Colomba Norero V

Por qué Investigar en Bioética

This article reviews the conceptual evolution of bioethics, conditioned by cultural changes. The discipline could be strengthened with new analytical methodologies and with an empirical approach. The dangers of a purely descriptive bioethics, solely linked to practical experience are also discussed. This may cause the loss of the regulatory frame, that allows bioethics to enrich medical practice from a humane and moral viewpoint. Therefore, there is a need to find the balance between the theoretical analysis and an empirical approach, to face the growing complexity of contemporary ethical problems (Rev Med Chile 2002; 130: 911-5

Cintigrafía renal con Tc99m DMSA (ácido dimercaptosuccínico) en pielonefritis aguda

Twenty patients, 6 months to 11 year old, with clinically recognized acute pyelonephritis, were evaluated withTc99m DMSA renal scintigraphy in the first 15 days of their illness to validate this method in the detection o-f theacute renal inflamatory disease. In 85% of Tc99m DMSA scintigrapnies some kind of abnormality (focal or diffuse,unilateral or bilateral) was observed. Second renal images obtained at an average 8.5 months later, showed totaldisappearance of abnormal fndings in 42%; partial regression in 50% and no changes in 8% of these cases. Tc99mDMSA scintigraphy seems to be a good diagnostic tool to confirm acute renal compromise in urinary tract infec-tions. Besides follow up examinations, at least three months later with this same method, ware able to confirmsustained renal lesions.(Key words: acute pyelonephritis, Tc99m DMSA renal scintigraphy, infants,children,)

Formación profesional y su acreditación en medicina, un paradigma en garantía de la fe pública

Sustaining quality control of learning programs for health professions has become a central issue in university systems, under the pressure of an unexpected merging of new medical schools in Chile, during the last decade, and the massive arrival of other Latin American physicians. Accreditation of institutions and programs represents valid safeguards used in most countries where professional training processes take place. Due guarantee of its quality is required to assure proper health care to people. The authors provide specific arguments to support systematic evaluation and accreditation processes, as those introduced in our country to fulfill the requirements of a high level medical practice (Rev Med Chile 2002; 130: 585-89)

Investigación clínica en Chile: ¿Cómo superar una inquietante evolución?

There is still great collective paucity in our society in appreciating the importance of scientific work for the devolopment of the nation. In this context, relevant clinical research has ben greatly discouraged. The Ministry of Education and the National Comission for Technical and Scientific research (CONICYT) have been committed, with no outstanding results however, to encourage these activities, specially sustaining individual projects originated in the tradicional universities. Precarious conditions persist as manifested by meager budgets for investigation. Public health policies and organization are scarcely endorsed in locally generated clinical or public health knowledge. Postgraduate training programs, specially doctorates, needed to increase the academic human resources with a consistent scientific potential, are very limited. Recent governmental initiatives, altogether with specific proposals waiting for implementation, would certainly contribute to optimize and promote the revival of our impoverished scenarios in clinical research. (Rev Med Chile 2001; 129: 317-23)

Control de calidad de los médicos que inician el ejercicio profesional en Chile: Declaración de la Academia Chilena de Medicina del Instituto de Chile

The Chilean Academy of Medicine supports the 2009 law by which all medical graduates from Chile as well as from foreign countries that wish to start their medical practice should have approved the National Board Examination in Medicine (“Eunacom”). Success in this examination of basic clinical knowledge and competences is mandatory to become attending physicians at the Public Health Care System and to apply to state-funded postgraduate education. Annually, about 90% Chilean graduates approve this examination, while no more than 20 % of foreign graduates do. Given the shortage of primary care physicians, some members of the Parliament have proposed to simplify the test or to exempt foreign medical graduates from it in order to broaden the coverage of primary care and decrease the waiting lists. The Chilean Academy of Medicine considers this shortcut strategy as dangerous for the Chilean population and unfair for our graduates. This Declaration has been sendto the National Health Authorities, to Deans of all Medical Schools, and to public press media.

Un fondo competitivo de desarrollo para el fomento de la calidad de la educación superior en Chile

In 1997, the Chilean Government and the International Bank for Development convened on a strategy to improve Chilean university education. It was based on quality improvement, effectiveness, relevancy and innovation on university education programs. A US

Humanismo y Medicina. La proyección humanista en la enseñanza de la Medicina chilena del siglo XXI

245 millions fund was afforded, for a five years competitive grants program, among certain traditional Universities and Technical Education Institutes. The authors reviewed the projects that won the contests during the first three years in the health area, to determine their impact, demands supported, difficulties and assets. These projects obtained 13.6% of the assigned funds (a total of US

Síndrome nefrótico en el primer año de vida

16.5 millions). Funds were requested mostly to build spaces, obtain equipment, laboratories and computational support. Funds were also requested to carry out methodological changes and teaching improvements. The importance of teaching health sciences in locations outside the Metropolitan area of Santiago, the modification of undergraduate medical curriculum and the development of post graduate networks are emphasized (Rev Med Chile 2002; 130: 1051-4).