Collection: Revista Chilena de Medicina Familiar

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.

Nowadays, oral child’s health is one of our country’s priorities. Promotion of an adequate oral hygiene should be frequently discussed with patients and parents, both as primary and secondary prevention. On the other hand, even so dental caries are highly prevalent, we doctors have very little information in the subject. Consequently, we don’t get involved in the field very often. The present article is intended to review  general aspects of etiopathology of caries and what are the recommendations we shouId follow as primary care physicians to prevent them in pediatric population. The appropriate timing for stating toothbrushing or when to prescribe toothpaste are some of the aspects discussed, making an emphasis in critical appraisal of the literature.

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.

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.

This paper is the first of two articles, discussing Urinary Incontinence, to be published in this journal. First, we will discuss briefly some aspects related to basic physiology and physiopathology of storage and voiding, ending with a review of the main evaluation Strategies available to patients suffering from incontinence. In the second article (to be publish in the next issue of this journal), we will summarize the main aspects related to treatment options, either physical, pharmacological or surgical. Articles were written to fulfil the needs of updated medical information of family practioners.

Chile is one of the countries with more consumption of cigarettes in America and the prices are cheaper compared with the food necessary. The new Law of Tobacco in Chile was very important in public health, however, the law has its defects. According to the cost effective interventions suggested by the World Bank, an analysis has been done to compared the Chilean law with the actual law in the countries of Brazil, Spain and Italy. The principal
differences found, were in the smoking prohibition in public places and in work places. Another difference found between the law in those countries was the access to centres of help for smokers who wish to quit. Though, the publicity and citizen conscience are essentials, to modify the conduct and to prevail the idea that not smoking is normal.

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.

La Adición de Aspirina al Tratamiento Anticoagulante Oral logra una disminuión de los eventos tromboembólicos en el total de pacientes, pero con un aumento del riesgo de hemorragía mayor de similar magnitud relativa. Este beneficio es principalmente debido a la disminucuón de estos eventos en los pacientes con Válvula Mecánica. En otros tipos de pacientes (Fibrilación Auricular y Enfermedad Coronaria), no habría diferencias estadisticamente significativas.

Se acerca un nuevo Congreso de Medicina Familiar y con él una nueva convocatoria a presentar trabajos de Investigación y Experiencia.

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).