Notes

Future Evaluation of Anti-biotic Administration inside Ureteral Stent along with Nephrostomy Treatments.
Alarms about mistreatment in medical education have been raised for almost 30 years.

To describe the frequency of abuse reports among medical students at a university in Chile, investigating their association with age, sex, and educational level.

The Mistreatment by Teachers Questionnaire was applied to 264 first to seventh year medical students (54% males). An exploratory factorial analysis of the instrument was performed, a descriptive analysis was made and its relationship with age, sex and level of training were evaluated.

Ninety eight percent of respondents reported having been mistreated at least once. Mistreatment was grouped into three factors with a confidence ranging between α = 0.79 and 0.93, namely demoralization, deregulated demands and physical aggression. The first two were associated with age and level of education. There were no differences by sex.

Mistreatment is common in undergraduate medical education, as it has been found in other universities around the world.
Mistreatment is common in undergraduate medical education, as it has been found in other universities around the world.Among the several programs that allow access to medical specialization in Chile, the National Health Services System Entrance Contest (CONISS) is held annually for newly graduated physicians, which has a high number of applicants. The academic qualifications expressed as National Medical Qualification (CMN) are the main item of the scoring system. We reviewed the total scores and the CMN of the different medical specialization programs that exist in the country, which constitutes novel and relevant information for future medical graduates interested in applying to the program. In addition, the quotas of the different programs are reported, expressed as total, free, and used quotas.Alejandro Goic, M.D., son of Croatian immigrants, graduated as M.D. in 1955, studying at the Catholic University of Chile Medical School. After a residency in internal medicine, he followed post graduate studies in psychosomatic medicine at the University of Oklahoma and in gastroenterology at Harvard University. Upon his return to Chile he had a brilliant career as clinician and medical educator, becoming a leader and advisor in medical education, clinical ethics and public health. Elected Dean of the University of Chile School of Medicine (1986-1994), he promoted important changes in undergraduate studies as well as in Magister and PhD programs in Biomedical Sciences. During the difficult years of the military government intervention in Chilean universities, he was one of the leaders of critical opposition. In parallel he was chief editor of Revista Médica de Chile (1976-1996), improving the editorial process according to the recommendations of ICMJE and WAME. In 1989 he was elected member of the Chilean Academy of Medicine and became its President (2000-2010). He was awarded honors and membership in prominent national and foreign institutions. In 2006 he received the National Prize in Medicine, the highest medical distinction in Chile. His wise thinking and enthusiasm gave origin to several books that have become classics in Medicine and Medical Education, permeating our institutions.PAHO/WHO proposes to implement the role of Advanced Practice Nurse (APN) in Latin America, to reduce gaps in coverage and access to health care. For this purpose, it is necessary to train nursing professionals with an expanded role, which allows them to collaborate in the diagnosis, treatment, and monitoring of people with specific diseases, under established protocols and clinical guidelines and within consolidated interdisciplinary health teams in a cost-effective way. One of the areas with the greatest coverage deficit in Latin America is adult oncology, with inequality in care opportunities for these patients. Part of the premature deaths attributable to this disease are due to the lack of access to timely diagnosis and treatment. As a contribution to the reduction of this gap, a training program of Advanced Nursing Practice was developed, addressing the most urgent needs in the field of oncology. The necessary competencies were defined to develop a professional-level master's degree program, considering prevention, early detection, diagnosis, treatment, and monitoring of people with oncological diseases at different levels of care. A program of this kind is an opportunity to reduce the access gap and coverage of health care for people with cancer, improving their quality of life and their survival.Screening programs for colorectal cancer (CRC) are standard in most developed countries because they reduce mortality and are cost-effective. Within them, colonoscopy allows to directly visualize the colon and remove neoplastic lesions. However, it is an expensive exam with low adherence in asymptomatic individuals. The fecal occult blood test (FOBT) is a low-cost and risk-free method for the user, which results in a high rate of adherence, explaining its use in most screening programs. This article analyzes the effectiveness of different fecal occult blood tests in screening programs. The main conclusions are that the sensitivity of the guaiac-based chemical test for the detection of colorectal cancer is lower than that observed with qualitative and quantitative immunological tests. Automated quantitative methods allow objective readings independent of the operator and the reaction reading time, necessary for the analysis of large numbers of samples. The participation rate with immunological FOBTs is higher than with chemical ones, which is why they are preferred by the different countries that have screening programs. The use of quantitative tests allows stratification of symptomatic and asymptomatic patients at higher risk, in the screening programs.Non-alcoholic fatty liver disease (NAFLD) encompasses a wide spectrum of hepatic pathologies ranging from simple steatosis (SS) to hepatocellular carcinoma. Intestinal microbiota (IM) is composed of trillions of microorganisms existing in the gut. It has 150 times more genes than the host. Changes in the composition and function of the IM are associated with different diseases, including NAFLD. In this condition, IM could have a pathogenic role through different mechanisms such as energy salvaging from food, an inflammatory stimulus, a modulation of the innate immune system, regulation of bile acid turnover, alteration of choline metabolism and increasing endogenous ethanol levels. This review is an update on the role of the intestinal microbiota in NAFLD and the possible mechanisms involved.Approximately 5% of COVID-19 patients will have a severe disease requiring invasive or non-invasive mechanical ventilation. In this conditions, sedatives and analgesics are fundamental to promote tolerance, comfort and synchrony with the mechanical ventilator. High and unusual requirements for sedation, analgesics and neuromuscular blockers have been reported in these patients, contributing to prolonged exposure, a high rate of delirium and prolongation of mechanical ventilation. These factors, added to the progressive shortage of these drugs, a high demand for care and less capacity for personalized attention, have created an adverse scenario for their proper and rational use. This paper proposes different pharmacotherapeutic optimization strategies for a rational management of sedation, analgesia and neuromuscular block in critically ill patients with COVID-19, with the therapeutic alternatives available in Chile.
Stroke is the third largest single cause of death in Chile, responsible for 7.3% of all deaths in 2019. Large declines in stroke mortality rates in most Latin American countries in recent decades have been reported.

To analyze the trend in stroke mortality in Chile between 1980 and 2015.

We extracted data for age-standardized death rate (ASDR) stroke mortality per 100,000 inhabitants in Chile for the period 1980-2015from the WHO Mortality Database. Joinpoint regression analysis was used to analyze the trend and compute the average annual percent change (AAPC) by gender in Chile.

The ASDR from stroke decreased from 92.8 per 100,000 in 1980 to 34.4 per 100,000 in 2015. The AAPC was -2.8% (-3.5, -2.1), with two jointpoints, 2008 and 2012. By gender, the AAPC was -2.4% and -2.9% in men and women, respectively.

Stroke mortality rate decreased significantly between 1980 and 2015 in Chile, mainly in women.
Stroke mortality rate decreased significantly between 1980 and 2015 in Chile, mainly in women.
Violence against women (VAW) is a violation of women's fundamental rights and special attention must be paid during the gestational and postpartum period.

To determine the prevalence of violence against women attending antenatal and postpartum controls in Primary Health Centers.

The Woman Abuse Screening Tool (WAST) for early detection of VAW was applied to 279 pregnant and 102 puerperal women attending five public primary health centers in metropolitan Santiago.

The prevalence ofviolence against pregnant and puerperal women was 5.7 and 5.9%, respectively. In both groups, the factors associated with a greater risk of violence were being immigrants, a history of domestic violence, not having a supportive partner and alcohol consumption by the partner.

Violence against these women is a multifactorial, complex and structural phenomenon, which involves the victim, the abuser and the entire social system. Primary health care level and health professionals can be key elements applying early detection strategies, timely referral mechanisms and bringing emotional support for victims.
Violence against these women is a multifactorial, complex and structural phenomenon, which involves the victim, the abuser and the entire social system. Primary health care level and health professionals can be key elements applying early detection strategies, timely referral mechanisms and bringing emotional support for victims.
There are marked differences associated with socio-economic factors in the prevalence of depressive symptoms (DS) in men and women.

To estimate the association between socioeconomic status and DS in Chile and to estimate the gender gaps in this association.

The Patient Health Questionnaire-9 (PHQ-9) was applied as part of a socioeconomic survey carried out in a representative community sample (n = 2913). Using this information, we analyzed the influence of social status (education level, occupation, household income) and other psychosocial factors (gender, perceived social support, stressful life events) on DS.

The prevalence of DS was 23.2% in women and 13.4% in men. A socioeconomic gradient was found in the distribution of DS. This gradient was more pronounced for women than for men. Gender, social support and stressful life events were the most important predictors of severe DS, with an estimated risk twice as high among women and almost three times as high among those with low social support.

There is a combined effect between socio-economic and gender inequalities on DS. selleck This partially explains the greater vulnerability of poor women and the DS gap between men and women.
There is a combined effect between socio-economic and gender inequalities on DS. This partially explains the greater vulnerability of poor women and the DS gap between men and women.
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