The Role of Knowledge and Attitudes About Nonsteroidal Anti-inflammatory Drugs in Determining Treatment Use.

Objective: The objective of this study was to evaluate how patient knowledge and beliefs regarding nonsteroidal anti-inflammatory drugs (NSAIDs) may influence the use of NSAIDs for osteoarthritis (OA).

Methods: Surveys of 334 adults with knee and/or hip OA were analyzed in this cross-sectional study. Familiarity with and perceptions of benefits/risks of NSAID use were measured to assess associations with the use of prescription and nonprescription oral NSAIDs.

Delphi Method to Achieve Clinical Consensus for a BPMN Representation of the Central Venous Access Placement for Training Purposes.

Unlabelled: Proper teaching of the technical skills necessary to perform a medical procedure begins with its breakdown into its constituent steps. Currently available methodologies require substantial resources and their results may be biased. Therefore, it is difficult to generate the necessary breakdown capable of supporting a procedural curriculum.

Nonsteroidal Anti-Inflammatory Drug Use in Chronic Arthritis Pain: Variations by Ethnicity.

Purpose: Our objective was to determine if there are ethnic differences in the use of over-the-counter (OTC) and prescription oral nonsteroidal anti-inflammatory drugs (NSAIDs) and if observed ethnic differences persist after adjustment for sociodemographic and clinical factors.

Methods: Knee and hip osteoarthritis study participants were identified. Surveys were administered to collect sociodemographics, clinical information, and oral treatment methods for arthritis.

Modifiable Determinants of Exercise Use in a Diverse Ethnic Population With Osteoarthritis.

Objective: To determine the extent of ethnic differences in the use of exercise for therapy and identify relevant modifiable determinants of exercise use among patients with knee/hip osteoarthritis (OA).

Methods: Knee/hip OA study participants were identified. Surveys were administered to collect patient sociodemographic and clinical information, and beliefs and attitudes about providers and treatments.

[Simulation in medical education: a synopsis].

Clinical simulation is defined as a technique (not a technology) to replace or amplify real experiences with guided experiences that evoke or replicate substantial aspects of the real world in a fully interactive fashion. Over the past few years, there has been a significant growth in its use, both as a learning tool and as an assessment for accreditation. Example of this is the fact that simulation is an integral part of medical education curricula abroad.

[What was the plague of Athens?].

In the year 430 B.C., at the beginning of the second year of the Peloponessian War, a terrible epidemic fell upon Athens and the most populous cities in Attica.

[Seventy five years of the Medical School of the Pontifical Catholic University of Chile].

Aiming to join academic excellence and an ethical and Christian approach to medical profession, the Medical School of the Pontifical Catholic University of Chile initiated its activities in 1930. Since then, the associated Health Care Network has incorporated all the technological breakthroughs in medicine and developed all the specialties. Undergraduate teaching is oriented to promote creativity and innovation.

Target-controlled infusion of remifentanil or fentanyl during extra-corporeal shock-wave lithotripsy.

Background And Objective: Target-controlled infusions (TCIs) of remifentanil and fentanyl in conscious sedation regimes for extra-corporeal shock-wave lithotripsy have not been reported. We estimated the effect site concentrations of remifentanil and fentanyl needed to obtain adequate analgesia in 50% of patients (EC50) and compared both drugs in terms of intra- and post-procedure complications.

Methods: Forty-four adult patients were randomly distributed into two groups: Group R received remifentanil and Group F received fentanyl TCI with initial effect site concentrations of 1.

Analgesia after thoracotomy: epidural fentanyl/bupivacaine compared with intercostal nerve block plus intravenous morphine.

Objectives: Intercostal nerve blockade plus intravenous (IV) patient-controlled analgesia (PCA) could be an easier and safer alternative to epidural analgesia for postthoracotomy pain, but information about the efficacy of this technique is scarce. The objective of this randomized study was to compare the quality of analgesia and lung function in 2 groups of patients undergoing pulmonary surgery through a posterolateral thoracotomy.

Methods: Two groups were studied: G1 (n = 16) patients received a 5-segment intercostal block plus IV PCA morphine, and G2 (n = 15) patients received a bupivacaine and fentanyl PCA infusion through a thoracic epidural catheter.

Remifentanil requirements during sevoflurane administration to block somatic and cardiovascular responses to skin incision in children and adults.

Background: The authors found no studies comparing intraoperative requirements of opioids between children and adults, so they determined the infusion rate of remifentanil to block somatic (IR50) and autonomic response (IRBAR50) to skin incision in children and adults.

Methods: Forty-one adults (aged 20-60 yr) and 24 children (aged 2-10 yr) undergoing lower abdominal surgery were studied. In adults, anesthesia induction was with sevoflurane during remifentanil infusion, whereas in children remifentanil administration was started after induction with sevoflurane.

Intramucosal gastric pH during liver transplantation.

Intramucosal gastric pH (pHi) was measured during liver transplantation in a 3-year-old girl. The basal value was below that reported as normal for paediatric patients under stable normal ventilatory and haemodynamic conditions. Additional reductions of the pHi were observed during the hepatectomy and anhepatic phase, in the absence of haemodynamic or ventilatory alterations.

Ondansetron and droperidol in the prevention of postoperative nausea and vomiting.

We have performed a prospective, randomized, double-blind clinical study to assess the efficacy of ondansetron, droperidol, or both, in preventing postoperative emesis. We studied 242 patients undergoing biliary or gynaecological surgery under general anaesthesia. Shortly before induction of anaesthesia, patients received: saline i.

[Acute effect of dobutamine and amrinone on hemodynamics and splanchnic perfusion in septic shock patients].

Background: Vasoactive drugs used in the reanimation of septic patients, can modify splanchnic perfusion.

Aim: To compare the effects of dobutamine and amrinone on gastric intramucosal pH (pHi), lactate levels and hemodynamics in surgical patients with compensated septic shock.

Patients And Methods: Fourteen postoperative patients with abdominal sepsis and compensated septic shock (pHi < 7.

Use of methylene blue in patients with refractory septic shock: impact on hemodynamics and gas exchange.

Purpose: The purpose of this study was to assess the acute effects of methylene blue, an inhibitor of nitric oxide synthesis, on hemodynamics and gas exchange in patients with refractory septic shock in a prospective clinical trial at medical and surgical intensive care units in a tertiary university hospital.

Patients And Methods: Prospective, sequential study of 10 consecutive patients admitted with severe septic shock of diverse causes and unable to achieve an adequate arterial pressure despite the use of at least two vasoactive drugs. Six of them also developed acute lung injury.

[Nocturnal hypoxemia after abdominal surgery: associated factors and usefulness of oxygen therapy].

Background: Postoperative nocturnal hypoxemia (PONH) is a main factor in the genesis of respiratory, cardiac and neurologic complications after surgery.

Aim: To describe the phenomenon of PONH after elective laparoscopy and laparotomy, and to evaluate the usefulness of oxygen therapy in its prevention.

Patients And Methods: Fifteen elective patients (6 M, 9 F, 51 +/- 8 years old) scheduled for laparotomy (n = 8) or laparoscopy (n = 7) were studied.

Epidural anaesthesia for ureteral reimplantation in an infant with congenital tracheal stenosis.

Purpose: We report a case of an infant with severe congenital tracheal stenosis who underwent ureteral reimplantation using lumbar epidural anaesthesia combined with light general anaesthesia.

Clinical Features: A six-month-old girl with symptomatic tracheal stenosis, demonstrated by computed tomography, was scheduled for ureteral reimplantation. She received continuous lumbar epidural anaesthesia with bupivacaine 0.

[Patients with acute adult respiratory distress syndrome: effects of inhaled nitric oxide on gas exchange and hemodynamics].

Background: Adult respiratory distress syndrome is highly prevalent in intensive care units and has a high mortality. Lately, nitric oxide has been used as adjuvant therapy.

Aim: To study the effects of nitric oxide inhalation in patients with adult respiratory distress syndrome.

[Inhibition of the nitric oxide pathway in refractory septic shock].

Aim: To assess the acute effects of methylene blue infusion, an inhibitor of nitric oxide synthesis, on hemodynamic parameters in patients with refractory septic shock.

Patients And Methods: Fourteen patients admitted to intensive care units with septic shock of diverse etiologies and unable to maintain median arterial pressures over 60 mm Hg with the use of at least 2 vasoactive drugs, were studied. All received a 1 mg/kg bolus of methylene blue Hemodynamic parameters were measured before and 30, 60, 120 and 180 min after the bolus.

[The imperative of medical involvement in the implementation of quality control systems].

Changes in health care delivery in Chile over the last years include rising costs and the relative increase of prepaid private insurance programs. It is expected that there will be increasing pressures on health providers to decrease cost while maintaining or improving quality. A series of common clinical problems are reviewed (hernia repair, appendicitis, gallstone disease, trauma, preoperative evaluation) to demonstrate that using a scientific method-continuous quality improvement- and considering the local socioeconomic reality, this challenge can be met.