Revista Confluencia is an electronic publication whose purpose is to disseminate scientific knowledge in the field of health. Its objective is the publication of unpublished articles in spanish in the field of health, whose elaboration emanates from the scientific production of students in the context of courses, workshops, clinical experiences, assistantships (among others), which can be presented in sections such as research (qualitative and quantitative), literature reviews, clinical cases, intervention programmes or projects, reflections and letters to the editor. From 2023, Revista Confluencia includes the publication of student articles with optional co-authorship by academics, researchers, health professionals, authorities and public health managers. It is very important for us to ensure that students continue to be the protagonists of the journal, so the participation of professors or clinical tutors who participate in the publication will be open to their inclusion as last authors. From the year 2024 Revista Confluencia takes on the challenge of continuous publication, which will reduce the time it takes to submit and publish articles.
Mortality due to necrotizing enterocolitis of the newborn in Chile: Descriptive analysis 2016-2024
Introduction: Necrotizing enterocolitis in newborns is a severe gastrointestinal disease that mainly affects preterm infants with low birth weight and is associated with high morbidity and mortality. In Chile, there are limited updated epidemiological data on deaths due to this condition. Objective: To describe the mortality rate from necrotizing enterocolitis in newborns as the underlying cause in Chile during 2016-2024. Methods: An observational, descriptive, cross-sectional study. The study utilised data on deaths from necrotising enterocolitis in newborns recorded by the Department of Health Statistics and Information, along with population data from the National Institute of Statistics for the period 2016-2024. Data processing was carried out in Microsoft Excel. Result: A total of 396 deaths from this cause were recorded between 2016-2024, with a mortality rate of 22,34 per 100.000 live births. The annual mortality rate was irregular and higher among males. Regionally, high rates were noted in Aysén and La Araucanía, and low mortality rates in Atacama, Arica and Parinacota. 97,73% of deaths occurred in hospitals. Discussion: Interannual variations may be explained by statistical instability associated with small numbers. Higher male mortality and regional variation may be related to biological factors and neonatal risk, such as low birth weight. Conclusion: Necrotising enterocolitis in newborns remains a relevant cause of mortality in Chile, with differences by sex and region, and with hospital as the predominant place of death. Strategies are needed to prevent prematurity and to enhance regional care capacity through increased availability of subspecialists and specialized centers.
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Mortality and hospital discharge rates for lip, oral cavity, and oropharyngeal cancer in Chile, 2002–2023
Introduction: Lip, oral cavity, and pharynx cancer represents a significant public health problem worldwide. In Chile, national epidemiological information is limited, and there are no specific clinical guidelines for its comprehensive management. Objective: To describe the epidemiological situation of cancer of the lip, oral cavity, and pharynx in Chile by analyzing mortality and hospital discharges according to time, place, age, and sex. Methods: A descriptive ecological study was conducted using secondary data from the Department of Health Statistics and Information (DEIS) of the Chilean Ministry of Health. Deaths occurring between 2002 and 2023 and hospital discharges between 2002 and 2021 corresponding to ICD-10 codes C00–C14 were analyzed. Crude rates, age-adjusted rates, and standardized mortality ratios were calculated, assessing their temporal, regional, and demographic variation. Result: In 2023, 304 deaths were recorded, with a crude mortality rate of 1,5 per 100.000 inhabitants. Crude mortality showed an upward trend, whereas the age-adjusted mortality rate decreased by 22,8% over the study period. Mortality was higher among men and increased significantly with age. Relevant regional differences were observed. Hospital discharges increased by 14,5% since 2002, predominating among men and older adults. Conclusion: In Chile, age-adjusted mortality from cancer of the oral cavity and pharynx has declined, while hospital discharges have increased. These findings highlight the need to strengthen prevention strategies, early detection, and the development of specific public health policies at the national level.
José Miguel Domingo Gastón de Toro Ballesteros
Spiritual accompaniment in palliative care from a comprehensive care perspective: A narrative review
Introduction: Spiritual care is an essential component of palliative care, as it supports the existential and spiritual well-being of patients with serious illnesses. However, its effective implementation remains a challenge in many health systems. Objective: To explore spiritual care, its meaning, and its relationship with comprehensive person-centered care according to scientific literature. Methodology: A narrative review of scientific literature was conducted using databases such as PubMed/MEDLINE, Scopus, Scielo and Redalyc. Language filters (English, Spanish and Portuguese) and publications from the last ten years were applied. DeCS/MESH, terms including spirituality, palliative care, comprehensive health care, religion and medicine were combined using boolean operators (AND and OR). Exclusion criteria included religious interventions unrelated to palliative care and articles lacking analytical development. No definitive number of articles was established due to the narrative nature of the review. Development: Spirituality is a dynamic and multifaceted dimension that becomes particularly relevant in palliative care by promoting meaning-making, coping and adaptation in the context of advanced illness. Spiritual care is grounded in genuine presence, active listening, and respect; however, its integration into clinical practice is affected by conceptual, professional, and organizational divergences. Conclusion: The implementation of spirituality in healthcare requires overcoming these existing barriers through interdisciplinary models that incorporate spiritual care as a core competency of comprehensive and humanized end-of-life care.
Hospital discharges for cystic fibrosis in patients aged 0-19 years in Chile: A descriptive study, 2021-2024
Introduction: Cystic fibrosis is a multisystem genetic disease that primarily affects respiratory and digestive systems. In Chile, evidence on hospital discharges due to cystic fibrosis in the pediatric population is limited. Objective: To describe the hospital discharge rate for cystic fibrosis in patients aged 0-19 years in Chile between 2021-2024. Methodology: Observational, descriptive, retrospective longitudinal study based on secondary records from the Department of Health Statistics and Information. Hospital discharges with a primary diagnosis code E84 “Cystic fibrosis” (International Classification of Diseases, Tenth Revision), were included. The denominator for rate calculation was obtained from the 2024 Census of the National Institute of Statistics. The analysis examined absolute frequencies and the hospital discharge rate per 100.000 inhabitants, as well as the weighted average length of hospital stay. Result: A total of 1.114 hospital discharges were analyzed. The overall hospital discharge rate was 6,2 cases per 100.000 inhabitants; the highest rate was recorded in 2022 (6,8) and the lowest in 2024 (5,1). The hospital discharge rate was higher among women (6,9) and in the 10-to-14-year age group (7,4). The average length of hospital stay was 15,4 days, higher among men. Discussion: Cystic fibrosis maintains a relevant hospital burden in pediatric and adolescent populations, with descriptive differences according to sex and age group, as well as prolonged hospital stays that reflect the complexity of inpatient management. Conclusion: Strengthening multidisciplinary outpatient follow-up, especially during adolescence, and generating national evidence to evaluate the impact of new diagnostic and therapeutic strategies are needed.
Descriptive analysis of mortality from bronchus and lung cancer in Chile: An epidemiological overview of 20 years (2002-2022)
Introduction: Bronchus and lung cancer is a malignant neoplasm originating from the bronchial epithelium or pulmonary parenchyma. Objective: To establish the mortality rate from bronchus and lung cancer in Chile between 2002 and 2022. Methods: A cross-sectional, observational, descriptive, and retrospective study was conducted. Deaths from bronchus and lung cancer (ICD-10 code C34) recorded in Chile from 2002 to 2022 were analyzed, based on official data from the Department of Statistics and Health Information. The variables considered were: cause of death, sex, age, and region. Mortality rate were calculated using population projections from the National Institute of Statistics. Result: A total of 59.720 deaths from lung cancer were recorded, with an average mortality rate of 15,39 per 100.000 inhabitants. Mortality was higher in men (19,02) than in women (11,79). The highest mortality rate was observed in older adults (65 years of age or older), reaching 78,67 per 100.000. Regionally, Antofagasta had the highest mortality rate (26,45), while Ñuble and La Araucanía had the lowest. Discussion: The increasing mortality trend reflects the persistence of tobacco use, population aging, and regional environmental exposures. The low five-year survival rate and delayed diagnosis emphasize the urgent need to implement early detection programs. Conclusion: This study highlights a high and rising burden of lung cancer mortality in Chile. Integrated public health policies are needed to improve prevention, early diagnosis, and timely access to treatment.
Jean Watson's humanized care: A literature review
Introduction: The increasing dehumanization of health care has negatively impacted the nurse-patient relationship, affecting the quality of care, therapeutic communication, and professional well-being. Objective: This literature review aims to analyze the impact of Jean Watson’s Human Caring Theory on nurse-patient care, focusing on three dimensions: communication, patient satisfaction, and the emotional well-being of the professional. Methodology: A systematic search was conducted in databases such as PubMed, SciELO, CINAHL, Medline, and Google Scholar, using MeSH terms and filters by recency, language, and article type. From a total of 671 initial articles, 21 were selected that met quality and relevance criteria. Result: The findings show that Watson’s Theory significantly enhances therapeutic connection through caritas processes, promotes human-centered care, and strengthens nursing vocation. Discussion: Structural barriers were identified, such as work overload, limited training in soft skills, and weak institutionalization of humanized approaches. Conclusion: It is concluded that Watson’s Theory represents an effective strategy to address the depersonalization of care and humanize clinical environments.
Children's views on their participation in vaccine clinical trials
Introduction: Since the start of the COVID-19 pandemic, efforts have been made to develop vaccines tailored to the needs of children and adolescents, a group from whom it is important to gather information regarding their participation in clinical trials. Objective: To determine the opinion of children and adolescents aged 7 to 11 and 12 to 17 years regarding their participation in clinical trials for vaccine development, considering the recent inclusion of this demographic in trials in Chile. Methodology: A quantitative descriptive, cross-sectional study using a questionnaire administered to 427 children and adolescents from two schools in the Metropolitan Region. The instrument assessed opinions, concerns, motivations, and willingness to participate in clinical trials. Result: 53,6% of the 7-11 age group and 55,4% of the 12-17 age group agreed with the participation of minors in clinical trials. Additionally, 45% and 42,4%, respectively, indicated their willingness to participate. The primary motivation was the desire to aid in vaccine development, although moderate concerns were evident, particularly regarding potential long-term effects. Discussion: The results reflect a predominantly positive attitude towards pediatric clinical research, with age-group differences in comprehension and argumentation. A clear awareness of justice, altruism, and appreciation for informed consent was observed. Conclusion: Including the voices of children and adolescents in the design of clinical research is essential to ensure respect, understanding, and truly meaningful participation.
Health knowledge, Attitudes and Practice
Review of cardiovascular disease prevention strategies in Chile: Acute myocardial infarction and stroke
Introduction: Cardiovascular diseases, primarily acute myocardial infarction and stroke, are the leading cause of death worldwide, generating a significant health, social, and economic burden. Objective: To review the primary, secondary, and tertiary prevention strategies for acute myocardial infarction and stroke implemented in Chile and to analyze their concordance with the main international cardiovascular prevention guidelines. Methods: A narrative review was conducted, which included grey literature, primary studies, reviews, clinical guidelines and regulatory documents—both national and international—as well as indexed scientific literature. Results: Chile has implemented integrated primary, secondary, and tertiary prevention strategies for acute myocardial infarction and stroke, mainly within the framework of the Explicit Health Guarantees system, showing overall concordance with the main international cardiovascular prevention guidelines. Discussion: Although national strategies are generally consistent with international recommendations, gaps persist between clinical recommendations and their implementation. These gaps affect risk factor control in primary prevention, timely access to diagnosis and treatment in secondary prevention, and follow-up, rehabilitation, and management of sequelae in tertiary prevention, ultimately impacting long-term outcomes in acute myocardial infarction and stroke. Conclusions: Chile has a solid regulatory framework for cardiovascular prevention that is consistent with the main international guidelines; however, implementation gaps remain. Strengthening equity, continuity of care, and the updating of clinical guidelines is necessary.
Geriatric dermatology in contemporary clinical practice: An analytical review of an emerging and underrepresented field in the scientific literature
Introduction: Population aging has steadily increased the proportion of individuals aged 65 and over, generating a significant impact on healthcare systems. In this context, the skin plays a central role in the comprehensive clinical assessment of older adults, as dermatological diseases are highly prevalent and are associated with impaired quality of life, frailty, hospitalizations, and increased morbidity and mortality. Geriatric dermatology thus emerges as an area of growing clinical and academic relevance, yet it remains underrepresented in the literature. Objective: To analyze and synthesize the published scientific evidence on geriatric dermatology, addressing the pathophysiological changes of cutaneous aging, the most prevalent dermatoses in older adults, and the main clinical and therapeutic considerations in this population. Methodology: A narrative literature review was conducted following PRISMA guidelines, using PubMed/MEDLINE. The search employed the MeSH terms “Dermatology” AND “Geriatrics,” including publications from the last five years and studies involving populations aged 65 and over. Development: Evidence shows that more than 70-80% of older adults present with at least one active dermatosis, most commonly xerosis, inflammatory dermatoses, cutaneous infections, chronic venous insufficiency, pressure injuries, and skin neoplasms. The physiological changes associated with aging modify both clinical presentation and therapeutic response, increasing the risk of adverse effects. Conclusion: This review underscores the need to develop specific clinical guidelines, promote the inclusion of older adults in dermatologic research, and advance care models adapted to the rapid growth of this population.
Public health interventions for the prevention and early detection of oral cavity and oropharyngeal cancer at the national and international levels: A literature review
Introduction: Oral cavity cancer represents a relevant public health problem in Chile due to its high morbidity and mortality, which is highly associated with diagnosis at advanced stages, despite being a largely preventable disease. Objective: This study analyzes the available evidence on public health interventions at the level of prevention, early detection, diagnosis, and management of oral cavity cancer, both international and national literature. Methodology: A bibliographic review of the scientific literature was conducted, including indexed publications and grey literature, prioritizing reviews, meta-analyses, and official documents from the last 10 years. Result: At the international level, the evidence supports the control of alcohol and tobacco consumption, together with vaccination against Human Papillomavirus, as the main pillars of primary prevention; while visual oral examination remains the method of choice for screening in high-risk populations due to its high cost-effectiveness and feasibility. In contrast, although in Chile there are regulatory policies and campaigns aimed at the main risk factors, there are no early detection programs nor standardized national clinical guidelines. Discussion: In agreement with previous Chilean reviews, this gap in management still persists, leading to delayed diagnoses, inequities in access to care, and poorer clinical outcomes. Conclusions: The implementation of systematic early detection strategies and the development of national clinical guidelines based on updated evidence represents a priority need to strengthen the response of the Chilean health system to oral cavity cancer.
Results of an educational intervention focused on the early detection of breast cancer in patients of the CRS of the Padre Hurtado Hospital
Introduction: This paper presents an educational intervention carried out at Padre Hurtado Hospital to address the population’s knowledge gap regarding breast cancer prevention and early detection. Interviews and clinical experiences revealed misconceptions, low understanding of risk factors, and limited knowledge about breast self-examination, which—together with the high prevalence of this condition—justified the intervention. Objective: To provide clear information about breast cancer, correct misconceptions, raise awareness about early detection and body self-awareness, and develop practical skills for performing breast self-examination. Methodology: The intervention was planned in accordance with the User-Centered Design Model and Jane Vella’s Adult Learning Model. Twenty-five users of various ages participated. Activities included brainstorming sessions, an educational roulette, anatomical models, guided self-examination practice, and infographics. The technique was evaluated using a checklist, and the final impact was assessed through written reflections. Result: Participation reached 100%. A total of 92% of participants correctly performed the breast self-examination, and 88% acquired new knowledge. Improved understanding of warning signs, risk factors, and the elimination of misconceptions was also observed. Discussion: Visual, practical, and spoken educational strategies proved effective in promoting meaningful learning, especially among groups with limited access to comprehensible health information. Conclusion: The intervention met all proposed objectives and highlights the importance of the educational role of nursing in fostering community self-care and early detection of breast cancer.
The emerging role of artificial intelligence in dermatology: Clinical applications and challenges, a bibliographic review of recent evidence
Introduction: Dermatology is a field strongly grounded in the visual and dermatoscopic assessment of cutaneous lesions, where clinical experience and specialist judgment are essential for accurate decision-making. In recent years, artificial intelligence has emerged as a tool with high potential to support diagnosis, severity assessment, and longitudinal monitoring of skin diseases, making a systematic and updated analysis of its usefulness, scope, and real impact in dermatological practice necessary. Objective: To critically analyze the current role of artificial intelligence in dermatology, describing its main clinical applications, benefits, limitations, and challenges, with emphasis on image-based diagnosis, severity assessment, multimodal models, artificial intelligence-assisted dermatopathology, medical education, and equity in access to dermatologic care. Methodology: A narrative literature review was conducted using PubMed/MEDLINE, applying exclusively the MeSH terms “Artificial Intelligence” and “Dermatology.” A total of 132 articles were selected after applying inclusion and exclusion criteria and a screening process based on PRISMA recommendations. Discussion: Recent evidence shows that artificial intelligence can achieve highly accurate diagnostic performance, enhance objective severity assessment, and optimize the longitudinal monitoring of skin diseases. However, challenges remain related to bias, clinical validation, explainability, and professional adoption. Conclusion: AI does not replace expert clinical evaluation, but it may serve as a valuable complement when integrated responsibly, ethically, and in an appropriate clinical context.
Klebsiella oxytoca as an unusual agent of mixed diffuse otitis externa: Case report and literature review
Introduction: Diffuse otitis externa is an acute inflammation of the external auditory canal, most commonly caused by Pseudomonas aeruginosa and Staphylococcus aureus. The involvement of other gram-negative bacilli is exceptional and poorly documented. Objective: This report aims to contribute evidence through the description of a case of diffuse otitis externa in which Klebsiella oxytoca was isolated, a bacterium not previously described as a causal agent of human otic infections, and to highlight the clinical relevance of considering unusual pathogens in cases with atypical clinical courses. Methodology: We present the case of a 43-year-old man with clinical features of mixed otitis externa, whose culture showed growth of Klebsiella oxytoca and Aspergillus niger. The patient was evaluated clinically and by otomicroscopy, with microbiological sampling and follow-up after targeted topical treatment. Result: The patient evolved favorably under topical antifungal and antibacterial therapy. Discussion: Klebsiella oxytoca is an opportunistic gram-negative bacillus whose role in otitis has only been reported in animal models and in a single human case of malignant otitis externa in 1992, with no subsequent reports in the literature. In this case, clindamycin-induced dysbiosis and local immunosuppression due to topical corticosteroids likely favored its occurrence. Conclusion: This report documents a case of diffuse otitis externa associated with Klebsiella oxytoca and Aspergillus niger, highlighting the importance of considering unusual pathogens and performing cultures with antibiograms in cases of atypical evolution, reinforcing the need for a clinical approach based on critical thinking and diagnostic reassessment when facing non-standard presentations.
Obsessive-compulsive disorder: A literature review of the main things to know and its relationship with other diseases
Introduction: Obsessive-compulsive disorder is a psychiatric disorder characterized by obsessions and compulsions that range from mild to very severe depending on the patient's functional impairment. This condition has multiple comorbidities, which underscores the importance of a proper diagnosis and a comprehensive view of the patient. Objective: To review the diagnosis, pathophysiology, and current therapeutic options for obsessive-compulsive disorder, along with comorbidities and a comprehensive view of the patient. Methodology: A systematic search was carried out mainly in Pubmed where the term Mesh "Obsessive-Compulsive Disorder" was used associated with epidemiology, etiology, pathophysiology, rehabilitation and therapy, added to gray literature and bibliography from other platforms. Development: The article details the concept of obsessive-compulsive disorder, its diagnosis in the DSM-5, the dimensions affected, and the assessment of symptom severity using the Yale-Brown Obsessive-Compulsive Scale. It also describes the use of high-dose selective serotonin reuptake inhibitors and cognitive behavioural therapy as the preferred treatment options, alongside a review of other available options. The comorbidity of obsessive-compulsive disorder is described, along with the need to treat patients using a broader approach. Conclusion: Obsessive-compulsive disorder is a psychiatric disorder with significant prevalence in the Chilean population. Also, the evidence suggests that obsessive-compulsive disorder responses favourably to combined treatment strategies. Given its high comorbidity with other disorders, a comprehensive assessment of the patient is vitally important.
The role of midwifery in education and prevention of pelvic floor dysfunction in primary care: An area of pending attention in adolescence
One in three adolescent girls experiences urinary incontinence without realizing it's related to their pelvic floor. They tend to normalize the symptoms and, consequently, downplay their importance despite the impact they have on their lives. This document reveals a worrying gap in pelvic health education, which focuses almost exclusively on pregnant women, postpartum women, and older women, leaving adolescents marginalized. Midwives in Primary Health Care can change this reality by becoming key agents, thanks to their training and close relationship with the adolescent population. Their work allows them to break down taboos, educate on basic anatomy, promote preventative habits, and detect early signs that may affect the pelvic floor. Incorporating a preventative approach in adolescence helps prevent future pelvic floor dysfunction, improves quality of life, and reduces healthcare costs.
Analysis of hospital discharges for hypospadias in Chile from 2021 to 2024
Introduction: Hypospadias is one of the most common congenital urogenital malformations and affects urinary, sexual, and reproductive function. Globally, it is estimated to affect 1 in every 200 to 300 live births. Objective: Descriptively analyse the hospital discharge rate for hypospadias during the period 2021 to 2024 in Chile. Methodology: An observational, descriptive, cross-sectional, and ecological study was conducted using data from the Chilean Department of Health Statistics and Information and the National Institute of Statistics (2021-2024), using the ICD-10 code Q54. Hospital discharge rates per 100,000 inhabitants, average length of hospital stay, and distribution by diagnosis and age were calculated. Result: A total of 1.561 hospital discharges were recorded. The overall rate was 17,01 per 100.000 inhabitants, highest in 2024 (19,39). The 0-4-year group had the highest rate (51,29) and the longest average stay occurred in the 10-14-year group (3,81 days). The most frequent diagnosis was “unspecified hypospadias” (41,9%). Discussion: It is suggested that the COVID-19 pandemic reduced elective hospitalizations in 2021. The greater care burden in children under 4 years is consistent with the recommended surgical age. The high number of nonspecific diagnoses reflects inefficiencies in coding, highlighting the need for improvement. Conclusion: Improving specific hospital records with individualised codes is essential for the quality of healthcare, as it allows for the proper classification of pathologies, improves the accuracy of clinical records, and facilitates medical and administrative decision-making.
When diagnosis is not enough: A call for ethics in care
This essay addresses dental bioethics as the inescapable foundation of professional practice, moving beyond mere technical competence. The aim is to analyze the structural tension in contemporary dentistry when the focus is on procedural diagnosis, overshadowing the patient's subjective experience. Through a critical review of bioethical principles and recent literature, incorporating concepts of professionalization and epistemic burdens. It is argued that humanized care requires an ethical-deliberative dialogue that harmonizes evidence with the individual's biography. The counterargument regarding the "priority of the epistemic" is introduced, suggesting that moral obligations depend on prior knowledge. A model is proposed where the dentist-patient relationship is an expert moral encounter. Bioethics, understood as the "heart" of the profession, guarantees co-responsible and respectful decisions, requiring specialized training that transcends voluntarism.
Limitations and exceptions to medical confidentiality in Chile
Medical confidentiality is a fundamental ethical duty in clinical practice, aimed at protecting patients' autonomy, privacy, and trust. However, in Chile, this principle is not absolute and includes exceptions when it conflicts with public health, the protection of minors, or serious risk to third parties, as established in Law No.20.584 and other applicable regulations. This article analyzes the bioethical conflict that arises between the duty of confidentiality and the obligation to prevent harm, examining. The criteria that justify limiting medical confidentiality from a perspective of proportionality. The analysis is based on the principles of autonomy, beneficence, non-maleficence, and justice, proposing a reasoned balance between respect for patients' rights and collective well-being. It concludes that medical confidentiality should be protected as a general rule but justifiably limited in exceptional situations.
Nail disorders as clinical markers of systemic disease: A literature review
Introduction: Physical examination remains essential in clinical practice and, within it, nail assessment is often overlooked despite its semiological value. Various nail abnormalities may represent early or persistent manifestations of systemic cardiovascular, hematologic, endocrine, autoimmune, infectious, or renal diseases, underscoring the importance of integrating nail evaluation systematically into patient assessment. Objective: To critically analyze recent evidence on nail disorders as clinical markers of systemic disease, describing their associations, diagnostic implications, and utility in medical practice. Methodology: A narrative review was conducted using PubMed/MEDLINE and MeSH terms specific to nail disorders and systemic diseases. The search identified 945 records; after applying filters for the last five years, full-text access, and inclusion/exclusion criteria, 56 articles were selected, of which 19 were used for this report. The selection process followed PRISMA recommendations. Discussion: Nail findings reflect inflammatory, vascular, metabolic, or immunological alterations. Several signs with high clinical value are highlighted, including digital clubbing, splinter hemorrhages, koilonychia, leukonychia, Beau’s lines, onychomadesis, and nail changes associated with chronic kidney disease, connective tissue disorders, or nail psoriasis. The topography, distribution, and number of affected nails help guide clinicians toward specific systemic etiologies and support comprehensive diagnostic evaluation. Conclusion: Nail abnormalities represent valuable semiological tools that remain underutilized in everyday clinical practice. Their timely recognition facilitates early detection of systemic diseases, strengthens diagnostic decision-making, and contributes meaningfully to the clinical training of students and healthcare professionals.
Perception of risk of sexually transmitted infections in Latin American immigrants
Introduction: Migration influences public health, increasing the vulnerability of migrant populations due to access barriers and socioeconomic conditions. In Chile, immigrant women face challenges in medical care, affecting their overall well-being. Objective: To analyze the perception of sexually transmitted infections risk among Latin American immigrant women in Santiago, Chile. Methodology: An observational, quantitative, and cross-sectional study was conducted with Latin American immigrant women residing in Santiago, Chile. A non-probabilistic snowball sampling method was used. Data were collected through a structured questionnaire validated by experts. Result: A total of 323 women were studied (average age: 33,7 years). Of them, 61,9% were single, 27,9% married, 8,7% divorced, and 1,5% widowed. Additionally, 51,2% had a stable partner. A high perception of risk in unprotected relationships was observed, but access to healthcare services was moderate. Previous experiences influenced their perception. Discussion: There is a high awareness of self-care in sexual health, but a gap between knowledge and action in prevention persists. Although participants identify risk behaviors, a perception of invulnerability remains when making decisions about condom use. Barriers to healthcare access and stigma are identified as limiting factors for prevention. Conclusion: The study highlights gaps between knowledge and action in sexual health. Gender inequalities and structural barriers persist, worsened by stigma. Comprehensive interventions are needed to improve decision-making and healthcare access.
Beyond the years: Reflections on sexuality and well-being in old age
Population aging poses significant challenges to the quality of life and comprehensive care of older adults. In Chile, although programs exist for this group, gaps persist in the sexual and emotional dimension, rendered invisible by myths and stigmas that associate old age with a lack of sexuality. The literature shows that sexual satisfaction positively influences physical, emotional, and social well-being, making it an essential component of quality of life. However, the lack of information, counseling, and sex education increases vulnerability to risks such as sexually transmitted infections. Current programs, such as the Day Centers for Older Adults, do not explicitly incorporate sexuality, limiting the health system's response to this need. A comprehensive approach is required that recognizes sexuality as part of well-being in old age.
The Cost of Beauty: Aesthetics vs. Health
Over the course of recent years, the evolution of scientific and technological development, along with the growth in the use of social networks, has created an increase in the demand for medical and dental procedures focused on aesthetics and beauty. However, the treatments have high risks that lead to damage that can permanently affect the patient's quality of life. For this reason, health professionals must face bioethical dilemmas and protect the well-being of comprehensive health, above the visual aspect.
The silences of Chilean sex education: Analysis and reflection on its main shortcomings
In Chile Comprehensive Sexuality Education has made significant progress in terms of regulations and legislation, particularly Law 20.418, which guarantees sexuality education as a right for all students in public and private schools. However, gaps exist in the implementation of school programs, characterized by a lack of depth in content related to emotional development, a lack of standardization in teacher training, and a plurality of sexuality education programs that do not guarantee proper implementation. Evidence reveals new challenges in the implementation of Comprehensive Sexuality Education in Chile. The creation of comprehensive public policies and programs led by health professionals, especially midwives, is required. These programs should also open new opportunities for research that strengthens the role of education and teacher training with a focus on sexual and reproductive rights.
Prevention and early detection of cervical cancer in Chile: An updated literature review
Introduction: Cervical cancer remains a global public health problem, despite being largely preventable. In Chile, mortality has decreased thanks to the Screening and Control Program implemented in 1987, but cervical cancer remains significant, ranking fourth in incidence and ninth in mortality, with notable gaps in Papanicolaou coverage. Objective: To compare cervical cancer prevention strategies in Chile with international recommendations, identifying gaps and opportunities for improvement to guide public health policies. Methodology: A literature review of national and international literature was conducted, including systematic reviews, meta-analyses, and articles in Spanish and English. From 311 initial documents, 21 studies were selected and analyzed regarding primary and secondary prevention, screening, and self-sampling. Result: The Papanicolaou test remains the main screening method in Chile, performed every three years for women aged 25 to 64, achieving only 66,2% coverage. The HPV test, more sensitive and cost-effective, is offered complementarily for women aged 30 to 64. HPV self-sampling has shown high acceptance, increasing participation and detecting precancerous lesions. Internationally, primary HPV screening allows greater detection and longer intervals between tests, whereas its implementation in Chile is limited. Discussion: There is a persistent lag in the adoption of cervical cancer prevention strategies. Low Papanicolaou test coverage and barriers to access highlight the need to modernize secondary prevention approaches. Conclusion: Despite progress, gaps in coverage and access persist. Expanding the use of HPV testing and self-sampling is recommended, as these are feasible, cost-effective strategies that optimize secondary prevention and promote greater equity in access.
Characterization of obstetric diagnoses of pregnant women hospitalized in Chile during 2023
Introduction: Hospital admissions during pregnancy have a significant impact on mother and fetal health. Its study in Chile allows to identify risk profiles in order to stablish health policies. Objective: The aim of this study is to describe the hospitalized pregnant characteristics in Chile during 2023 according with maternal age, health system, nationality, region and diagnostic. Methodology: A transversal descriptive study was carried out on 24.743 registers obtained from the National hospital discharge register due to pregnancy during 2023. Sociodemographic and clinical variables were analyzed through Excel and Jamovi software. Result: Most of the hospital discharges were on pregnant women between 30-39 years old (50,5%); an 85,5% were assisted in the public system, and 40,1% were residents of the Metropolitan region. The most frequent diagnostics were metabolic disorders (39,3%) and hypertensive disorders (23,9%). There were more admissions in south regions of the country. Discussion: The analysis of the pregnant admissions shows an increase on age group of pregnancy hospitalization, predominating metabolic disorders. South regions of the country show more hospitalizations based on total live births, potentially revealing territorial gaps in prenatal care access. Conclusion: The age group with the highest number of hospitalizations was 30-39 years. The most frequent diagnoses were metabolic disorders, followed by hypertensive pathologies. It is necessary to strengthen maternal health policies with a regional and age-based approach, focused on prevention, early detection, and timely management of obstetric pathologies, especially those of metabolic origin.
Communication inequalities in health: Case study of a person with hearing impairment in Chile
Introduction: This study addresses the communication barriers faced by individuals with hearing disabilities within the Chilean healthcare system, specifically through the experience of a user with acquired hearing loss following adolescent meningitis. Objective: The objective was to analyze the communicative and social barriers that affect healthcare delivery for hearing-impaired individuals. Methodology: A qualitative methodology was employed, utilizing semi-structured interviews with a deaf patient, a family member, and a healthcare professional. Result: Key aspects identified included accessibility, emotional impact, and support networks. The results highlighted a lack of proficiency in sign language among staff, an absence of inclusive protocols, and a sense of exclusion experienced by the user. Furthermore, the findings underscored the psychological impact of inaccessibility and the critical value of family and community networks. Discussion: The discussion reflects a disconnect between the actual needs of deaf patients and current clinical practice. Conclusion: It is concluded that there is an urgent need to implement inclusive policies, provide sign language training for healthcare personnel, and recognize Deaf culture as an integral part of comprehensive healthcare.
In the fight against neurophobia: Clinical confrontation and differential diagnoses of parkinsonism
Introduction: Neurophobia is defined as the fear of neurosciences and clinical neurology, representing a challenge to be overcome in medical education for both undergraduate students and recently graduated professionals. Parkinsonisms are clinical syndromes characterized by the presence of bradykinesia, rigidity, and tremor. Although Parkinson’s disease is the most frequent diagnosis, other “atypical parkinsonisms” are of great clinical relevance and require thorough evaluation for diagnosis. Objective: To conduct a review of the main differential diagnoses of parkinsonisms, presenting a straightforward clinical approach aimed at combating neurophobia among medical students. Methodology: A non-systematic literature search of national and international indexed literature was carried out in order to present the information in an accurate and up-to-date manner. Result: Lewy body dementia, multiple system atrophy, progressive supranuclear palsy, and corticobasal degeneration are the main differential diagnoses to consider in clinical assessment. Each of these can be clinically distinguished from Parkinson’s disease in terms of the rate of symptom onset, pattern of appearance, symptom predominance and imagenological findings. Furthermore, the prognosis of these conditions is generally poorer both in terms of pharmacological management and life expectancy. Conclusion: For medical students or general practitioners, parkinsonian syndromes can often seem overwhelming. However, a systematic approach focused on the timeline of symptom onset can be highly clarifying. Combined with the proper selection and interpretation of imaging studies, this allows the general practitioner to achieve a simple and direct understanding of the neurological condition.
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Epidemiological situation of Hepatitis C in Chile between 2002 and 2023
Introduction: Hepatitis C, caused by the Hepatitis C Virus, is transmitted through contact with infected blood, through sexual transmission (the main route of transmission in Chile among men who have sex with men), and via vertical transmission. Diagnosis is carried out through antibody testing and polymerase chain reaction, and it is mandatorily reportable to the Health Authority. In Chile, various public health policies have been implemented, significantly improving disease control. Objective: Analyze the epidemiological situation of hepatitis C in Chile during the period 2002-2023, characterizing morbidity, mortality, and reporting according to sociodemographic variables. Methodology: Descriptive study from 2002 to 2023 based on data from the Department of Health Statistics and Information of the Chilean Ministry of Health and the register of notifiable diseases. Notifications, hospital discharges, and deaths related to Hepatitis C Virus were analyzed by time, sex, age, and region. Result: Mortality peaked in 2014 and subsequently declined. Hospital discharges decreased to 700 cases between 2002 and 2021. Both acute and chronic notifications increased until 2011, followed by a decline. Discussion: The decrease in mortality and hospital discharge rates since 2014 may be attributed to improvements in prevention and control strategies. The initial increase in notifications may reflect the strengthening of epidemiological surveillance. Public health policies have been effective; however, there is a need to reinforce epidemiological control strategies. Conclusion: Chronic hepatitis C is not highly prevalent in Chile, but strengthening control strategies is essential to achieve the World Health Organization goal of eliminating viral hepatitis by 2030
Epidemiological analysis: Mortality in Chile from traffic accidents between 2002 and 2019
Introduction: Traffic accidents can be preventable and understandable. In Chile, they represent a serious public health issue, being an important cause of death and disability in our population. Objective: Describe the trend in the mortality rate from traffic accidents in Chile between 2002-2019 and compare mortality rates by sex and age group. Methodology: Retrospective longitudinal ecological and descriptive study, analyzing mortality data from traffic accidents between 2002 to 2019. Result: The crude mortality rate decreased by 16,1% in total, with men at higher risk of mortality compared to women always, although this difference narrowed through time. Regarding age group, mortality was highest among adults aged 75 and older, as well as among young people aged 15 to 24. Discussion: Despite the decrease in the mortality rate, traffic accidents remain a significant concern. Chile shows lower rates than the global average but higher than those of the Organization for Economic Co-operation and Development. Reckless driving is a determining factor in the occurrence of accidents. Conclusion: It is crucial to implement interventions in road safety to reduce deaths and their socioeconomic impact on the population.
Compliance of protein content in food products labeled as high protein, sold in retail stores of the Metropolitan Region, 2025
Introduction: First, the market for high-protein foods has grown significantly globally and nationally, making it necessary to verify compliance with the protein content declared on nutritional labels. Objective: To evaluate compliance with the declared protein content in foods labeled as high-protein and sold in retail stores in the Metropolitan Region, 2025. Methodology: A cross-sectional, descriptive study was conducted on 19 products selected using non-probability quota sampling. Protein content was determined using the Kjeldahl method. Differences between declared and determined protein were analyzed using the Wilcoxon signed-rank test (Alpha=0,05). Result: 89% of the products met the minimum tolerance established by the Food Sanitary Regulations (greater than or equal to 80%). However, the determined content was lower than the declared content in 89% of the products, with relative differences ranging from 3% to 44%. Statistically significant differences were observed in the milk (p=0,043) and cereal (p=0,010) categories. Discussion: Discrepancies between declared and measured protein content could be due to analytical variability, conversion factors, or labeling errors. Although the products comply with the Food Sanitary Regulations standard, the overestimation of protein content affects transparency and may mislead consumers with higher nutritional requirements. Conclusion: It is concluded that, although most products comply with current regulations, the actual protein content is consistently lower than declared, which may affect the transparency of nutritional information and consumer decision-making.