Internal medicine, art and science in the third millennium / Medicina interna, arte y ciencia en el tercer milenio

Internal medicine, art and science in the third millennium is a statement that Medicine is not only science. It acts on the sick individual to reestablish a natural state as a curative art. Medical art, commissioned by an individual or a society, is service. It requires vocation to obtain satisfaction. However due to the incidence of value changes, market globalization, technological and industrial development, the patient/physician relationship is becoming a user/provider relationship. Physician-related factors such as a higher health care demand, resource shortage and a progressive specialization have also influenced this change of paradigm. This is causing dissatisfaction, loss of self-esteem and a lower ethical commitment among professionals. We need to recover a professional repertoire of ideas in the context of a global ethics. Responsibility and co-responsibility are ethical principles addressed to technological civilizations and their collateral effects on people and environment that lead to a "responsible globalization". We also need a scientific futurology to define risks and avoid errors. In this era of progressive specialization, Internal Medicine, with its holistic vision of mankind, may play a fundamental role in the field of bioethics.

Medicina Interna, Arte y Ciencia en el Tercer Milenio", expresa que la medicina no es exclusivamente ciencia. Tiene de sí actuar hábilmente sobre el hombre enfermo, (arte curativo), buscando restablecer un estado natural. El arte médico, comisionado por el enfermo o por la sociedad, es servicio. Requiere vocación, obteniendo su propia satisfacción. Sin embargo, la relación "paciente / médico", se ha visto transformada actualmente en "usuario /prestador", Incidiendo factores generales, tales como cambios valóricos, preeminencia del mercado (globalización), desarrollo de la tecnología e industria, y además factores propiamente médicos: mayor demanda asistencial, escasez de recursos, progresiva especialización, presencia de gestores no médicos, y otros. Ello ha provocado en los médicos insatisfacción, pérdida de autoestima y menor compromiso ético. Necesitamos recuperar un ideario profesional, en el contexto de una "ética global". El "principio de la responsabilidad" (Jonas) o la "corresponsabilidad" (Apel), son éticas destinadas a la civilización tecnológica y a sus efectos colaterales sobre las personas y el medio ambiente, conducentes a una "globalización responsable". Necesitamos, además, estimular el desarrollo de una "futurología científica" que permita definir los riesgos a evitar o los errores a corregir. En esta era de creciente especialización, la Medicina Interna, beneficiaria de la mejor tradición médica por su visión holística del hombre, puede y debe jugar un rol fundamental en el campo de la Bioética.

How far has The Korean Journal of Internal Medicine advanced in terms of journal metrics?

The Korean Journal of Internal Medicine has already been valued as an international journal, according to a citation analysis in 2011. Now, 2 years later, I would like to confirm how much the Journal has advanced from the point of view of journal metrics by looking at the impact factor, cites per document (2 years), SCImago Journal Rank (SJR), and the Hirsch index. These were obtained from a variety of databases, such as the Korean Medical Citation Index, KoreaMed Synapse, Web of Science, JCR Web, and SCImago Journal & Country Rank. The manually calculated 2012 impact factor was 1.252 in the Web of Science, with a ranking of 70/151 (46.4%) in the category of general and internal medicine. Cites per documents (2 years) for 2012 was 1.619, with a ranking of 267/1,588 (16.8%) in the category of medicine (miscellaneous). The 2012 SJR was 0.464, with a ranking of 348/1,588 (21.9%) in the category of medicine (miscellaneous). The Hirsch index from KoreaMed Synapse, Web of Science, and SCImago Journal & Country Rank were 12, 15, and 19, respectively. In comparison with data from 2010, the values of all the journal metrics increased consistently. These results reflect favorably on the increased competency of editors and authors of The Korean Journal of Internal Medicine.

Prevalencia de pie diabetico en pacientes internados en el servicio de clinica medica-hospital central del instituto de previsiòn social en el periodo de enero a diciembre del 2009 / Prevalence of diabetic foot in patients of the service medical clinic-hospital central ips in the period from january to december 2009

El pie diabètico es la complicaciòn crònica de la diabetes mellitus con mayores implicaciones econòmicas y sobre la calidad de vida de los pacientes..

Detecciòn de factores de riesgo cardiovascular en familiares hasta de segundo grado de personas diabèticas / Detection of cardiovascular risk factors to the second degree relatives of people with diabetes

Hay factores de riesgo que,son factores pronòstico de mayor probabilidad de que se desarrolle un evento.En epidemiologìa,los factores de riesgo son aquellas variables que se presentan asociados diversamente eon el evento estudiado..

Relações entre Clínica e Osteopatia / Relations between Internal Medicine of the Osteopathy

Este estudo teve como objetivo, evidenciar aspectos comuns entre a Clínica Médica e a Osteopatia, comparando exigências, interações e semelhanças. Sendo que, ambas tem como objetivo principal a busca da saúde e qualidade de vida. Embora atuem com conceitos diferentes, têm conhecimentos anatâmicos, fisiológicos, semiológicos comuns, que devem ser sempre centrados num único propósito: a restauração e manutenção da integridade física, moral ou social do homem

Propuesta para nuevo modelo de gestión clínica en medicina interna / Proposal of a new clinical management model for internal medicine

El caos y la crisis de identidad de la medicina interna, con el desconocimiento de los contenidos y características por la opinión pública y las autoridades sanitarias han llevado al desentendimiento de las partes y al recorte progresivo de funciones por la competencia de otras especialidades que ofrecen una tecnología deslumbrante. El nuevo y cambiante entorno social, económico y cultural debe interpretarse como oportunidades de mejora para la medicina interna y el papel de los internistas como agentes gestores del cambio a favor de una especialidad en situación de privilegio, con acceso a un mercado ilimitado y que, además, es necesaria, integradora, resolutiva e insustituible. En estas circunstancias sólo medidas de gestión con definición de líneas de productos y demostración de rentabilidad pueden rediseñar la especialidad en la búsqueda de innovación competitiva para mejorar resultados y reducir costos con criterios de eficiencia, calidad, ética y seguridad. Los modelos de gestión clínica buscan objetivos de descentralización de la responsabilidad, mejora de las relaciones entre profesionales, usuarios y directivos, y control de costos vinculando la financiación a la actividad asistencial. La esencia de la gestión clínica es reducir la brecha entre eficacia –lo que puede conseguirse- y eficiencia –los resultados-, mientras que la mejora de la calidad pasa por cruzar el abismo entre el mejor cuidado posible y el cuidado rutinario diario

El internista: un ser humano ayudando a otro: de la formación y ejercicio clínico de la profesión / The internist: a human being that helps others: on the training and clinical practice of the specialty

This is a critical overview of an internist with 33 years of practice, about the activities which are inherent to internal medicine. The author analyzes strategies on how to keep updated in the scientific literature, the importance of acquiring experience from peers and teachers and emphasizes the value of an adequate patient-physician relationship.

La Medicina Interna: retos y oportunidades al inicio de un nuevo siglo / Internal medicine: challenges and opportunities at the beginning of a new century

Internal medicine was born at the end of the nineteenth century as the result of the great amount of medical knowledge that accrued. The word "internal" has a great meaning and symbolism that underscores a holistic view of the patient. After some years of fruitful work, internal medicine experienced the appearance of subspecialties. This meant a great technological advance but increased the costs of services and deteriorated patient-physician relationship. These tactics along with world sanitary changes, offer a unique opportunity for the resurgence of Internal Medicine. Nowadays the internist has the image of an expert able to treat patients with diseases that involve several organs or systems or to serve as a consultant for complex medical problems. The new threats of the specialty are Family Medicine and hospital physicians. The areas in which the internist should acquire expertise to cope with the new sanitary requirements are also analyzed.

Os desafios da clínica médica e do clínico: para onde vai a clínica neste século? / What is a clinician and what does he do?: the challenge of the medical clinic at this century?

O objetivo deste trabalho é trazer à discussão questões sobre a função e a arte do clínico e da clínica médica. Apresenta a essência da atuação clínica, como age idealmente o clínico, como estabelece seu limite e campo de ação. Discute como sua atuação está modificada atualmente. Infere sobre o desafio da atividade clínica no próximo século, seja para sua caracterização como especialidade médica e área de relevância na medicina, seu espaço no mercado de trabalho, a forma de atualização do clínico, e qual o impacto que exercerá, em decorrência da forma como aborda as questões da relação saúde e doença, sobre o sistema de saúde.

This article shows the challenge of the Internal Medicine and the Internist at this century.

Medicina basada en evidencias: ¿una estrategia que acerca o aleja de la medicina interna? / Evidence based medicine: a strategy that brings near or moves away from internal medicine?

In the last years, evidence based medicine has been considered a main factor for the diagnostic and therapeutic decisions in medical practice. However, one must consider the complexity of human beings and the difficulties in the interpretation of some results obtained in randomized prospective trials that support this theory. Therefore the importance of clinical experience, rational and logical medical thinking and facing patients as individuals must prevail at the moment of complex medical decisions