Teledermatology Evaluation and Feedback Systems: A Tool for Improving Care.

Chile is a country where teledermatology has been growing exponentially since the implementation of a single national asynchronous teledermatology platform for the public system in December 2018. To ensure the quality of care in teledermatology systems, it is crucial to evaluate the fulfillment of basic specifiers such as ICD-Diagnosis, therapeutic suggestions, and diagnostic suggestions, among others. This article aims to evaluate the teledermatology system of the Chilean public health service by analyzing 243 randomly extracted consultations, representative of the 20,716 electronic consultations performed during 2020. Compliance with basic specifiers is evaluated. From these, fulfillment of core teledermatology functions, such as diagnostic and therapeutic suggestions, is observed in most consultations. There are statistically significant relationships between the patient's destination (primary health center [PHC] or face-to-face referral), pharmacological prescription, coverage of the drug prescribed by the public system, and the education received by the consulting physician. If the consultation is resolved in the PHC, there is a higher chance for pharmacological prescription, prescribing mostly drugs that are covered by the government. This is less likely to occur when patients are referred for face-to-face evaluation. A targeted evaluation of education, pharmacological prescriptions, and their applicability is key to improving the quality of teledermatology systems.

[Cutaneous anthrax, the last outbreak diagnosed in Chile]. / Ántrax cutáneo, último brote diagnosticado en Chile.

Anthrax is a zoonosis caused by a spore-forming bacterium, called Bacillus anthracis. Naturally it is of global distribution, with a predilection in agricultural zones with few norms of public veterinary health. Human contagion occurs through the consumption of diseased animal's meat or through a doorway into the skin or through the spores inhalation of products derived from the affected animal (wool, leather, bones). The most frequent infection in humans occurs in the skin, followed by the gastrointestinal tract and lungs. We present the last outbreak of cutaneous anthrax diagnosed in Chile with a description of the first two clinical cases of the outbreak. Control disease is based on prevention, hence the importance of surveillance in detecting cases and outbreaks.

Descended mouth corner: an ignored but needed feature of facial rejuvenation.

For years, the gold standard in facial rejuvenation has been the face lift. However, exploring new, less complex procedures for achieving the same goal is currently drawing interest. Rejuvenation of the perioral area is a difficult task for plastic surgeons because of the minimal effect that face lift procedures have over this region and the lack of published material on the subject. In this article, the descended mouth corner anguloplasty technique is presented. It is a 20-minutes lift technique that can correct this typical feature of the ageing mouth. The authors have treated 71 patients using the technique with consistently good results, with just one requiring revision. They conclude that this procedure by itself and in combination with other small operations or even a full face lift can rejuvenate the ageing face.

Ántrax cutáneo, último brote diagnosticado en Chile / Cutaneous anthrax, the last outbreak diagnosed in Chile

Resumen El ántrax, es una zoonosis causada por una bacteria generadora de esporas, llamada Bacillus anthracis. En forma natural tiene una distribución global, con una predilección en zonas agrícolas con pocas normativas de sanidad pública veterinaria. El contagio humano ocurre por el consumo de carnes de animales enfermos, por contacto a través de una puerta de entrada en la piel o por la inhalación de esporas de productos derivados del animal afectado (lana, cuero, huesos). La infección en los seres humanos compromete con mayor frecuencia la piel, seguido por el tracto gastrointestinal y los pulmones. El control de la enfermedad se basa en la prevención, de allí la importancia de la vigilancia en la detección de casos y brotes. Presentamos el último brote de ántrax cutáneo diagnosticado en Chile con descripción de dos primeros casos clínicos del brote.

Anthrax is a zoonosis caused by a spore-forming bacterium, called Bacillus anthracis. Naturally it is of global distribution, with a predilection in agricultural zones with few norms of public veterinary health. Human contagion occurs through the consumption of diseased animal's meat or through a doorway into the skin or through the spores inhalation of products derived from the affected animal (wool, leather, bones). The most frequent infection in humans occurs in the skin, followed by the gastrointestinal tract and lungs. We present the last outbreak of cutaneous anthrax diagnosed in Chile with a description of the first two clinical cases of the outbreak. Control disease is based on prevention, hence the importance of surveillance in detecting cases and outbreaks.