Collection: Revista Chilena de Medicina Familiar

Giant cell tumor of the tendon sheath is the most common tumor of the hand. Are many theories of its development incluiding that is a neoplasia and/or inflammatory process. This is why is important to remote it by a trained physician. We presents a patient who consulted to minorsurgey  department of the Sotero del Rio Hospital sent by the primary care physician with a tumor in the second phalanx right hand.

El Modelo de Salud Familiar se construye con aportes disciplinarios varia-dos. Desde la perspectiva de la Medicina Familiar, un grupo importante de voluntades viene de aquellos que hoy en día se encuentran en formación. Los residentes de Medicina Familiar no solo son el recambio futuro de los que hoy estamos trabajando en el ámbito, sino que son una fuente de energía y proposiciones que modelan el ahora y construyen propuestas de desarrollo. En atención a su rol clave en este proceso, es que presentamos en este Tema Central un artículo que se refiere a un con-junto de reflexiones y propuestas de un grupo de médicos residentes de los distintos programas de Medicina Familiar del país, acompañados por médicos familiares egresados recientemente, que surgieron en el marco del último Congreso Chileno de Medicina Familiar en Santiago.

Paciente de sexo masculino, R.I.N, 39 años de edad, fumador de media cajetilla de cigarrillos al día, otros antecedentes mayores de riesgo cardiovascular y mórbidos de importancia. Inicio cuadro de disconfort retroesternal mal definido, de 2 horas de duración, no relacionado a esfuerzo, no irradiado, asociado a disnea, mareo y fatigabilidad.

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.

Menstruation disorders are a common cause of office visits in female adolescents and can cause great anxiety and concern among patients and their parents. These disorders can be transient during puberty due to the immaturity of the hypothalamus —pituitary— ovary axis. This article reviews and updates the most common menstruation disorders to improve their management in primary care. The primary care physician must be able to identify; certain pathologies that can appear at this age and to identify situations in which a menstrual flow alteration should be referred to the secondary or tertiary level for further study or treatment.

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.

This article describes some practical’ tips to improve the organization and administration of the patientflow in aFamily Medicine Health Centrehasecl an intemationalexperience and the authors experience inprimaiy care in Chile. It is an introduction to the subject, hopingthat some of these ideas can be put into practice in the not too distant future.
 

In this article we will review clinical and epidemiological aspects of sudden death in the designated age group, the national situation in terms of official health policies concerning the subject and the evidence based screening methods used internationally, to try to contribute to the development of a national consensus, effective, efficient and feasible to implement in Primary Healthcare.

Equity is one of the objectives of the current health reform. For promoting equity in primary health care, the financing mechanism must adjust for the socioeconomic status of the beneficiaries. The objective of this work was to revise the current formula and propose an alternative and most accurate indicator. The current indicator of poverty (municipality ‘s financial power) shows low correlation with the information from the National Survey of Socioeconomic Status (CASEN) for 2003 (R2 = 0.38). In contrast, the Public Health Fund (FONASA) definition of poverty (Group A) shows a significant improvement (R2 = 0.59).

Este encuentro fue organizado por la Sociedad Colombiana de Medicina Fa-miliar con apoyo y colaboración de la Universidad del Valle de Cali, representados ambos por la Dra. Liliana Arias-Castillo en su calidad de Presidenta de la Sociedad Colombiana y Decana de la Facultad de Medicina de la Universidad del Valle.