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Biomedical subjects

E Medina

Publications and source records attributed to E Medina.

At least 127 records · Page 7Linked to original sources
PubMed1990

[Complicated hepatic hydatid cyst and acute pancreatitis. Value of ERCP and treatment with endoscopic sphincterotomy].

We present the case of a 29 year-old cholecystectomized woman with hepatic hydatid cysts who was admitted for acute pancreatitis. Echography and abdominal CAT revealed three thydatid cysts-the one in the right liver lobe being complicated-as well as pancreatitis. Endoscopic retrograde cholangiopancreatography (ERCP) confirmed the suspected diagnosis of intrabiliary hydatid cyst rupture. An endoscopic sphincterotomy was performed, posterior evolution being asymptomatic, thus permitting the postponing of surgery.

Adult↗
PubMed1990

[Candida esophagitis treated with a single dose of fluconazole in patients with HIV: presentation of 11 cases].

We have reviewed the efficacy of the use of fluconazole in patients with definitely proven Candida esophagitis (CE) associated with human immunodeficiency virus (HIV) infection, using a single 400 mg oral dose of fluconazole and evaluating the patient three days afterwards. This drug showed to be effective for the clinical and endoscopic cure in all patients (100%), and with microbiological cure in ten cases. There was no clinical feature of toxicity. The only side effect was an increased alkaline phosphatase and transaminase activity without hyperbilirubinemia, but this finding was not statistically significant (p greater than 0.05). Fluconazole, given in a single 400 mg dose, was absolutely effective to cure esophagitis in AIDS, thus permitting to avoid parenteral amphotericin.

Adult↗
PubMed1990

[Effects of cigarette smoking in women].

The relation between cigarette smoking and obstetrical history, characteristics of skin and voice, presence of hirsutism and newborn weight/height index was studied in 100 hospitalized women. 45 had never smoked, 36 were present and 19 former smokers. No differences were found in the average age of menarche, number of live births or stillborns. Abortions were twice as frequent in women smoking more than 10 cigarettes a day. Menopause occurred an average of 5 years earlier among smokers. A significant increase in hoarseness and face hirsutism was detected, the relative risk for heavy smokers (more than 10 cigarettes per day) being 14.2 for hoarseness, 5.6 for facial hirsutism and 2.8 for other locations of hirsutism. Obesity was twice as common among smokers. These findings, related to hormonal disturbance, should be used in education efforts in the anti-smoking campaign among Chilean women.

Chile↗
PubMed1990

[Health in Chile: reflections for the future].

The health situation in Chile is analyzed. The influence of geographic, ethnic, racial, demographic, socio-economic and cultural factors is considered. Strategies for prevention depend on the epidemiologic status of communities. The quality and availability of health care services is considered to be the main factor influencing health maintenance in Chile. The present health coverage situation which provides for health insurance to 15% of the population using 37% of the resources is clearly inappropriate. The separation of hospitals and outpatient facilities is recognized as an unfavourable situation. A worrying increment in the incidence of tuberculosis and a stagnation in the improvement of maternal child health indexes since 1983 have been observed. Priorities for health development and modifications in health care and prevention systems are discussed.

Chile↗
PubMed1990

[Medical specialties and specialists in Chile].

The majority of Chilean physicians work as specialists, mainly as internists, surgeons pediatricians or gynaecologists. The number is higher in Santiago than in other parts of the country, with a better supply in the predominantly urban areas of the country. Only a fraction of the Chilean specialists work at the National Health Service. During the 1980 decade a process of specialist certification was initiated as a joint effort of the Universities, the Chilean Medical Association, the scientific societies and the Chilean Academy of Medicine. The residency programs offered by the universities, the high level of specialization, the need for a better knowledge of the specialists needed in the country and the absence of a planning system for the production are discussed.

Certification↗
PubMed1990

[Physical exercise and gastric acid secretion].

The effects of physical exercise on the basal acid secretion of the stomach has been investigated in 10 healthy individuals and 16 hypersecretors with duodenal ulcer. The gastric basal secretion was collected during 3 hours; during the first hour the patient was at rest, during the second he realized a training exercise, according to Roskamm's formula, and in the third was at rest. While normal subjects showed a significative reduction of the acid secretion during the period of exercise, in the hypersecretory patients with ulcer the acid secretion increased significantly during exercise, from 4.25 +/- 1.52 mEq/h to 7.79 +/- 3.49 mEq/h; these figures reverted to normal values (5.45 +/- 2.21) during the recovery period. We comment the potential mechanisms of these differences in both groups of patients.

Adult↗
PubMed1989

Hypertrophic pyloric stenosis in the adult.

In view of the low incidence of hypertrophic pyloric stenosis, we present a case of this pathology in a male aged 74. Stenosis was of the diffuse type, associated with gastric ulcer and chronic atrophic gastritis. The patient was admitted to our Service with upper digestive tract hemorrhage after deterioration of the ulcer.

Aged↗
PubMed1989

[Prevalence of esophageal and gastrointestinal symptoms in Chilean adults].

We surveyed 300 randomly selected presumable healthy adults for previously defined gastrointestinal and esophageal symptoms. Heartburn was the most common symptom, more frequent in females than in males (p less than 0.01). An association of esophageal symptoms to heartburn but not to smoking habit was found. Constipation was frequent in females and diarrhea in males. We conclude that esophageal symptoms are frequent in presumable healthy individuals.

Adult↗
PubMed1989

[Professional role of the physician in health care].

The professional role of the doctor in health care was analyzed in terms of the peculiarities of the chilean social reality. Determining factors include tradition, the expectations of society and demands of health policies. Action fields and primary and delegated functions are identified. This may be important to help prevent the take over of some of these functions by other health professionals.

Chile↗
PubMed1989

[Colon and rectum neoplasms in Chile: epidemiological characteristics].

A rising incidence and mortality rate from cancer of the colon and rectum has been observed in some Chilean regions. An estimated 1.350 hospital admissions and 650 deaths occurred in the last decade. Cumulative risk for developing these lesions is estimated at 0.75% under 60 and 1.52% under 75 years of age. Mean age at presentation was 65 years for colon cancer and 63 for cancer of the rectum. Both sexes were equally affected. Valid survival studies are not available in Chilean literature. The relation of number of deaths and admissions per year was 78.5% for colon cancer and 28.9% for the rectum. From 1965 to 1985 an 83% increase in the prevalence of rectum cancer and 7% for colon cancer was observed. This trend was most marked in the Magallanes region. A family history appears as a significant risk factor (1.4 to 49.1 odds ratio). Borderline significance as risk factors was observed for obesity and meat and relish consumption. No effect of smoking, alcohol intake, history of lithiasis or exposure to asbestus or ionizing radiation was observed.

Adolescent↗
PubMed1989

[Prostitutes of the east sector of Santiago: characteristics and pathology of sexual transmission].

We studied the frequency of venereal disease in 329 prostitutes working at massage parlours in Santiago. The mean age was 24 years and half of them had high school or university studies. In spite of frequent sexual contacts averaging 2.8 per day, the prevalence of significant venereal disease was not high in this group. Notably, AIDS infection was not detected. Vaginitis due to Trichomonas or Candida infection was the commonest problem and this was half as frequent among gum preservative users. Marital condition, age, obstetrical history and other variables were not related to genital infection.

Adult↗
PubMed1989

[Superficial gastric carcinoma. Clinical analysis].

While in Japan the incidence of superficial gastric cancer (CGS) is very high (35%), with a mean 5-year survival rate of 95%, in our environment it is infrequent. Although the global incidence of gastric cancer is declining, recently, since endoscopy became routine, an increase has been seen in the diagnosis of superficial gastric cancer. In the period between 1976-1982 two cases were diagnosed in our service, but between 1982-1986 the total number of cases found was 23, representing 0.37% of all the endoscopies performed (approx. 6,800) and 8.6% of those diagnostic of gastric cancer (266 cases). Of the lesions, 60.8% were located in the antral region and the most common accompanying symptomatology was ulcerative syndrome (47.3%). The predominant tumoral type was ulcerative (73.9%) (classification of the Japanese Endoscopy Society). The benefits of radiological study were nil, while endoscopic biopsy was diagnostic in 100% after an average of 1.8 (1-4) endoscopies per patient with 6-12 biopsy samples obtained in each endoscopy. Of these 23 patients, 8 underwent total gastrectomy, 14 partial gastrectomy and one refused surgical treatment. The survival was 91.3%, with a follow-up of 6 to 60 months, and two deaths were due to nontumoral causes.

Adult↗
PubMed1989

[Medical care in 12 Chilean cities].

Frequency of diseases and accidents and the main aspects of medical care were studied in 12 larger Chilean cities, excluding the metropolitan area of Santiago. A survey of 4,737 individuals was performed in a random sample of homes and medical problems observed during a 2 week period were analyzed. A mean of 4.17 disease episodes per person-year was registered, 47% of them receiving medical care. This rate was higher for acute conditions (69%) than for chronic diseases (32%). The sum of consults for disease and health controls gave a total assistance of 3.42 per person-year. 70% of visits took place in outpatient hospital clinics and 30% in private practice facilities. Two thirds of the visits were done in National Health Service's outpatient clinics. The quality of medical care was rated by patients as good or very good in 81% of cases, fair in 13% and deficient in 6%. Main reasons given by patients for not seeking medical care (31% in acute episodes and 68% in chronic patients) were the short course of disease in acute conditions or a feeling that control was not needed in chronic diseases. Problems linked to the medical care system, including financial reasons, explained lack of care in 28% of cases. The medical care situation in these 12 larger cities is similar to that observed in Santiago, using the same type of survey.

Accidents↗