Abstract:
:This article explores the causes of the crisis in the role of internists. As in the United States, the progressive specialization of internists lead to a dehumanized, expensive and technical practice of medicine. Aiming to better incomes and prestige, more than 60% of internists practice as specialists. Primary care physicians, with a very low rate of problem solving, cover 75% of consultations. Specialists, with increasing costs, cover the rest of consultations. Patients, medical schools and health organizations are claiming the return of the general internal medicine specialist. To increase the interest for general internal medicine, several strategies are applicable. Medical students interested in general internal medicine could receive a focused training, provided by these specialists. A greater emphasis should be put on primary care. More independent, secondary care diagnostic and treatment centers, should be created. Continuous medical education should be done with periodical re certification of physicians. The public health system should increase its wages and the generalist view should be maintained by physicians when practicing at their private offices.
journal_name
Rev Med Chiljournal_title
Revista medica de Chileauthors
Varela Nsubject
Has Abstractpub_date
2002-01-01 00:00:00pages
96-100issue
1eissn
0034-9887issn
0717-6163journal_volume
130pub_type
杂志文章abstract:BACKGROUND:Osteoporotic hip fractures are devastating events in older women. There is a genetic modulation of bone phenotypic parameters including bone density (BMD) and bone fragility fractures. Vitamin D receptor (VDR) gene polymorphisms explain a small part of the genetic influence on BMD, whereas their effect on fr...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:/S0034-98872008000400008
更新日期:2008-04-01 00:00:00
abstract::Antibacterial potency of cephalosporins depends on inhibition (acylation) of one or more penicillin-binding proteins (PBP). Recently, reduced affinity of PBP for cephalosporins and other B-lactam agents has been found in some cases. Mechanism for these changes in affinity are analyzed in this review. ...
journal_title:Revista medica de Chile
pub_type: 杂志文章,评审
doi:
更新日期:1989-09-01 00:00:00
abstract::This is the conference given by Jorge Mardones, Emeritus Professor of the University of Chile on the occasion of receiving the Juvenal Hernández award. A biographical trace of Professor Mardones scientific career and its motivations, including his relation to outstanding Chilean scientists is included. A remembrance o...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:
更新日期:1989-02-01 00:00:00
abstract:BACKGROUND:Diagnostic scores have been developed as simple, user-friendly, cost-effective instruments to improve the early diagnosis of acute appendicitis. AIM:To assess the yield of a diagnostic score for acute appendicitis, measured by trained health-related non-physician professional. PATIENTS AND METHODS:A prospe...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:10.4067/s0034-98872006000100005
更新日期:2006-01-01 00:00:00
abstract::Herpes simplex virus type 1 (HSV-1) is ubiquitous, neurotropic, and the most common pathogenic cause of sporadic acute encephalitis in humans. Herpes simplex encephalitis is associated with a high mortality rate and significant neurological, neuropsychological, and neurobehavioral sequels. HSV-1 infects limbic system ...
journal_title:Revista medica de Chile
pub_type: 杂志文章,评审
doi:/S0034-98872011000600013
更新日期:2011-06-01 00:00:00
abstract::One of the main challenges in environmental management is to prevent the public health impact of projects that can cause pollution. To tackle this problem, the new Chilean bill on environmental management has defined the need to determine the potential health risks of a given Project. This paper gives a summary of the...
journal_title:Revista medica de Chile
pub_type: 杂志文章,评审
doi:/S0034-98872011000800015
更新日期:2011-08-01 00:00:00
abstract::A lateral abdominal bruit is considered an important finding for the detection of renovascular hypertension. However, the precision and accuracy of new techniques such as angiography, Doppler ultrasound and studies with radioisotopes have changed its value and clinical interpretation. We report a 75 years old woman wi...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:
更新日期:1997-11-01 00:00:00
abstract:UNLABELLED:Circulating concentrations of the high affinity growth hormone binding protein (GHBP) may be a marker of GH receptor density as well as GH sensitivity. GOAL:To determine values of GHBP for a normal Chilean pediatric population. METHODS:We determined GHBP levels in 73 males and 73 females between 4 to 15.5 ...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:
更新日期:2001-04-01 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::When assessing a patient with depression it is crucial not to miss a diagnosis of bipolar depression. In this review we suggest that it can be achieved, first, by consistently usingstandardised diagnostic criteria (e.g., DSM-IV-TR or ICD 10) and, second, by ascertaining the presence of some clinical features. The latt...
journal_title:Revista medica de Chile
pub_type: 杂志文章,评审
doi:10.4067/s0034-98872010000600017
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:Uterine cervical cancer (UCC) is an important public health problem in Chile. Although HPV infection has been established as the main cause of UCC, little is known of its frequency and distribution in our population. AIM:To determine the presence and frequency of viral genotypes in uterine cervical specimen...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:
更新日期:2003-12-01 00:00:00
abstract::The mortality of acute bacterial meningitis (BM) has remained stable in the last decades in spite of the use of new antibiotics, probably due to vascular complications. We report a 68-year-old woman with BM who had a malignant infarction of left middle cerebral artery territory 72 hours after admission to the hospital...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:10.4067/s0034-98872004001000009
更新日期:2004-10-01 00:00:00
abstract:BACKGROUND:Type I human immunodeficiency virus (HIV) is characterized by a great genetic variability. There are three groups of virus throughout the world: O, N and M. Group M is responsible for AIDS pandemic and is subdivided in 9 genetic subtypes. Most viral strains in South America are subtype B. AIM:To determine t...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:
更新日期:2003-07-01 00:00:00
abstract:BACKGROUND:The Latin American Study of Congenital Malformations (ECLAMC) has performed an epidemiological surveillance of congenital malformations since 1967. This allows to detect any unexpected change in the incidence of malformations, possibly caused by a new environmental teratogenic agent. AIM:To report a summary...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:/S0034-98872011000100010
更新日期:2011-01-01 00:00:00
abstract::We are reporting a 37 year old male with severe oligozoospermia and a history of infertility for thirteen years and surgery for severe unilateral varicocele. The hormonal levels for FSH, LH and T, and karyotype were within the normal range. Multiplex PCR revealed the presence of a de novo microdeletion in the azoosper...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:
更新日期:2000-07-01 00:00:00
abstract:BACKGROUND:Nasal continuous positive airway pressure therapy (CPAP) in the treatment of choice for adult obstructive sleep apnea (OSA). The diagnosis is established with polysomnography, but this study is expensive and must be repeated in those patients that require CPAP, to titrate the pressure of the therapy. Split p...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:10.4067/s0034-98872006001100004
更新日期:2006-11-01 00:00:00
abstract::Examinations performed beside the bed of patients ("Point-of-care testing, POCT") provide immediate results and are simple to perform. The most common of these tests is the self control of blood glucose levels in diabetic patients. The use of these devices at the hospital level, introduces a new set of requirements to...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:/S0034-98872009000900018
更新日期:2009-09-01 00:00:00
abstract:BACKGROUND:The preferred treatment for ischemic mitral insufficiency is mitral valve repair with a prosthetic ring, because it does not deteriorate left ventricular function, allowing better immediate and long-term results. AIM:To assess long-term results of mitral annuloplasty with a prosthetic ring for ischemic mitr...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:/S0034-98872011001200003
更新日期:2011-12-01 00:00:00
abstract::We report a 52 year old man with a pancreatic pseudocyst, that was admitted with severe abdominal pain, severe vomiting, fever and malaise. The clinical picture was considered secondary to a pseudocyst infection and the patient was operated, draining the infected cyst performing a necrosis surgery and pancreatojejunos...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Twenty to twenty two percent of work related accidents have a direct or indirect relationship with recent alcohol use. AIM:To detect recent alcohol or drug use in patients who required hospitalization for severe work related accidents. PATIENTS AND METHODS:Blood and urine samples were obtained from patient...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:
更新日期:1998-10-01 00:00:00
abstract::Congenital malformations of the spleen are rare. We report a patient with an ectopic spleen located in the left iliac fossa, which was excised in order to prevent severe complications such as torsion of the pedicle, rupture or infection. A second patient with idiopathic thrombocytopenic purpura presented with an acces...
journal_title:Revista medica de Chile
pub_type: 杂志文章,评审
doi:
更新日期:1989-12-01 00:00:00
abstract:BACKGROUND:There is consensus in promoting the selective use of glucocorticoids (GC) in the peri-operative period of transsphenoidal surgery (TE) for pituitary adenomas (PA). AIM:To evaluate the safety of a selective glucocorticoid administration protocol and the usefulness of immediate postoperative cortisol levels a...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:10.4067/S0034-98872014000900004
更新日期:2014-09-01 00:00:00
abstract::The aim of this study was to look for pathological changes in the oral cavity in a group of 40 non cirrhotic male alcoholics, ranging in age from 30 to 40 years old. These subjects were compared with a group of 40 non alcoholic male subjects of similar age. The presence of lip, dental, periodontal, salivary gland and ...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:
更新日期:1994-02-01 00:00:00
abstract:BACKGROUND:Inferior vena cava (IVC) filters are used to prevent massive pulmonary embolism in cases where anticoagulation is contraindicated or has failed. It is usually implanted below the renal veins. In a few cases it is necessary to deploy the filter above them, with theoretical risk of secondary renal failure. AI...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:/S0034-98872008001200005
更新日期:2008-12-01 00:00:00
abstract:BACKGROUND:Education may induce voluntary behavioral changes in patients that lead to an improvement in health status. AIM:To assess the impact of the educational manual "Aches and Pain" on knowledge and attitudes of patients with chronic rheumatism and paramedics, using an instrument with 40 asseverations extracted f...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:
更新日期:1996-09-01 00:00:00
abstract:BACKGROUND:The frequency of diseases caused by non tuberculous mycobacteria has increased in the last years. Their clinical diagnosis is difficult, mainly in immunocompromised patients. The identification of these mycobacteria by traditional methods is based on phenotypic characteristics and the results are obtained tw...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:10.4067/s0034-98872006000700010
更新日期:2006-07-01 00:00:00
abstract::The rapid development of molecular biology techniques as well as recent progress in the understanding of genetic and molecular basis of human diseases have had enormous impact in the practice of clinical pathology. Since new diagnostic (molecular) tools are now available, the concept of Molecular Pathology is emerging...
journal_title:Revista medica de Chile
pub_type: 杂志文章,评审
doi:
更新日期:2001-07-01 00:00:00
abstract::Cholangiocarcinoma is a malignant lesion of the bile duct epithelium. Its incidence and prevalence are low. It appears from the sixth decade of life and there is slight male predominance. It is most frequently found in the confluence of the hepatic ducts, where it is called hilar cholangiocarcinoma or Klatskin tumor. ...
journal_title:Revista medica de Chile
pub_type: 杂志文章,评审
doi:/S0034-98872008000200015
更新日期:2008-02-01 00:00:00
abstract::We report a 56 years-old man presenting with chest pain with exercise, seven years after an orthotopic heart transplant. A coronary angiography showed an atherosclerotic lesion in the common left main coronary artery with more than 90% obstruction. The lesion was successfully treated with a transluminal angioplasty wi...
journal_title:Revista medica de Chile
pub_type: 杂志文章
doi:/S0034-98872007001200012
更新日期:2007-12-01 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