Abstract:
:The development of the subspecialties of internal medicine in the western world is reviewed from a historical perspective, focusing on the case of the United States of America. During the last decades, changes both in society and in medicine as a whole have prompted a great dispersion of medical practice styles, not always well-defined in their contents and goals, and ranging from primary care to ultra specialization. The definition of the general internist and of the subspecialist together with the attributes of each category according to an American College of Physicians task force group are commented upon. Some of the possible reasons accounting for a decreased interest in general internal medicine during the eighties together with figures supporting a recent reversal of this trend are given. New proposals have originated in government as well as in medical circles to promote the development of general internists, conceived as physicians knowledgeable in the classic subspecialties but also skilled in clinical epidemiology, informatics, behavior medicine, decision-making, clinical economics, ethics, and problem solving. The American College of Physicians, on the other hand, considers that allowing the community-based general internists to disappear, strengthening the generalist's identity as a primary care-oriented physician who provides no subspecially care, becoming hospital-based generalists who act mainly as consultants, or becoming fully trained subspecialists who also provide primary care, are all rejectable options. These arguments illustrate the fact that even in highly developed societies a degree of indefinition remains as to the best balance between general internal medicine and its subspecialties.
journal_name
Rev Med Chiljournal_title
Revista medica de Chileauthors
Rosselot Esubject
Has Abstractpub_date
1996-04-01 00:00:00pages
481-9issue
4eissn
0034-9887issn
0717-6163journal_volume
124pub_type
历史文章,杂志文章abstract::Hyperbaric oxygenation consists in exposing patients to increased gas pressures while inhaling pure oxygen. It involves the use of hyperbaric chambers that can double or triple gas pressure inside them. Hyperbaric oxygenation may be useful in different clinical situations, but mostly for the treatment of decompression...
journal_title:Revista medica de Chile
pub_type: 杂志文章,评审
doi:10.4067/S0034-98872014001200011
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Diabetes mellitus is a risk factor for atherosclerosis. Low density lipoproteins are considered a key factor in the formation of atheroma and the immune system has an important contribution to this process. AIM:To quantify the immune response against modified low density lipoproteins in patients with non in...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:
更新日期:1997-08-01 00:00:00
abstract::A 19 yr-old female patient with the diagnosis of late onset adrenal hyperplasia was treated since age 15 with different glucocorticoid preparations and dosage schedules plus spironolactone. In spite of a very good response in terms of amelioration of their hirsutism she experienced cushingoid manifestations associated...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:
更新日期:1989-06-01 00:00:00
abstract:BACKGROUND:Vildagliptin is a dipeptidyl peptidase IV inhibitor (DPP4i). Its efficacy and safety of DPP4i in Chilean real life type 2 diabetic (T2D) patients is not well known. AIM:To assess the safety profile and effectiveness of 12 weeks of treatment with Vildagliptin for glycemic control in T2D Chilean patients with...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:10.4067/S0034-98872015000100008
更新日期:2015-01-01 00:00:00
abstract::Spontaneous hemoperitoneum secondary to intraabdominal variceal rupture, is an uncommon and highly lethal complication of cirrhosis. We report a case of a 68 years old male submitted because of abdominal pain and fainting. The clinical and laboratory work up concluded that the patient had cirrhosis and hemoperitoneum....
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:
更新日期:2002-04-01 00:00:00
abstract::We evaluated the concentration of cefotaxime in the exudate from ischemic leg ulcers in 9 subjects with severe obstructive arterial disease. The administration of the drug was either systemic (1 g in 250 ml of saline given in 30 min) or regional at a vein of the foot while a tourniquet was applied at the level of the ...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:
更新日期:1990-03-01 00:00:00
abstract::Medicine is progressively loosing its prestige and efficacy and needs to rebuild the moral values that maintain the tacit social contract subscribed between doctors and patients. This altruistic commitment to serve people has been devaluated by changes in health systems, by advances in knowledge and by social and econ...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:10.4067/s0034-98872006000500016
更新日期:2006-05-01 00:00:00
abstract::Platelet Rich Plasma (PRP) is used in musculoskeletal lesion surgery, including muscle, bone, tendons and ligaments. PRP might accelerate the healing process and the integration of the graft, allowing an earlier return to sports activities of patients. PRP is obtained from autologous blood, which is centrifuged, obtai...
journal_title:Revista medica de Chile
pub_type: 杂志文章,评审
doi:10.4067/S0034-98872013001000011
更新日期:2013-10-01 00:00:00
abstract::Technology for diabetes care has undergone major development during recent decades. These technological advances include continuous subcutaneous insulin infusion (CSII), also known as insulin pumps, and real-time continuous glucose monitoring system (RT-CGMS). The integration of CSII and RT-CGMS into a single device h...
journal_title:Revista medica de Chile
pub_type: 杂志文章,评审
doi:10.4067/S0034-98872017000500011
更新日期:2017-05-01 00:00:00
abstract::Sickle cell anemia was a rare disease in Chile, especially in adults, however the recent immigration wave from Haiti is changing this scenario. We report a 29 year old black female from Haiti with a non-disclosed history of sickle cell anemia. She was transfused with two units of red blood cells, found unconscious and...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:10.4067/S0034-98872018001101347
更新日期:2018-11-01 00:00:00
abstract:BACKGROUND:Postoperative hypocalcemia is one of the most common complications of thyroid surgery. It is related to the type of disease (malignant or benign), the number of identified parathyroid glands during the surgical procedure, and the surgeon's experience. Total thyroidectomy is the procedure of choice in our hos...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:10.4067/s0034-98872007000100004
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:Mortality caused by cardial gastric cancer in Chile, is increasing. Previously we demonstrated an association between Epstein Barr virus and this specific location of gastric cancer. AIM:To perform a clinical and molecular characterization of cardial gastric cancer associated to Epstein Barr virus. MATERIA...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:10.4067/s0034-98872005000700001
更新日期:2005-07-01 00:00:00
abstract:BACKGROUND:Enterococcus is a bacterial genus with low virulence. However, in the last years, the importance of some enterococcus species as nosocomial pathogens has increased, specially due to their resistance to some antimicrobial. AIM:To identify enterococcus strains using classical biochemical techniques and genomi...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:
更新日期:2002-01-01 00:00:00
abstract::The preliminary results of a prospective and cooperative protocol for the treatment of soft tissue sarcomas of trunk and extremities, stages IB-IIIB are presented. Thirty one patients (17 males, 22 with a tumor larger than 5 cm) aged 16 to 68 years, were treated with one dose of epirubicin 70 mg/m2 i.v. and radiothera...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:
更新日期:1993-02-01 00:00:00
abstract::A loop ileostomy with intraoperative anterograde colonic lavage has been described as an alternative to colectomy in the management of cases of Clostridium difficile infection refractory to medical treatment. We report a 69 years old diabetic women admitted with a septic shock. An abdominal CAT scan showed a pan-colit...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:10.4067/S0034-98872015000500016
更新日期:2015-05-01 00:00:00
abstract::To be successful, modern medical acts require the participation of several professionals and assistants and, as such, there has been a steady trend from individual medicine to the collective practice of the profession. This format raises issues in determining when a medical professional or other practitioner is liable...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:/S0034-98872011000500016
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:There is paucity of information about viral etiology of community acquired pneumonia in adults. AIM:To investigate the viral etiology of pneumonia among hospitalized patients. MATERIAL AND METHODS:All adults with pneumonia that were hospitalized were prospectively enrolled at Puerto Montt hospital. A micro...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:10.4067/S0034-98872012000800003
更新日期:2012-08-01 00:00:00
abstract::A consensus meeting held by the Chilean Endocrinological Society reached to 22 consensus proposals on the use of iodine-131 in hyperthyroidism and thyroid cancer, that are reported in this paper. Some of these propositions are: 1) Hyperthyroidism: A previous 131I uptake test must be performed. A calculated or an ablat...
journal_title:Revista medica de Chile
pub_type: 共识发展会议,杂志文章,评审
doi:
更新日期:1998-07-01 00:00:00
abstract:BACKGROUND:Glutathione peroxidase (GP) can be used as a marker of oxidative stress in infectious diseases. AIM:To evaluate the association between the levels of glutathione peroxidase (GP) and the manifestations and complications of dengue. PATIENTS AND METHODS:Between April 2003 and December 2004, 161 patients with ...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:10.4067/s0034-98872007000600008
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:Culture is defined by the Webster's dictionary as acquaintance with and taste in fine arts, humanities, and broad aspects of science as distinguished from vocational and technical skills. AIM:To assess the general cultural knowledge of university students. MATERIAL AND METHODS:A test containing 58 question...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:/S0034-98872010000300005
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND:Understanding how autonomous students are capable of regulating their own learning process is essential to develop self-directed teaching methods. AIM:To understand how self-directed medical students approach learning in medical schools at University of Concepción, Chile. MATERIAL AND METHODS:A qualitative...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:10.4067/S0034-98872015001200011
更新日期:2015-12-01 00:00:00
abstract::Herod the Great was the founder of a dynasty that reigned on Judea for several generations. His birth date is estimated on year 73 AC and died at 70 years old. Descriptions of the final disease of Herod were obtained from the classical chronicles of Flavius Josephus, "The Jewish war" and "Jewish Antiquities". A medica...
journal_title:Revista medica de Chile
pub_type: 传,历史文章,杂志文章
doi:
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND:p53/p21WAF1/CIP1 and mdm-2 proteins play an important role in cell cycle regulation. The study of the pathogenesis of gastric cancer is important to understand how these tumors progress during their natural history. AIM:To study the relationship between the immunohistochemical expression of p53/p21WAF1/CIP1...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:
更新日期:2000-02-01 00:00:00
abstract::ANCA (anti-neutrophil cytoplasmic antibodies) associated vasculitis or AAV are a group of diseases with predominant inflammation of small vessels and the presence of detectable ANCA in serum. Due to these common features, it is considered that AAV share pathogenic mechanisms. Consequently, a similar therapeutic approa...
journal_title:Revista medica de Chile
pub_type: 杂志文章,评审
doi:10.4067/S0034-98872013000600011
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:Type 2 diabetes etiology has a strong genetic component. More than 20 genetic variants have been associated with diabetes and other metabolic markers. However, the polymorphism rs7903146 of the TCF7L2 gene has shown the strongest association. AIM:To investigate the association of TCF7L2 (rs7903146) genotype...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:10.4067/S0034-98872019000800965
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Hepatitis B vaccine has demonstrated to be very effective and safe preventing hepatitis B virus infection. Long term protection induced by hepatitis B vaccination depends on the initial immune response and the declining rate of anti-HBs titers. AIM. To investigate early and late response to hepatitis B vacci...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:
更新日期:1993-05-01 00:00:00
abstract::In biomedical measurement, comparisons between two instruments or between a new instrument and the gold standard is commonly needed to evaluate the reliability and validity of the instruments. Such studies are frequently analyzed using statistics that are inappropriate for studying concordance. This article reviews th...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:
更新日期:1997-04-01 00:00:00
abstract:BACKGROUND:We report a 56 year old male hypertensive, who presented with a posterior reversible encephalopathy syndrome (PRES) as an initial manifestation of Guillain-Barré syndrome (GBS). His first symptoms were right hemiparesis and hemihypoesthesia, followed by headache, dizziness, dysarthria and a general feeling o...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:10.4067/S0034-98872012001000012
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Cardiovascular diseases are the main causes of death in Chile and there is a high prevalence of cardiovascular risk factors in the population. AIM:To assess the prevalence of those risk factors in a group of employees. SUBJECTS AND METHODS:We studied 2,219 individuals, 1,378 males with a mean age of 46.2 +...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:
更新日期:2003-02-01 00:00:00
abstract::Protective immunity against rotavirus infection is directed against antigenic epitopes on the outer capsid proteins VP7 and VP4. The aim of this study was to characterize the VP7 and VP4 antigenic types circulating in different hospital areas of Santiago, Chile, over different time periods. Between April 1993 and Apri...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:
更新日期:1995-05-01 00:00:00