Collection: Revista Chilena de Medicina Familiar

Se entiende por Gestion de la demanda al proceso de análisis y búsqueda de respuestas a las demandas de los usuarios. Dicho proceso involucra tanto la gestión interna del lugar de origen de la demanda come la gestión de la demanda referida a otros niveles o nodos de la red. La presente revisión analiza estos ámbitos come una forma de aportar al complejo proceso de abordar las necesidades reales de demanda de atención de salud que enfrenta una organización sanitaria.

Photoaging is considered as a group of clinical manifestations due to chronic exposure to solar ultraviolet irradiation (UV). Although it ‘spathophysiology is not totally clean reactive oxygen species are known to be generated by UV radiation causing dermic damage, as well as an augmentation in transcription of metallioproteinases (MMPs) due to radiation UV: MMPs produce damage in extracellular matrix and accumulates tissue damage; all that conducing to photoaging Multiple treatments have bemproposed to stop damagingeects  UV Amongthem, reducing skin exposure to UV radiation remains as the most importan,  followed by the use of antioxidants and treatments which moderate gene expression of MMPs. However, we are only able to diminish photoagingdamage since a specific tmatment to photoaging has not yet been found.

This story about the history of the chair in the region was prepared by the fellows of the first year of family medicine in april 2008.Through interviews with the protagonists are trying to reconstruct the events that led to the realization of the fundamentals and the stamp of the specialty in this area. In Chile the process has been delayed more in relation to marry other Latin American countries and Europe and has not been without difficulties and oppositions. We surrender without judgments vision of the past trials that urges us to see what progress and continue to work towards the future.

Cough is a respiratory reflex, or defensive mechanism, that allows to eliminate thepresentmaterial in the bronchial tree to maintain its permeability. It is chronic when itperszsts by more than 8 weeks. It has a prevalence of23% in healthy people and nonsmokers. 13% of older peoplehave chronic cough, and it is described as the mostfrequent ambulatory cansultatiorz,predominantly in women. The reason to consult is the fear to steer an oncogenk disease, also the secondary upheavals to thepersistent cough,like bad sleeping, synco and urinary incontinence in women. Thepnzsent review shows the dOrential diagnosis ofthronic cough and their management accarrlingto the consensus ofthe evidence and to the possibilities at primazy care

The Subclinical Hypothyroidism is a frecuent illness in the medicine practice. But it is not always a real benefit under levothyroxine treatment with theres patients. Now we will try to interpret the meaning and epidemiology of the illness mentioned abate. We will evaluate in whose patients it is correct to aplly the exams of thyroid and when. We can justify and begin a teatment in the effeted patients.

El uso de corticoides en el manejo agudo de la parálisis facial periférica no muestra mayor efectividad que placebo en la recuperación de la función motora facial a los 6 meses.

En nuestra práctica diaria nos enfrentaremos a niños con Trastorno Autista, y se ha visto que las intervenciones dirigidas a mejorar la socialización son más efectivas si se realizan a edades más tempranas. Es posible sospechar precozmente la presencia de un trastorno autista y la Atención Primaria de Salud es el escenario ideal para la sensibilización de los profesionales y donde debe realizarse la pesquisa precoz de este Trastorno. Para esto, los profesionales que atienden niños deben estar familiarizados con este trastorno, es necesario vigilar la evolución del DSM y estar atento a alteraciones tempranas que pudieran indicar un Trastorno Autista. El diagnóstico es complejo y debe realizarse por un equipo especializado en este tema, por lo que es necesario conocer los centros disponibles para la derivación según donde uno trabaje. Es importante no olvidar que no existen dos niños con Trastorno Autista iguales, y que cada niño es único en su enfrentamiento.

En pacientes con factores de riesgo (glicemia de ayuno alterada o intolerancia a la glucosa), tanto el uso de metfor-mina como un programa de cambios de estilo de vida comparados con placebo disminuyeron la incidencia de DM2 en 31% y 58% respectivamente (NNT 13,9 y 6,9).