Collection: ARTÍCULOS ORIGINALES

exuality in the elderly continues to be a topic of little scienti c approach in primary health care. In the older adult there are changes in their sexuality and a group of factors that can in uence on the satisfactory sex have been determined. ere have been several studies on sexuality in the general population, focusing mainly on young population and little on the elderly.
OBJECTIVES: To know some of the characteristics of the sexuality of the elderly population in the commune of Retiro. Identify if there was interest in receiving information or education regarding sexuality.
MATERIAL AND METHODS: We surveyed 97 older adults who attended the health center of Retiro and voluntarily lled out the survey. We applied questions from the study “Sexual Habits of Latin American – GDA 2010” and from “National Study of Sexual Behavior – Chile 2000” and the results were obtained.
RESULTS: 97 elderly people were interviewed, of whom 54 were males and 43 were females. e average age of the sample was 71 years. 64% of the respondents were married. e frequency of sexual intercourse in sexually active older adults (n = 32) was on average once every 3 months. 33% of respondents reported having had some degree of sexual dysfunction. Most sexually active AMs were satis ed with their sexuality. 94% of the sexually active AM expressed the desire to receive information and / or education regarding sexuality.
CONCLUSION: It is necessary to contribute with more research on sexuality in the elderly in order to identify in uential factors in this area. A high percentage of older adults who have sexual activity reported interest in receiving information and / or education about it, which is why respond to this need by developing strategies.

Introducción: Actualmente, existe pre-ocupación por certificar la seguridad de los escolares durante actividades deportivas, traduciéndose en una creciente solicitud de certificaciones en la atención primaria. Buscando optimizar la evaluación, implementamos sistemáticamente la aplicación del electrocardiograma a todos los escolares derivados, para evaluar la eventual presencia de alteraciones constantes, altamente predictivas de muerte súbita. Objetivos: Determinar prevalencia de alteraciones en el patrón electrocardiográfico en escolares derivados a evaluación, destacando las de carácter ominoso, y estableciendo correlación con antecedentes clínicos. Material y Método: Se diseñó estudio descriptivo, transversal, basado en revisión de datos clínicos e informes electrocardiográficos en fichas clínicas de 100 escolares entre 7 y 19 años, evaluados por médicos generales, certificados ACLS. Validación herramientas diagnósticas mediante determinación de sensibilidad y valores predictivos. Resultados: Prevalencia de asintomáticos cardiovasculares, 92%. Sólo 8% sintomáticos, a expensas de 6% con palpitaciones, 1% síncope y 1% disnea. Hubo 63% de electrocardiogramas normales, 37% alterados; de éstos, lo más frecuente fue BIRD, 9%. Se encontró 2% con patrón de SWPW y 2% con Brugada; siendo la mitad de estos, asintomáticos. Conclusiones: La gran mayoría de los pacientes fue asintomático, presentando electrocardiograma normal. Aproximadamente 2/5 de los electrocardiogramas mostró alteraciones, mayoritariamente benignas. No obstante, se pesquisaron alteraciones potencial-mente ominosas, como SWPW y Bruga- da, la mitad de éstos sin correlato clínico, lo que ameritó referencia a especialista en 4 de 100 pacientes. Esto evidencia la utilidad del ECG como parte del screening básico en la evaluación del riesgo cardiovascular, ante actividad física en escolares, por la capacidad de evidenciar patrones predictivos de alto riesgo en población asintomática.

Introduction: Phimosis is a physiological condition with spontaneous resolution over 90% within the first three years of life. If not resolved or complications are added, probability of disease progression is high. Corticosteroid therapy is suggested as first line, by its cost effectiveness, high resolution rate and no adverse effects. Objective: To describe the results of topical corticosteroids treatment in children with more than 36 months or younger with a medical indication for treatment, in primary care. Methods: longitudinal, prospective, concurrent study analyzed 31 patients during 3 years, diagnosed with high degree phimosis greater than 36 months, and younger with complications. Response to betamethasone 0.05% treatment was assessed. Resolution, relapses and adverse effects up to 16 weeks and 2 years after treatment were recorded. Results: Short term total resolution reached 83.3%, and 16.7% was sent to surgery. In two-year follow-up, total resolution reached 73.3%, and 26.7% was sent to surgery. In relation to the treatment groups, in children with high degree phimosis and age 80.8% were resolved in a short term and 69.2% in two-year follow-up. The group of recurrent infections showed 100% resolution, without relapses. Conclusion: Topical betamethasone 0.05% is effective, safe and accessibility treatment in primary care for persistent phimosis in children older than 3 years and in younger children with need for circumcision. Keywords: phimosis,

Introduction: Approximately 14,000 people died in Chile because of smoking related diseases in 2002. Tobacco companies affirm that smokers know about the smoking health risks. However, medical evidence concludes the opposite. Objectives: To study the level of knowledge and the personal risk perception of smoking related diseases in a group of current smokers in Santiago. Methods: A voluntary survey was administered by trained interviewers to 251 current smokers consulting in two Family Medicine centers in Santiago, between April and June 2006. Results: 27% of respondents answered incorrectly questions about smoking health effects. 43% of respondents do not perceived a greater personal risk of cancer or acute myocardial infarction respect to other people of the same age. Conclusions: An important percentage of current smokers do not know the effects of smoking on heath and only a half of them perceive a greater personal health risk. lt is necessary to apply public health strategies in order to improve the knowledge and the personal risk perception of smoking health effects. Medical advice should be also improved.

Major depression is a pathology of high prevalence in Chile and the world, with repercussion in the quality of life of people. The proper treatment of this pathology has proven to be effective and is considered a health priority. An obstacle in the achievement of this purpose is the abandonment of treatment, which makes it difficult to implement the different interventions. The importance of the perspective of the patient is raised in order to improve the treatment programs. The objective of this study is to rescue the experience of women between 24 and 65 years of age, diagnosed with depression, belonging to the San Alberto Hurtado Family Health Center, Puente Alto, who abandoned treatment. Through a phenomenological study with in-depth interviews, four comprehensive categories were revealed: depression experience, desire for improvement, abandonment-related circumstances, and actions to improve. Among the findings of the study, it should be noted that the representation that patients have of depression is different from the biomedical representation and that the treatment is secondary to other responsibilities (“it is a luxury)

Aims: to adapt and validar an instrument that mother – son evaluates attachment for his application in the diada to 6 months in communes of the sector South – orientates of Santiago. Method: the process of validation consisted in: 1) The selection of the instrument across an extensive bibliographical review, there being selected the “Scale of Massie-Campbell’s Attachment”; 2) The adjustment of the instrument to the language and culture places; 3) HU validation as for Appearance Constructo and Content across a committee reviser of experts; 4) It field tries the instrument; 5) Evaluation of reliability across the Inter-observant analysis of conformity for Wilcoxon Signed-Rank’s method Test for Difference in Medians. Results: there was achieved the final version of the Scale of adapted, modified Massie-Campbell and validada in appearance, constructo and content. Reliability  evaluated across the Inter-observant analysis of conformity for Wilcoxon Signed-Rank’s methodTestfor Difference in Medians. Conformity was confirmed in five of seven observed conducts. Concomitantemente developed a Manual and Mini manual* his use. Conclusion: the adjustment and validation of appearance was realized, constructo and content of an instrument for the measurement of attachment in Chilean’s infants, fulfilling with all the necessary stages described in the literature for the validation of an instrument of typical these. In view of the important of the topic; this scale will allow the detection and precocious intervention of upset bosses of attachment, which according to the evidence has demonstrated to be the most e ective method among the interventions in attachment.

Los cuidados de salud son un tema que en los últimos 15 años se ha abordado en la literatura mundial del área de las ciencias médicas, pero escasamente en nuestro país. Los estudios sugieren a los profesionales socio-sanitarios que el conocer y comprender las prácticas de cuidados de las personas es una tarea necesaria para la práctica asistencial.

Se estudiaron prospectivamente, con igual protocolo de estudio, 193 pacientes portadores de diabetes mellitus tipo 2 durante el año 2006, procedentes del Centro de Salud Rinconada, y correspondientes al 98% de la prevalencia esperada (5%) para determinar las características clínicas de estos en lo relativo a la presencia de retinopatía diabética, mediante oftalmoscopia directa con midriasis farmacológica. Se encontró una prevalencia de retinopatía diabética del 22%, situación que se presentaba con mayor frecuencia a medida que empeoraba el control metabólico, medido con hemoglobina glicosilada A1c, y con el tiempo de evolución de la enfermedad, expresado como años de diagnosticó. Adicionalmente, se encontró la microalbuminuria como factor de riesgo a tener presente en el estadio de la afección. Se refuerza el concepto de pesquisa asociado a derivabilidad de la patología en cuestión con el consiguiente ahorro de recursos oftalmólogo.

El Centro de Referencia de Salud (CRS) se crea como una institución de mediana complejidad para atender pacientes derivados desde la atención primaria. EL CRS San Rafael de La Florida atiende a los pacientes derivados desde los cinco Centros de Salud de Atención Primaria de la Comuna de La Florida y a los pacientes de esta comuna que se atienden en los Servicios de URgencia o CDT del Hospital Sótero del Río. En las Unidades de Medicina y Pediatría de este CRS se desempeñan, hace cuantro años, médicos postbecados de los programas de MEdicina Familiar del niño y del adulto de la Pontificia Universidd Católica de Chile, los cuales han desarrollado diferentes trabajos de investigación, coordinación de diferentes niveles de atención y cargos directivos; de los cuales uno de ellos se presenta en esta oportunidad.
Se da comienzo a este programa, por parte de la Unidad de Medicina del CRS San Rafael de La Florida, en Mayo del año 2000, por la necesidad de absorver los pacientes con tratamiento anticoagulante de la comuna de La Florida, que se estaban atendiendo en la Unidad de Cardiología del CDT del SSMSO, que por problemas de presupuesto y presión asistencual no podían continuar en esa unidad.
Actualmente existe 151 pacientes bajp control, con la posibilidad de alcanzar aproximadamente 500 pacientes, tanto derivados del CDT, dek mismo CRS y de otros Servicios de Salud por cambio de domicilio.

 

MINOR SURGERY: A 6 MONTH EXPERIENCE DESCRIPTION IN PRIMARY CAREFamily Health Centers (FHC) are establishments of primary care, responsible of give solutions to the needs of health of persons and family. In this context, Minor Surgery assumes procedures on superficial tissues, in order to improve the accessibility and resolution rate. The aim of this study is to describe the experience in Minor Surgery in FHC Cristo Vive. Minor surgeries realized between January and July of 2008 were analyzed. A total of 101 procedures were realized, in 97patients of 43 years average and 58 % were woman. The minimal standby time between diagnosis-procedure was fulfilled in 57 % of the patients. The most frequent diagnosis was Ingrown Nail. The rate of complication was 0,9/100pacientes. In Conclusion, Minor Surgery is an important tool in primary care, with a low rate of complications, which every doctor should be familiarized.