Search

Resumen El sindrome de fuga capilar sistemica es una entidad infrecuente descrita por Clarkson en los anos 60 del siglo xx . Su etiologia es desconocida y su curso se caracteriza por cuadros recurrentes de paso masivo de plasma y proteinas desde el espacio intravascular al intersticial. Estos provocan hipoalbuminemia, hemococentracion, anasarca, rabdomiolisis, hipotension arterial y shock. Se ha postulado un origen autoinmune, por lo que el uso de inmunoglobulinas endovenosas se ha considerado como una alternativa terapeutica, reduciendo el numero de brotes. Presentamos el caso de un paciente varon de 58 anos con diagnostico de sindrome de fuga capilar sistemica asociado a infeccion por virus Influenza A con evolucion hacia shock refractario fulminante.

Background Recall bias is a potential source of misclassification in case-control studies. Studies have shown that the association between exposure and disease can differ according to participants’ beliefs or knowledge about the effect of that exposure on disease. We investigated the association between belief about breast cancer causation and self-reported shift work exposure in a case-control study. Methods Women completed a questionnaire asking whether they believed that shift work caused cancer either before or after reporting their history of shift work. We measured: whether belief modified the association between reported shift work and disease; whether belief was associated with reported shift work exposure; and whether being prompted to recall shift work exposure was associated with an increased likelihood of believing that shift work increased breast cancer risk. Results There was a significant association between believing shift work increased breast cancer risk and reporting exposure to shift work. Being prompted to recall shift work was not associated with a belief that shift work increased risk. Conclusion The association between pre-existing belief about breast cancer risk and reported shift work is likely to be due to exposed individuals believing that exposure increases risk, rather than resulting from recall bias.

ISSUE ADDRESSED: Up to one-third of incident cancers in Australia are attributable to modifiable factors. Understanding the general public's awareness of cancer risk and protective factors is important for identifying knowledge gaps and informing the development of effective and targeted health promotion strategies. METHODS: In a telephonic survey of 355 Western Australian adults aged 18-54 years (48% male), with a sample skewed towards low-socio-economic status areas, respondents rated the effect on cancer risk of 11 established cancer risk factors and seven established cancer protective factors. RESULTS: Most respondents correctly recognised the increased cancer risk from sun tanning (94%), asbestos (92%), pesticide use (92%) and being overweight or obese (86%), and the protective effect of being physically active (82%). Half (52%) of respondents incorrectly believed that red wine decreased or had no effect on cancer risk. One in five respondents (19%) incorrectly believed that sunscreen use increased cancer risk. Only 18% of respondents were aware that human papillomavirus (HPV) vaccination confers a protective effect, while 17% believed it increases risk. CONCLUSIONS: Although the majority of respondents were aware of certain established cancer risk and protective factors, a sizeable proportion held misconceptions about the cancer risk associated with red wine consumption, sunscreen use and HPV vaccination. SO WHAT?: Health promotion programs designed to educate the public about modifiable cancer risk factors may need to increase public awareness of the safety of preventive factors such as HPV vaccination and sunscreen, and the increased cancer risk from consumption of all alcoholic beverage types, including red wine.

Objective Our study sought to ascertain women's beliefs about breast cancer risk factors and whether these beliefs differed by demographic factors and personal and family history of breast cancer. Methods Participants in a case–control study of breast cancer rated the effect of 37 exposures on the risk of being diagnosed with breast cancer. Chi-square tests were undertaken to measure differences in responses between cases and controls for each exposure. Logistic regression was undertaken to ascertain whether demographic factors and personal and family history of breast cancer affected participants' ability to correctly identify known breast cancer risk factors. Results A total of 2742 participants completed the questionnaire, comprising 1109 cases and 1633 controls. Significant differences (p

Aim To investigate general practitioners' (GP) perceptions about communication when providing cancer care. Methods A self-report survey, which included an open response section, was mailed to a random sample of 1969 eligible Australian GPs. Content analysis of open response comments pertaining to communication was undertaken in order to ascertain GPs' views about communication issues in the provision of cancer care. Results Of the 648 GPs who completed the survey, 68 (10%) included open response comments about interprofessional communication. Participants who commented on communication were a median age of 50 years and worked 33 h/week; 28% were male and 59% practiced in the metropolitan area. Comments pertaining to communication were coded using five non-mutually exclusive categories: being kept in the loop; continuity of care; relationships with specialists; positive communication experiences; and strategies for improving communication.GPs repeatedly noted the importance of receiving detailed and timely communication from specialists and hospitals, particularly in relation to patients' treatment regimes and follow-up care. Several GPs remarked that they were left out of “the information loop” and that patients were “lost” or “dumped” after referral. Conclusion While many GPs are currently involved in some aspects of cancer management, detailed and timely communication between specialists and GPs is imperative to support shared care and ensure optimal patient outcomes. This research highlights the need for established channels of communication between specialist and primary care medicine to support greater involvement by GPs in cancer care.

En este artículo, a fin de colaborar en la introducción del análisis constructivista a los estudios latinoamericanos, se recogen las principales ideas y conceptos del constructivismo que pueden ayudar a entender que en las relaciones internacionales también influyen los llamados factores ideacionales, como la identidad e intereses, y no sólo los factores materiales. Junto a ello, se dará luces de cómo este enfoque puede ampliar el análisis de la relaciones entre Bolivia y Chile, centrándose en las identidades estatales de ambos países que inciden en las relaciones bilaterales.

Aim To investigate general practitioners' (GPs) preferences for involvement in the management of people diagnosed with the seven most frequent cancers and any barriers to or concerns about an expanded role for GPs. Methods A self-report survey was mailed to a random sample of 1969 Australian GPs. Results In all, 33% (648) of GPs participated. Participants were a median of 50 years and worked 38 h per week; 53% were male and 68% practiced in metropolitan areas. Most participants preferred to be involved in cancer prevention (86%) and initial diagnosis (85%). Fewer were interested in monitoring for recurrence (70%), follow up after treatment (68%), coordinating psychological support (70%) and palliative care (68%). Only 52% of GPs had a preference for providing supportive care to manage the symptoms of cancer treatment, 45% for managing postoperative care and 40% for coordinating treatment. On multivariate analysis, preference for involvement in more aspects of cancer management increased with age (P = 0.030), if the GP practiced in rural compared to metropolitan areas (P = 0.005), was a partner in a practice compared to a sole practitioner (P = 0.003), had previously received cancer-specific training (P

To investigate general practitioners' (GP) perceptions about communication when providing cancer care.A self-report survey, which included an open response section, was mailed to a random sample of 1969 eligible Australian GPs. Content analysis of open response comments pertaining to communication was undertaken in order to ascertain GPs' views about communication issues in the provision of cancer care.Of the 648 GPs who completed the survey, 68 (10%) included open response comments about interprofessional communication. Participants who commented on communication were a median age of 50 years and worked 33 h/week; 28% were male and 59% practiced in the metropolitan area. Comments pertaining to communication were coded using five non-mutually exclusive categories: being kept in the loop; continuity of care; relationships with specialists; positive communication experiences; and strategies for improving communication.GPs repeatedly noted the importance of receiving detailed and timely communication from specialists and hospitals, particularly in relation to patients' treatment regimes and follow-up care. Several GPs remarked that they were left out of "the information loop" and that patients were "lost" or "dumped" after referral.While many GPs are currently involved in some aspects of cancer management, detailed and timely communication between specialists and GPs is imperative to support shared care and ensure optimal patient outcomes. This research highlights the need for established channels of communication between specialist and primary care medicine to support greater involvement by GPs in cancer care.

To investigate general practitioners' (GPs) preferences for involvement in the management of people diagnosed with the seven most frequent cancers and any barriers to or concerns about an expanded role for GPs.A self-report survey was mailed to a random sample of 1969 Australian GPs.In all, 33% (648) of GPs participated. Participants were a median of 50 years and worked 38 h per week; 53% were male and 68% practiced in metropolitan areas. Most participants preferred to be involved in cancer prevention (86%) and initial diagnosis (85%). Fewer were interested in monitoring for recurrence (70%), follow up after treatment (68%), coordinating psychological support (70%) and palliative care (68%). Only 52% of GPs had a preference for providing supportive care to manage the symptoms of cancer treatment, 45% for managing postoperative care and 40% for coordinating treatment. On multivariate analysis, preference for involvement in more aspects of cancer management increased with age (P = 0.030), if the GP practiced in rural compared to metropolitan areas (P = 0.005), was a partner in a practice compared to a sole practitioner (P = 0.003), had previously received cancer-specific training (P 0.001) or was interested in future training (P 0.001). Open responses identified limited time, communication and information transfer between GP and specialists as important barriers to involvement in cancer management.While many GPs are currently involved in some aspects of cancer management, with training, good communication and support from specialists this role may be successfully expanded.