Dilemas éticos acerca de la revelación de errores médicos a los pacientes

Since the publication of the Institute of Medicines report “To Err is Human: Building a Safer Health System” awareness of the importance of medical errors has increased. These are a major cause of morbidity and mortality and recent studies suggest that they can be the third leading cause of death in the United States. Difficulties have been identified by health personnel to prevent, detect and disclose to patients the occurrence of a medical error, an also to report them to the appropriate authorities. Although human error cannot be eliminated, it is possible to design safety systems to mitigate their frequency and consequences. Our goal is to provide an update on the major concepts related to medical errors, a review of Chilean legislation on the subject, and a bioethical analysis on the principles involved, along with a management proposal. We propose mandatory reporting of errors to the health institution where they occur, to serve as a measure of personal and team learning, and to disclose the error to patients, depending on their own preferences.

Caracterización morfológica y molecular de aislados de Macrophomina phaseolina asociados a caña de azúcar en México / Morphological and molecular characterization of isolates of Macrophomina phaseolina associated with sugarcane in Mexico

La pudrición carbonosa, causada por Macrophomina phaseolina, es una enfermedad importante de la caña de azúcar en México. Este estudio se realizó con el objetivo de caracterizar aislados de M. phaseolina obtenidos de caña de azúcar mediante análisis morfológicos y moleculares. La caracterización morfológica de 10 aislados se llevó a cabo con el uso de microscopia electrónica de barrido y microscopia de luz. Para confirmar la identificación, se extrajo el ADNr de 2 aislados representativos, y la región del espaciador interno transcrito (ITS) se amplificó mediante la reacción en cadena de la polimerasa y se secuenció usando los iniciadores específicos MpKF1 y MpKR1. Los aislados se identificaron como M. phaseolina con base en la morfología. El análisis de secuencias ITS mostró 100% de similitud con las secuencias de M. phaseolina depositadas en el GenBank. Para nuestro conocimiento, este es el primer estudio del mundo enfocado a caracterizar aislados de M. phaseolina obtenidos de caña de azúcar

Charcoal rot caused by Macrophomina phaseolina is an important disease of sugarcane in Mexico. This study was carried out to characterize isolates of M. phaseolina obtained from sugarcane by the combination of morphological and molecular analyses. The morphological characterization of 10 isolates was performed using scanning electron microscopy and light microscopy. To confirm the morphological identification, rDNA from two representative isolates was extracted, and the internal transcribed spacer (ITS) region was amplified by polymerase chain reaction and sequenced using specific primers MpKF1 and MpKR1. Based on their morphological characteristics, all isolates were identified as M. phaseolina. Moreover, the analysis of two ITS sequences showed 100% similarity with the M. phaseolina sequences deposited in the GenBank. To our knowledge, this is the first study in the world aimed at characterizing isolates of M. phaseolina obtained from sugarcane