ABSTRACT
Background: The Patient Assessment of Chronic Illness Care (PACIC) questionnaire is a widely used instrument to assess chronic disease care from a patient's perspective. Aim: To adapt the PACIC questionnaire to Chilean Spanish and to evaluate the psychometric properties of the translation. Material and Methods: Descriptive, cross-sectional design with exploratory and confirmatory factor analysis. The PACIC questionnaire was applied, throughout an external client, to 200 users who received health care at the cardiovascular program in a Family Health Center in Concepción, Chile. Results: The confirmatory factor analysis did not show a good adjustment with the proposed structure in the original instrument. An exploratory factor analysis revealed five factors explaining 58% of total data variability. The distribution of the factor-items of the original questionnaire underwent some modifications, which are explained when analyzing the theoretical construct. A good reliability of the global scale was obtained (Cronbach's α 0.886). Conclusions: The PACIC questionnaire, Chilean version does not replicate the proposed structure of the original questionnaire. Therefore, further research about its validity, incorporating a higher number or diversity of participants is recommended.
Subject(s)
Humans , Male , Female , Middle Aged , Chronic Disease , Surveys and Questionnaires , Delivery of Health Care/standards , Psychometrics , Translations , Chile , Cross-Sectional Studies , Reproducibility of Results , Cultural CharacteristicsABSTRACT
Bruxismo se define como un trastorno del movimiento mandibular que se caracteriza por apretamiento o rechinamiento dentario. Se estima que la prevalencia de éste puede variar desde un 8 por ciento a un 20 por ciento de la población adulta. Quienes padecen esta parafunción relatan manifestación en otras personas del grupo familiar. Existen teorías que buscan explicar la etiología del bruxismo, basados principalmente en estudios clínicos y encuestas a pacientes. Estas proponen que los principales factores etiológicos de Bruxismo serían estrés y alteraciones en ciertos neurotransmisores o sus vías (Dopamina, Ácido Gamma-Aminobutírico y Serotonina). La posibilidad de que alteraciones genéticas del ADN influyan en la aparición de bruxismo no ha sido considerada. Dado que no existe en la literatura consultada estudios genético-moleculares y/o funcionales que confirmen las teorías basadas en estudios clínicos, parece necesario iniciar investigaciones en esta área que lleven a una mejor comprensión de esta parafunción, con el ánimo final de aportar en el desarrollo de más y mejores terapias para el tratamiento del bruxismo...
Bruxism has been defined as a sleep-related movement disorder characterized by tooth grinding or clenching. Between 8 percent to 20 percent of adult population is affected by this parafunction. Relatives of these patients have reported to be affected by bruxism as well. There are theories that want to explain bruxism ethiology based on factors as stress and alteration in neurotransmitters (Dopamine, GABA and Serotonin). Possible epigenetic alterations in DNA influencing bruxism appearance have not been considered. It is therefore necessary to perform genetic, epigenetic and molecular research to confirm theories related to bruxism ethiology, with the aim to improve knowledge in this field as well as to contribute in the development of new and better therapies in bruxism treatment...
Subject(s)
Humans , Bruxism/genetics , Dopamine , gamma-Aminobutyric Acid , Serotonin , Bruxism/classification , Bruxism/physiopathology , Epigenesis, GeneticABSTRACT
We report a 42 year-old woman with a hypothyroidism and a mixed connective tissue disease treated with prednisone and methotrexate. The patient had normal blood glucose levels but when the methotrexate dose was tapered, she presented a diabetic ketoacidosis that required up to 520 units of insulin per day. Due to the intensification of the mixed connective tissue disease symptoms, the doses of methotrexate and prednisone were increased again with a simultaneous normalization of serum glucose levels and glucose tolerance. In the following six months, when the dose of methotrexate was tapered again, the hyperglycemia reappeared and was again controlled increasing the dose. Thirty months after the episode of keotacidosis, the patient was with a weekly dose of methotrexate, asymptomatic and with a normal glucose tolerance. Anti insulin antibodies were not detected and anti islet antibodies were indeterminate, due to interference with antinuclear antibodies. It is possible that the episode of ketoacidosis was unveiled by an autoimmune phenomenon.
Subject(s)
Adult , Female , Humans , Diabetic Ketoacidosis/drug therapy , Immunosuppressive Agents/administration & dosage , Insulin Resistance/physiology , Methotrexate/administration & dosage , Mixed Connective Tissue Disease/drug therapy , Blood Glucose , Diabetic Ketoacidosis/chemically induced , Dose-Response Relationship, Drug , Drug Administration Schedule , Hypoglycemic Agents/administration & dosage , Hypothyroidism/drug therapy , Immunosuppressive Agents/adverse effects , Insulin/administration & dosage , Methotrexate/adverse effects , Substance Withdrawal Syndrome/drug therapy , Substance Withdrawal Syndrome/etiologySubject(s)
Male , Humans , Female , Infant, Newborn , Infant , Hirschsprung Disease/pathology , Enterocolitis/diagnosis , Gastrointestinal Motility , Biopsy , Chile , Enema , Manometry , OstomyABSTRACT
Revisamos la experiencia institucional en la reparación de las fístulas vesicovaginales operadas entre marzo de 1974 y marzo de 1995. Se estudiaron 41 pacientes con 44 fístulas vesicovaginales. La etiología fue variada con una preponderancia de la cirugía ginecológica. Hubo corrección quirúrgica en todos los casos, predominando el abordaje abdominal de O'Connor en la reparación de las fístulas vesicovaginales
Subject(s)
Humans , Female , Adult , Middle Aged , Vesicovaginal Fistula/diagnosis , Vesicovaginal Fistula/surgery , Surgical Procedures, OperativeABSTRACT
Lawsuits against physicians are becoming relevant in Chile. We analized 18 trials against physicians that occured between 1977 and 1985 and that were ruled by Metropolitan Region courts. The causes of demands were death of patients in 8 trials and severe lesions in the rest. Twelve trials originated from surgical procedures (6 from gynecological interventions) and 9 came from private clinics. Nine trials lasted less than 2 years and 3, more than 5 years. Sentences was pronounced by criminal courts in 12 cases and by appealing courts in six
Subject(s)
Humans , Jurisprudence , Malpractice/legislation & jurisprudence , Patient Advocacy/legislation & jurisprudence , Liability, Legal , Legislation, Medical/statistics & numerical dataABSTRACT
Entre mayo de 1992 y febrero de 1995 un total de 33 pacientes con cánceres prostáticos clínicamente localizados y con linfadenectomía pélvica negativa fueron sometidos a prostatectomía retropúbica radical por considerar que se trataba de casos órgano-confinados. Hay que señalar, no obstante, que el 72,7 porciento de ellos tenían valores de antígeno prostático específico mayores de 10 ng/ml. El estudio histopatológico diferido de las piezas operatorias demostró márgenes con tumor en el 57,6 porciento. Al cabo de un año de observación sólo un tercio de los pacientes controlados tenían valores de antígeno prostático inferior a 4,0 ng/ml
Subject(s)
Humans , Male , Middle Aged , Prostatectomy , Prostatic Neoplasms/surgery , Diagnostic Techniques, Surgical/statistics & numerical data , Epidemiology, Descriptive , Postoperative Complications/epidemiology , Prostate-Specific Antigen/isolation & purification , Prostatic Neoplasms/pathology , Retrospective StudiesABSTRACT
Con el ánimo de validar la biopsia rápida de ganglios ilíacos para etapificar el cáncer prostático, 45 pacientes con cancer prostático clínicamnete localizado, fueron sometidos a linfadenectomía ilíaca en el Departamento de Urología del Hospital San Juan de Dios, 12 pacientes fueron informados comop positivos para metástasis de adenocarcinoma en biopsia rápida y el resto, informada como negativa. Los pacientes informados como negativos fueron sometidos a prostatectomía radical retropúbica. La capacidad de la biopsia rápida para pesquisar los ganglios con metástasis, es decir, su sensibilidad, alcanzó al 75 porciento, su especificidad alcanzó al 100 porciento, es decir todos los casos informados como positivos en la biopsia rápida fueron confirmados en la biopsia diferida
Subject(s)
Humans , Male , Lymph Node Excision , Prostatectomy , Prostatic Neoplasms/surgery , Biopsy , Diagnostic Techniques, Surgical , Sensitivity and SpecificityABSTRACT
La angioplastia transluminal percutanea (ATP), permite la dilatacion de una estenosis o la desobstruccion vascular por medio del cateterismo. Tecnica introducida por Dotter en 1964, en los ultimos anos ha experimentado gran difusion mundial a raiz del uso del cateter de Gruntzig. Practicamente en todos los territorios vasculares se han efectuado angioplastias, siendo sus indicaciones y resultados a largo plazo, todavia no totalmente definidos. Sin embargo el metodo ha sido aceptado y sus buenos resultados comprobados, cuando la cirugia no permite realizar procedimientos de revascularizacion o estos involucran un importante riesgo para el enfermo.Nuestro interes es que el primer caso exitoso de ATP realizado en nuestro pais, sea el comienzo de un trabajo a largo plazo para valorar las posibilidades de dicho metodo terapeutico