Collection: Revista Chilena de Medicina Familiar

Phimosis treatment with topical corticoids in children older than 36 months and under 36 months with surgical treatment indication, in primary care

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,

Rational prescription of benzodiazepines in primary care: are we on the right track?

It is estimated that around 20% of primary care consultations are related to mental health problems, which, together with the high demand for care, make doctors in primary care vulnerable to the prescription of drugs such as benzodiazepines (BDZ). The objective of the study was to contribute to the correct use of BZD in the San Alberto Hurtado CESFAM, through a description of the prescriptions emitted, identification of the factors that influence the indication and description of the best available evidence for the rational prescription, with emphasis on depressive disorders, panic disorders and insomnia. Statistical data was collected from the medical prescriptions emitted. In addition, a modified survey was applied to the doctors about the factors that influence the prescription of BDZ and possible actions to diminish it. Among the findings, there is an annual 2% of all the prescriptions emitted were for BZD, with an average patient age of 46, 7 years. 20.3% correspond to prescriptions emitted to people over 60 years. Clonazepam was the BZD most prescribed (86%). 24.2% of the prescriptions were emitted for more than 3 months. From the survey, most doctors recognize that the most influential factor for prescripting BZD was the decrease in the threshold of tolerance of the population to emotional distress caused by the problems of daily life, resulting in a “medicalization ” of life and consider that the most important action to reduce the prescription of BZD is to train doctors about good prescribing habits and how not to medicalize problems of daily life. Considering  the adverse effects of this type of medication, BZD should not be prescribed for more than 4 weeks for the conditions stduied, and should not be prescribed for insomnia. Sending personalized letters to the patient with prolonged consumption is an encouraging strategy.

Significados de la experiencia de enfermedad en mujeres con diagnóstico de depresión y abandono tratamiento

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)

Impacto de la sociedad de medicina familiar a través de sus congresos anuales

The Society Scientific of Family and General Medicine of Chile has as mission to promote the growth scientific and professional of the Family physician and contribute to the development of the family medicine and family health of our country. One of the activities that contributed to this have been the Conferences which have been organized annually for 18 years without interruption. Throughout the history of them, one can observe the ups and downs that had the Society and the family medicine in our country. The aim of this article is to show this history.

Desafíos del Trabajo Comunitario realizado desde un Centro de Salud Familiar: La experiencia de Salud Arte

 El gran desafío de los Centro de Salud Familiar (CESFAM) es el de buscar estrategias de acción que sean coherentes con la redefinición del concepto de salud, hecha en la Declaración de Alma-Ata (1978): “el completo estado de bienestar físico, mental y social del individuo, la familia y la sociedad en su conjunto”. En ella se plantea que la salud den individuo trasciende su propio bienestar y se entrelaza con el bienestar de su familia y la sociedad.

Cuidados de Salud en mujeres chilenas

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.