Prevalencia de diabetes mellitus en la VII Región de Chile / Prevalence of diabetes in the seventh Region of Chile

Background: The prevalence of diabetes mellitus in Latin America is not well known. Aim: To study the real prevalence of diabetes mellitus (DM) and its associated risk factors in the VII region of Chile. Material and Methods: A probabilistic sample of 1,325 subjects over the age of 20, stratified by age and differentiated by place of residence was studied. The criteria of the World Panel of Experts convened by the World Health Organization in 1997, was used to define the presence of diabetes (two fasting blood glucose values over 126 mg/dl or a blood glucose over 200 mg/dl, 2 hours after a 75 g carbohydrate oral load). Results: The global prevalence estimated for DM in this population was 5.39 percent. The calculated prevalence in subjects between 20 and 44 years was 1.88 percent (CI 0.39-3.37); between 45 and 64 years, 10.75 percent (CI 8.35-13.14); 65 years or older 11.30 percent (CI 8.00-14.60), p <0.05. The prevalence was 5.8 percent in urban areas and 4.5 percent in rural areas. Forty five percent of diabetics were not aware of their condition. Forty eight percent of diabetics and 31 percent of non diabetics were hypertensive (p <0.01), whereas 47.8 percent of diabetics and 24.6 percent of non diabetics had at least one diabetic parent (p <0.01). Smoking was less frequent in diabetics than in non diabetics (15.7 and 24.3 percent respectively, p <0.05). Ninety percent of both diabetics and non diabetics were sedentary. Discussion: Health care systems require an epidemiological monitoring system to provide information about the prevalence of diabetes mellitus and to control the evolution of patients

Prevalencia del cáncer de próstata en la comuna de Talca, VII región Chile / Prevalence of prostate cancer in the seventh region of Chile

Background: In 1998, there were 1,218 deaths in Chile caused by prostate cancer. This figure results in a death rate of 16.6 per 100,000 males for this disease. Aim: To assess the prevalence of prostate cancer in the Seventh Region of Chile. Material and methods: A probabilistic sample of 327 males aged 40 to 59 years old was studied. In all, a codified questionnaire was applied, a digital rectal examination was performed and a blood sample was drawn to measure prostate specific antigen. All digital rectal examinations were performed by the same observer. Patients with an abnormal rectal examination or prostate specific antigen were subjected to a prostatic biopsy under ultrasound guidance. Results: In 14 subjects, the digital rectal examination was considered abnormal and in seven, prostate specific antigen was over 4 ng/ml. All subjects with elevated prostate specific antigen had an abnormal rectal examination. In three of the 14 subjects, the biopsy showed a well differentiated adenocarcinoma. All three were aged over 50 years old. The resulting calculated prevalence of prostate cancer was 9.2 per 1,000 males (CI 4.2-14.1). Conclusions: the cost effectiveness of screening for early diagnosis of prostate cancer must be calculated, to decide its incorporation in preventive medical examinations

Costo de las prestaciones de salud / Cost of health deliveries

The income source and the use of assets at the Health Department of a Chilean city hall was studied. A cost control system was created to know the real value of health services, which were compared with the administrative tariffs determined by the authorities. Specific health programs such as complementary feeding, immunizations and responsible paternity programs represented 48.1 percent of the Health Department expenses. Ninety four percent of services had a real cost that exceeded their administrative price. A reformulation of resource distribution for primary health care and the development of control systems that measure the results of experience activities is proposed

Atención de salud en desastres: una expereriencia local / Health care in natural disasters: a local experience

Se analiza la repercusión que tienen los Desastres Naturales en el Campo de la Salud Pública, haciendo mención a los terremotos que ha sufrido Chile en los últimos 50 años. Se presenta el impacto del terremo del 3 de marzo de 1985 en Chile, confrontando el daño ocurrido en la Zona de Desastre con el observado en la Comuna de Rengo (IV Región), describiendo la experiencia de atención médica, en un Hospital de Campaña durante 66 días en esta Comuna. Se compara el número de casos notificados en Rengo de Fiebre Tifoidea y Hepatitis de 1985 con respecto al año anterior. Se comenta algunas variables que influyen en Morbimortalidad del Sector Salud frente a las Catástrofes, finalmente se establece la necesidad que exista Organizaciones locales que sean capaces de prevenir el efecto potencial de catástrofes