried out in four steps, namely team generation, development, planning and implementation, and continuous improvement. With this methodology, 23 clinical pathways were developed between 2014 and 2018. Their implementation significantly reduced hospitalization days and their variability, optimized the use of resources and standardized clinical records. The standardization of clinical processes allowed the development of new skills such as the generation of clinical projects, an institutional methodology for managing change and sustainability through cycles of continuous improvement.We share the experience of a clinical relationship that arose between a medical student and a patient hospitalized due to a SARS-CoV-2 pneumonia. The analysis of this experience and the discussion of medical students' possible role in patient care suggest that they should be included as members of the health care team during their clinical practice. This would mean a positive contribution for both the patients' care and the students' learning experience.Conventional radiography of hands has been the imaging technique used for the early diagnosis of rheumatoid arthritis, considering its easy access and ability to reveal structural damage. However, it does not provide information about inflammatory activity or prognosis of this disease. On the other hand, magnetic resonance imaging is becoming the technique of choice for the early diagnosis of this disease and for the assessment of treatment response. It has a better sensitivity for the detection of inflammatory findings that cannot be identified with physical examination, analytical and conventional imaging techniques. This article reports the imaging protocol for magnetic resonance of the hands used at our institution for the diagnosis and follow-up of patients with rheumatoid arthritis. We also review the main imaging findings of the disease.There is an important interindividual variability in dose requirement for coumarinic anticoagulants, which could be explained by genetic and non-genetic factors. Among hereditary factors, there are gene polymorphisms that code the therapeutic target and the main enzyme responsible for their metabolism. However, there are other candidate genes that could modulate dose requirements. The is a paucity of pharmacogenomic platforms to determine dose requirements of coumarinics in the Chilean population. Therefore, algorithms considering different variables to adjust individual dosages are required. Herein, we analyze the available evidence about factors that can modify the effects of vitamin K antagonists and that should be incorporated to dosing algorithms.We analyze the transmission routes, possible viral reservoirs in the oral cavity and considerations about dental care of SARS-CoV-2 virus infection. We also analyze the protocols required before and after a dental procedure, aiming to increase the awareness of dentists about the importance of virus spread prevention among health care workers and patients. The evaluation of symptoms associated with SARS- CoV-2 such as fever, fatigue, dry cough, myalgia, dyspnea, and the inquiry about possible contacts with infected people is of utmost importance. The tongue and oral mucosa are important viral reservoirs and the transmission of the virus occurs primarily by saliva droplets. Therefore, elective dental care should be postponed, attending only dental emergencies during this period, incorporating the use of protective personal equipment (PPE) and using manual instruments to prevent the production of aerosols.
Cardiogenic shock (CS) is uncommon in the cardiac catheterization laboratory (CCL) among patients undergoing coronary angiography. Periprocedural CS is more frequent in high-risk patients and in technically demanding procedures.

To describe the clinical outcomes of patients who underwent peripheral venoarterial extracorporeal membrane oxygenation (pVA-ECMO) for CS associated with interventional cardiology procedures.

Review of clinical records of seven patients treated between January 2014 and October 2018.

pVA-ECMO was implanted within 6 hours of the interventional cardiology procedure. All patients had coronary artery disease and one of them also had symptomatic severe aortic stenosis. One patient entered the CCL in cardiac arrest. Percutaneous coronary intervention (PCI) was performed in all patients; four patients underwent an emergency procedure and five patients experienced PCI complications. One patient undergoing transcatheter aortic valve replacement suffered acute severe aortic regurgitation. An intra-aortic balloon pump was inserted at the CCL in five patients. Six patients experienced cardiac arrest. Mean SAVE score was -4.3 and baseline lactate 55 mg/dl. Actinomycin D research buy pVA-ECMO mean duration was 5 ± 4 days. Survival after both hospital discharge and 12 months of follow-up was 85.7% Regarding vascular access complications, we observed one access site hematoma and one episode of cannulation site bleeding requiring surgical repair.

pVA-ECMO should be considered in patients with periprocedural CS as a bridge to recovery. Its use was associated with improved clinical outcomes in this series.
pVA-ECMO should be considered in patients with periprocedural CS as a bridge to recovery. Its use was associated with improved clinical outcomes in this series.
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