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Biomedical subjects

E Medina

Publications and source records attributed to E Medina.

At least 109 records · Page 6Linked to original sources
PubMed1992

[Hospitalization in Chile: a critical analysis].

Main features of hospital stay in Chile are analyzed with special regard to incidence, geographic, sex and age variations, main causes and trends observed in the last decades. The annual admission rate in 1989 was 107 per 1000, twice the overall Latin American rate. Wide variations are observed among geographical areas, with relatively low use of hospital beds in the capital city of Santiago. Hospital needs differ for men and women and according to age, being greater for infants, older people and women of childbearing age. Near two thirds of the needs are related to pregnancy. Admissions for traumatic, digestive, respiratory, urinary and gynecological problems are also frequent. Accidents are the main cause for hospital admission among males, while tumor is foremost among women. During the last 30 years the hospitalization rate has remained stable while the case fatality rate has decreased. Different factors influencing the frequency and features of hospital stay are discussed.

Adolescent↗
PubMed1992

[Chilean hospitals: availability and productivity of the public and private sectors].

Hospital bed availability, trends in number of beds, productivity and administrative aspects in the public and private hospital sectors are analyzed. At present, there are 3.3 beds per 1000 population in Chile. This represents a decrease from previous figures, in spite of increasing demands derived from population aging and greater birth assistance needs. Overall productivity of the hospital system is reflected in 31 annual admissions per bed, an average hospital stay of 8 days and a 75% occupancy rate. The National Health Service System is responsible for 76% of admissions. However, it takes care of more than 90% of bed needs for tuberculosis patients and more than 80% for hospital birth assistance, complications of pregnancy, perinatal disease, communicable diseases, respiratory illnesses, miscarriages and skin diseases. The private sector takes care of more than 40% of rheumatic and musculo skeletal diseases and more than one third of mental health problems. The National Health Service, compared to the private sector, exhibits a greater occupancy rate with an average stay only one day longer. Complexities of hospital administration, new world trends and the relation to external economic resources are discussed.

Bed Occupancy↗
PubMed1992

[Primary care for adults in Chile: analysis of basic information].

According to national data the Chilean adult population on the average has 2.5 annual ambulatory visits with an increasing trend in the last decade. The figure has significant variation in the diverse geographic regions. Taking pregnant women out, main diseases assisted at the outpatient departments of general consultation include in a 70%, problems usually of the competence of internal medicine specialists. The solving problem capacity in these departments is 80 to 85% which means that 15-20% of the patients needs to be referred to a higher complexity medical care level. According to the National Health Service experience, two-thirds of the primary care level are done by general practitioners and one-third by specialists. A scarce preventive component and a low coverage of chronic disease among adult people and the problems of the primary care in the National Health Service are commented. A new structure of medical care levels is proposed separating a first level with include rural and basic urban outpatient clinics besides low complexity hospitals with general practitioners; a second level with urban general outpatient clinics served with specialists and median complexity hospitals; and a third level with new and specialized ambulatory centers for diagnosis and treatment and hospitals of high and great complexity.

Adult↗
PubMed1991

Health damage caused by the smoking habit in Chile.

The authors review available literature on tobacco use in Chile, devoting particular attention to smoking prevalences, smoking-related health problems, risk factors that tend to encourage smoking, and appropriate control measures. Overall, the available data indicate that roughly 40% of Chile's adult population smokes, that smoking among women is on the rise, that some 11% of both infant and general mortality can be linked to tobacco use, that smoking during pregnancy poses serious health risks, and that the attitudes of physicians and other health workers can have a crucial impact upon the smoking behavior of their patients.

Adolescent↗
PubMed1991

[Intestinal tuberculosis in acquired immunodeficiency syndrome].

We present a case of disseminated tuberculosis with peritoneal and intestinal involvement in a homosexual patient who presented micronodular fibrosis and was infected by HIV, with an AIDS diagnosis since he had previously presented an esophagitis caused by candida. Diagnosis was made from a sample obtained from an ulcerated lesion from rectum-sigmoid region by colonoscopy, and when stained with Ziehl-Nielsen revealed acid-alcohol resistant bacilli (AARB) identified as M. tuberculosis. The torpid evolution of the process, which was complicated by the uncompensation of the cirrhosis determined the patient's death inspite of treatment. The characteristics of intestinal tuberculosis in HIV infected patients is reviewed.

Acquired Immunodeficiency Syndrome↗
PubMed1991

[Smoking and health in Chile].

Findings from a literature review on the smoking problem in Chile are presented. According to prevalence studies, nearly 40% of the general adult population in Chile smokes. The proportion of smokers is smaller among women than among men. Between 1971 and 1984 the proportion of smokers rose from 36% to 41%, with an especially marked increase in women (from 26% to 39%). Calculation of the relative risk of mortality in smokers indicates that smoking accounts for 11% of all deaths in the country. Moreover, 11% of the infant mortality in Chile is attributable to the lower neonatal weight of children of women who smoke. The presence of smokers in homes is responsible for a 30% higher rate of acute respiratory infections. Women smokers have twice as many spontaneous abortions as nonsmokers and enter menopause an average of five years earlier. Hoarseness is 17 times more frequent and excess facial hair is seven times more frequent among women who smoke compared with those who do not. The habit tends to start during adolescence. The rising smoking rate among Chilean women is inversely related to level of schooling and directly related to economic capacity. Smoking during pregnancy is influenced by level of concern for the effects of tobacco and educational actions encountered during this period. The role of physicians and other members of the health team is crucial in this regard. Reference is made to organized antismoking measures, including bans on smoking, restrictions on advertising, warnings about its harmful effects, and various educational efforts. The main components of the Ministry of Health's smoking control program are reviewed.

Adolescent↗
PubMed1991

[Prevalence of gallbladder neoplasms in cholecystectomies].

The prevalence of gallbladder cancer in 10,468 cholecystectomy patients was studied: 3.4% of the female and only 1.32% of the male population had gallbladder cancer (p < 0.001). The female population had 2.7 times more cholelithiasis, and 7.9 times more cancer than the male population. Cancer incidence increases progressively with age, specially after the 5th decade.

Adult↗
PubMed1991

[Epidemic of cholera in Chile; 1991].

In January 1991 a severe epidemic of cholera started in Peru, a country located north of Chile. The first case in Chile was confirmed in april and so far 41 cases and 2 deaths have been reported. The epidemic is caused by Vibrio cholerae 01, El Tor biotype, Inaba serotype. Most cases occurred in Santiago, 2/3 of them in men and all above 15 years of age. An unknown number of asymptomatic infected people arriving in Santiago are the likely agents for the epidemic. Contamination of sewage and use of infected water to irrigate vegetable fields is involved in the transmission of the disease. The situation is linked to the inexistence of sewage treatment plants. In comparison to Peru, with near 200,000 patients and over 1000 deaths, the epidemic in Chile has been small as a consequence of intensive health education efforts. Personal hygiene, abstinence from eating raw vegetables and fish, destruction of presumed infected crops, and prohibition of vegetable transportation to other areas have been the cornerstone of the preventive strategies. Early treatment of severely dehydrated patients has determined a low fatality rate. At present, the epidemic is virtually controlled with 1 or 2 cases a week. However, the sanitary problems related to sewage treatment and the existence of cholera in other South American countries poses a serious problem for the future.

Adolescent↗
PubMed1991

[Breast cancer epidemiology].

204 pts with breast cancer were compared to 208 pts of similar age, with pathologies other than cancer, to assess the frequency of biological and social factors related to breast cancer, in Chilean females. The pts with breast cancer were in the 40 to 65 year old group, had a higher frequency of AB blood group, lower pregnancy and delivery rates and later pregnancies. Age of menarche and menopause, prolonged breast feeding, oral contraceptives and nutritional state were not related to a higher frequency of breast cancer. Further studies that include the analysis of previous breast pathology, diabetes, psychosomatic factors, alcohol and caffeine consumption, tobacco and others are suggested.

Adult↗
PubMed1991

[Incipient and intermediate gastric cancer II. Anatomo-pathological and surgical aspects. Cooperative study in 13 hospitals].

Anatomic and surgical characteristics of 233 pts with early, and 120 with intermediate gastric cancer, from 13 hospitals in Chile are analyzed. 63% had depressed or excavated lesions. Most of the tumors were located in the inferior or middle third, while only 17% of the early carcinomas were found in the superior third of the stomach, specially in the lesser curvature. 5% had residual tumor in the gastric remanent. Histologically, tubular adenocarcinoma was the most common finding. According to Lauren's classification intestinal carcinoma was more frequent than the diffuse type. Surgeons underestimated lymphatic node involvement (macroscopic appreciation) in up to 58% of the cases when compared to the pathologists observation (microscopic appreciation). This was specially true in muscular carcinomas. The incidence of lymphatic metastases was 6% in mucous, 12% in submucous and 57% in muscular carcinoma. The need of complete lymph node dissection of all the lymphatic barriers is emphasized.

Carcinoma↗
PubMed1990

Segmental tuberculosis of the colon diagnosed by colonoscopy.

We describe the case of a woman with rectorrhagia and rectal tenesmus. Colonoscopy revealed a 3-4 cm-long ulcerated lesion with a reduced colon lumen 35 cm from the anus, and multiple biopsies were obtained from the ulcerated region, but histopathology was non-specific. Biopsy culture was positive for M. tuberculosis. Anti-tuberculous chemotherapy was initiated on the diagnosis of segmental tuberculosis of the colon. Subsequent evolution was favorable, both clinically and endoscopically. Emphasis is placed on the importance of colonoscopy and biopsy in the diagnosis of tuberculosis of the colon.

Aged↗
PubMed1990

Low-back pain in pregnancy. Abdominal muscles, sit-up performance, and back pain.

An attempt was made to determine the effect of pregnancy on the abdominal muscles and to correlate changes in abdominal muscles strength with low-back pain during pregnancy. The study included 328 women. Group A consisted of 164 pregnant women; group B consisted of 164 non-pregnant women. The race, age, height, weight, parity, profession, time devoted to physical fitness per week, abdominal length, and relation between the abdominal length to height were recorded. A detailed history relating to backache prior to and during pregnancy was obtained. Each woman was asked to perform a single sit-up. The results of the study indicate that about 10% of pregnant women develop severe low-back pain that interferes with daily life activities. About 49% of the non-pregnant women complained of LBP. The pain did not interfere with activities of daily living. During pregnancy, due to overstretching of the abdominal muscles, the ability to perform a sit-up is significantly decreased. Whereas all non-pregnant women could perform a sit-up, 16.6% of pregnant women could not perform a single sit-up. There was no statistically significant correlation between the sit-up performance and backache. It may be concluded that during pregnancy the abdominal muscles become insufficient.

Abdomen↗