Cobertura de programas preventivos en Chile / Coverage with preventive programs in Chile

Introducción: Los Programas de Medicina Preventiva para que tengan un impacto en el nivel de salud deben tener una alta cobertura poblacional. Objetivo: Estudiar la cobertura de los programas preventivos que se realizaron en el Sistema de Salud Público Chileno el año 2007. Material y Métodos: Se revisó la cobertura de los programas preventivos en las bases de datos del Departamento de Estadísticas e Información en Salud del Ministerio de Salud de Chile del año 2007. Resultados: La cobertura global de los programas preventivos medido a través del Índice de Medicina Preventiva fue de0.202. El programa de salud dirigido a los < de 6 años (infantil) fue el que registró una mayor cobertura (0.84), un nivel de cobertura intermedio se observó en los programas de la mujer (0.34) y del adulto mayor (0.29), por su parte los programas dirigidos a la población escolar, adolescente y adulto fueron los que presentaron menores coberturas (<0.1). Discusión: La alta cobertura observada en el programa preventivo dirigido a la población infantil, ha sido un factor que ha favorecido la mejoría en el nivel de salud de este grupo poblacional, particularmente ha contribuido a reducirla mortalidad infantil en Chile. El país debe crear estrategias que permitan incrementar la cobertura en programas preventivos dirigidos a la población escolar, adolescente y adulta, solo de esta forma podrá seguir avanzando en la senda de mejorar el nivel de salud poblacional.

Introduction: In order to have an impact on the level of health, Preventive Medicine Programs should have high population coverage. Objective: To study the coverage of preventive programs which were conducted in the Chilean Public Health System in 2007. Material and Methods: The coverage of preventive programs in the databases of the Department of Health Statistics and Information of the Chilean Ministry of Health in the year 2007 were reviewed. Results: The overall coverage of preventive programs as measured by the index of Preventive Medicine was 0.202. The health program aimed at < 6 years (children) was the one that recorded a greatest coverage (0.84). An intermediate level of coverage was observed in the women’s program (0.34) and in that of elderly (0.29). Programs conducted for school children, teenagers, and adults presented a low coverage (<0.1). Discussion: The high coverage observed in the child health preventive program, has been a factor that has led to the improvement of the health status of this population group. Particularly, it has contributed to reduce the infant mortality in Chile. The country must create strategies to increase the coverage of preventive programs aimed at schoolchildren, teenagers and adults. Only in this way we can go on improving the level of population health.

Características cefalométricas en el síndrome de Beckwith-Wiedemann / Cephalometric features of Beckwith-Wiedemann's syndrome

Doce niños afectados por el síndrome de Beckwith-Wiedemann fueron estudiados cefalométricamente por medio del análisis arquitectural y estructural cráneo-facial de Delaire, en la búsqueda de características comunes. Los resultados muestran una normalidad de las estructuras craneanas, en la cara, la posición adelantada del maxilar y la biprotrusión dentoalveolar son características casi constantes, la falta de desarrollo vertical del maxilar superior y la mordida abierta anterior están presentes en una gran mayoría de los pacientes estudiados. En nuestra opinión, estas características son deformidades secundarias al excesivo tamaño de la lengua más que una condición primaria de la malformación (AU)

[Ultrasonography: a complement to sialography in recurrent chronic childhood parotitis]. / L'échographie: un complément à la sialographie dans les parotidites récurrentes chroniques infantiles.

The objective of this research is to compare the ultrasonographic (USG) and sialographic contributions for the diagnosis of Recurrent Parotitis in Childhood (RPC). Bilateral USG of the parotid gland was performed among 16 children with RPC and 16 healthy children. The image of the normal parotid glands was compared with the image of the parotid gland with RPC. A pathologic USG pattern for RPC was obtained which consisted in a homogeneous, micronodular parenchyme with a diffuse increase density, sometimes with multiples hypoechogenous areas, that were considered solid hypoechogenous nodules suggesting inflammatory nodes. A glandular contour finely granulated was described with normal peri-parotidareas and with aponeurotic-muscular planes. Then 16 USG of the parotid gland of the children with RPC were compared with 16 Sialography previous obtained. The possibilities of diagnosis of the disease with both techniques was not different (p > 0.05). When the clinic was correlated with the USG it was possible to obtain parameters of severity of the glandular damage and to visualise the degree of changes of the parenchyma of each child with RPC. In some cases, bilateral damage was observed in children with clinical unilateral symptoms. The USG was performed in children in the acute phase of disease, visualising the microabscess in the gland and confirming the previous diagnosis. Finally, it was possible to conclude the utility of USG in the study of the disease. Being a not invasive exam, harmless, unpainfully echography, was easily accepted by the child. Also, we obtain information not only about the diagnosis of the disease, but also about the severity, prognosis, treatment and follow-up of the infant patients.

[Anatomic bone and dento-alveolar changes in patients with lip incompetence]. / Modifications anatomiques squelettiques et dento-alvéolaries chez les sujets atteints d'incompétence labiale.

Twenty young patients with clinical labial incompetence have been studied cefalometrically using Delaire's Analysis, in order to determine anatomical alterations who explains this condition. In all of them we have found some anatomical alteration in sagital or vertical plane or both, in maxillary or mandibular squeletal bases or their dento-alveolar squeletic unit. Knowledge of anatomical factors contributing or determining labial incompetence is the key of the planification and execution of an etiologic approach, what is the best way to obtain physiological rapport and consequently good aesthetic results.

[Vertical condylar hyperplasia, clinical and histologic aspects. Apropos of 2 cases]. / L'hypercondylie verticale, aspects cliniques et histologiques. A propos de deux cas.

Condylar hyperplasia is a pathologic condition associated with an overgrowing of the condylar cartilage. It is possible to distinguish two clinical forms; vertical and horizontal when the lesion is unilateral. We have reported two cases of vertical condylar hyperplasia, both of them treated by simple condylectomy, in our opinion the selected treatment. Histopathological images show an increase of the growth and maturation layers of the condylar cartilage and inclusions of cartilaginous tissue, with appearance of glove fingers into the underlying cancellous bone.

[Facial esthetics for the maxillo-facial surgeon]. / Estética facial para el cirujano máxilo-facial.

Has been pointed out that this is the aesthetic era for current dentistry. The oral and maxillo facial surgeon plays an important role in this regard emfatizing that the facial aesthetic is part of our field and responsibility in conjunction with the functional goal of most of our treatments.

[Salivary glands and maxillofacial surgery]. / Las glándulas salivales y el cirujano maxilofacial.

In this paper a brief and general review was made of the different pathologies that affect the salivary glands, as well as the emphasis of the role of the maxillofacial surgeon in the search, diagnosis and treatment of these pathologies.