The frequency of dietary references in homeopathic consultations.

A retrospective quantitative study on dietary references found in medical records of 2753 patients attending consultations from 10/1/1994 to 5/31/2007 was conducted. The symptoms found in the rubrics relating to food and drink aggravation and amelioration, aversion and craving of homeopathic repertories reflect diets at different places and times and do not correspond fully, to contemporary gastronomy. Desires for sweet and spicy foods were statistically more frequent, revealing the prevailing taste for such food among the studied population. Food cravings should be carefully analyzed before considering them as indications for choosing homeopathic therapy, they are less significant than aversions, aggravations and ameliorations.

Do you consider complementary and alternative medicine in your medical history review?

Complementary and alternative medicine (CAM) represents a group of diverse medical and health care systems, practices, and products that are not considered to be part of conventional medicine. Nevertheless, 83 million adults and 8.5 million children used these products and services in 2007 alone, spending almost $34 billion out-of-pocket for many products that have not been proven and, in fact, may be contraindicated. A review is used to raise awareness and concern among dental practitioners as they consider new and current patient medical histories.

How do parents of child patients compare consultations with homeopaths and physicians? A qualitative study.

OBJECTIVE: How do parents of child patients experience and compare consultations with homeopaths and physicians, and how do they describe an ideal consultation. METHODS: A qualitative study with interviews of parents to 16 children who had consulted both a homeopaths and a physicians. RESULTS: Comparing consultations with physicians and homeopaths, the parents experienced the homeopathic consultations to a greater extent to have a whole person approach, also described as a core factor in an ideal consultation. This approach included exhaustive questioning, longer consultations, more interaction with the child and looking for the underlying cause. CONCLUSION: The parents in this study perceived that the homeopathic consultation had a whole person approach while consultations with most physicians focused on the symptoms. The homeopathic consultation was said to be more in line with what the parents perceived to be an ideal consultation for their children than consultation with physicians. PRACTICE IMPLICATIONS: Treatment philosophy and the aim of the consultation are likely to play a larger part than the technical aspects in determining the form and content of a consultation. Training in communication could benefit from including discussions on how the practitioner's treatment philosophy influences the consultation behavior.

Etiopatogenia de las uñas frágiles / Etiopathogenesis of brittle nails

Las uñas frágiles se caracterizan por ser quebradizas, de superficie áspera y descamativa, es una entidad que predomina en mujeres y afecta principalmente las uñas de las manos. En condiciones normales las uñas estás compuestas por agua, cuya concentración oscila entre 7 % al 18 %, lípidos entre 0,1 % y 5%, siendo el colesterol su principal componente, además están compuesta por células queratinizadas sin descamación, dando origen a tres capas histológicas llamadas dorsal, media y ventral. Estas también contienen trazas de elementos como hierro y zinc. La alteración y disminución de estos componentes favorecen está condición. La causa puede ser idiopática o secundaria a enfermedades sistémicas, pueden estar presentes en algunas patologías dermatológicas. Una correcta anamnesis e historia clínica son necesarias para un correcto abordaje terapéutico. Su implicación cosmética nos obliga a tener un conocimiento claro de su etiopatogenia para así poder establecer un tratamiento efectivo y oportuno(AU)

Brittle nails are characterized by being brittle, witha rough and scaly surface, it is an entity that predominates inwomen and mainly affects the fingernails. In normal conditions the nails are made up of water, whose concentration ranges from7% to 18%, lipids between 0.1% and 5%, with cholesterol beingits main component, they are also composed of keratinized cellswithout desquamation, giving rise to three histological layerscalled dorsal, middle and ventral. These also contain traces ofelements such as iron, and zinc. The alteration and decreaseof these components favor this condition. Yhe cause may beidiopathic or secondary to systemic diseases, they may be presentin some dermatological pathologies. A correct anamnesis andmedical history are necessary for a correct therapeutic approach.Its cosmetic involvement forces us to have a clear understandingof its pathogenesis in order to establish an effective and timelytreatment(AU)

Estudio Retrospectivo de Fisuras Labio-Máxilo-Palatina en Chile, 12 Años de Seguimiento / Retrospective Study of Cleft Lip and Palate in Chile, 12-Year Follow Up

Describir el perfil epidemiológico de los pacientes con FLMP no sindrómica de acuerdo a los factores que involucran a la madre. Estudio de tipo observacional, retrospectivo y analítico a partir de los datos de los casos de FLMP no sindrómicos. Se clasifico el tipo de FLMP y las variables que involucran a la madre. Fueron evaluadas 236 fichas completas de pacientes. Un 56,60 % pertenecen al sexo masculino y 43,40 % al sexo femenino. El mayor porcentaje nació el año 2011 (15,57 %), la FLP es la más prevalente (44,92 %), el 26,67 % de las madres tenía entre 21-25 años al momento del parto, un 80,50 % y 87,50 % consumió alcohol y tabaco respectivamente durante primer trimestre del embarazo, y un 41,33 % se desempeñó en rubro agrícola. Pueden ser considerados como factores de riesgo durante el embarazo: estrés post catástrofe natural, enfermedades crónicas, consumo de fármaco, hábito tabáquico y alcohólico y exposición a pesticidas.

The objective of the study was to describe the epidemiologic profile of patients with non-syndromic cleft palate according to factors that involve the mother. Observational, retrospective and analytical study from data obtained of non-syndromic cleft lip palate cases. The type of cleft lip and palate (CLP) and the variables that involve the mother were classified. In this analysis 236 fulfilled clinical records from patients were evaluated; 56,60 % correspond to male and 43,40 % to female. Most births occurred in 2011 (15,57%), cleft palate is the most prevalent (44,92 %), at the moment of birth mothers were 21-25 years old (26,67 %), most of the mothers consumed alcohol or tobacco during the first trimester of pregnancy (80,50 % and 87,50 %, respectively), and 41,33% worked in agriculture related jobs. In conclusion post natural catastrophe stress, chronic diseases, consumption of drugs, smoking and alcohol habits and exposure to pesticides can be considered as a risk factor for having a child with CLP.

Clinical rounds in the well-baby nursery: treating jaundiced newborns.

Ten pearls (and pitfalls) in the management of the jaundiced newborn: Remember to take a history. Ask about jaundice in previous siblings and check family ethnicity. Don't ignore jaundice in the first 24 hours--it is considered pathologic until proven otherwise. Some normal infants may appear jaundiced and have a bilirubin level of 5 mg/dL at 23 hours and 59 minutes. On the other hand, a bilirubin level of 5 mg/dL at 10 hours is almost certainly pathologic. Use your judgment. Don't treat 35 to 37 week gestation infants as if they were full-term infants. Although these babies are cared for in well-baby nurseries and are generally treated like full-term infants, they are not full term. They are not as vigorous and do not nurse as well as full-term infants. Infants at 37 weeks gestation are four times more likely to have a serum bilirubin level greater than 13 mg/dL than those at 40 weeks gestation. Don't send 35-week gestation infants home before 48 hours. Document your assessment, particularly if the infant is being discharged early. Document the presence or absence of jaundice and its severity. A late rising bilirubin is typical of G6PD deficiency. Think about the ethnic background: G6PD deficiency is much more likely to occur in families from Greece, Turkey, Sardinia, and Nigeria, and particularly in Sephardic Jews from Iraq, Iran, Syria, and Kurdistan. Your practice may not contain many such families but remember in today's world of travel and intermarriage, etc, these genes are ubiquitous and the diagnosis of G6PD deficiency should always be considered in a newborn child with a significant elevation of bilirubin, particularly if it is a male and the rise in bilirubin is of late onset. Don't use homeopathic doses of phototherapy. As with any drug, phototherapy should be provided in a therapeutic dose (see above), but with the light sources commonly used, it is impossible to overdose the patient. Don't ignore a failure of response to phototherapy. If the bilirubin rises despite adequate phototherapy, there must be a reason. Consider the possibility of an unrecognized hemolytic process. Provide timely follow-up. Infants discharged (as most are) before 48 hours should be seen by a health-care professional within 2 to 3 days of discharge. Don't ignore prolonged jaundice. About one in three normal breast-fed infants still will be clinically jaundiced when they are 2 weeks old (two thirds will be biochemically jaundiced). These infants all have indirect hyperbilirubinemia. Occasionally, however, an infant with prolonged jaundice has direct hyperbilirubinemia. In these infants, the diagnosis of biliary atresia or some other cause of cholestatic jaundice must be considered. If the infant is clinically jaundiced beyond age 2 weeks, you should: 1) check the newborn record to make sure that the metabolic screen for hypothyroidism is normal (congenital hypothyroidism is a cause of indirect hyperbilirubinemia), and 2) ask the mother about the color of the urine and stool. If the baby's stools are pale or the urine is dark yellow, you must get a direct bilirubin to rule out cholestasis. If there is direct hyperbilirubinemia, a urine dipstick will identify the presence of bile (bilirubin). If the color of the urine and stool are normal (by history), it is reasonable to follow the child for another week. However, any infant who is still jaundiced beyond age 3 weeks must have a measurement of direct bilirubin. Don't ignore severe jaundice. If the bilirubin is sufficiently elevated, kernicterus can occur in a healthy, breast-fed infant.

The Constitutional Type Questionnaire: validation in the patient population of the Royal London Homoeopathic Hospital.

In homeopathy the choice of a medicine is based on the total 'picture' presented by the patient. This picture includes 'constitutional type' which comprises personality, and general physical features. The Constitutional Type Questionnaire (CTQ) is designed to systematically assess constitutional types. This study examines the reliability and validity of the CTQ. Four hundred and seventy-two outpatients attending clinics at the Royal London Homoeopathic Hospital completed the CTQ, a 152-item scale rating features traditionally considered typical of 19 constitutional homeopathic medicine 'pictures' on 5-point frequency or severity scales. A subsample was retested after 1 week to measure the test-retest reliability. Another subsample was prescribed a medicine by a homeopathic doctor. Prescriptions were compared with the CTQ, to assess the content validity of the scale. The construct validity was measured by Grade of Membership (GOM) analysis. The scale demonstrated good test-retest reliability (r=0.73), internal consistency (r=0.95). The correlation between CTQ results and the medicine prescribed by the homeopathic doctor was 75.8%. The GOM analyses are reported by Davidson et al elsewhere in this issue of the journal. Although the CTQ could be improved, the scale displays good reliability and validity.

Evaluación del riesgo de la caries dental como un proceso infeccioso: propuesta de un modelo para historia clínica / Evaluation of the dental caries risk as an infectious process. Proposal of a model for the clinical record

En éste artículo se hace un llamado al profesional de la odontología a generar cambios conductuales (tanto diagnósticos como terapéuticos) en cuanto al manejo de la caries dental, bajo el entendido de la misma como un proceso infeccioso que debe atacarse antes de que se produzcan las manifestaciones clínicas. El objetivo de este artículo, es presentar una herramienta guía consistente en una historia clínica, expresamente diseñada para detectar el riesgo de la caries

Importância pericial dos registros odontológicos decorrentes de tratamento restaurador / Forensic relevance of dental records obtained from the restorative treatment

Durante a execução dos diversos tipos de tratamentos odontológicos, o cirurgião-dentista tem a necessidade e obrigação de registrar adequadamente, no prontuário odontológico, todos os procedimentos realizados na cavidade bucal, além das particularidades que o paciente já apresenta. A importância destes registros está relacionada a uma finalidade primordialmente clínica, visando propiciar o acompanhamento adequado dos tratamentos efetuados, a qualquer tempo. Entretanto, esta mesma documentação pode subsidiar relevantemente nos casos de identificação humana, principalmente nas situações em que os cadáveres encontram-se irreconhecíveis. Neste contexto, o presente trabalho tem como objetivo relatar um caso pericial em que um indivíduo encontrado carbonizado, em decorrência de acidente automobilístico seguido de incêndio, foi positivamente identificado com base nas anotações clínicas referentes à realização de um tratamento odontológico restaurador. A adequada qualidade dos registros odontológicos associada à resistência dos dentes remanescentes à ação do fogo permitiram que diversas particularidades odontológicas fossem identificadas, associando a pessoa desaparecida ao corpo carbonizado. Portanto, ressalta-se a importância dos registros odontológicos nos casos de identificação humana, evidenciando a necessidade do cirurgião-dentista atuar junto dos Institutos Médico-Legais, colaborando para esclarecimentos à justiça.

Ficha de exame clínico odontológico para pacientes em idade avançada / Dental clinical examination form for geriatric patients

Na literatura especializada são poucas as citações de fichas para exame clínico odontológico para utilização específica no atendimento à população em idade avançada. O objetivo deste estudo é sugerir uma ficha clínica odontológica que principalmente sirva como protocolo para os profissionais que atuam diretamente com aquele segmento da população. A seqüência protocolar, extraída de diferentes fontes, tem a intenção de sistematizar a anamnese, com o sumário da história médico-odontológica do paciente, a utilização do miniexame do estado mental, a escala de depressão geriátrica (GDS), auferição da pressão arterial, dosagem de glicose e freqüência cardíaca, a avaliação da necessidade de profilaxia antibiótica, classificação do estado físico (ASA), considerações sobre o cuidado prévio ao atendimento, exame clínico, plano de tratamento geral e o consentimento de tratamento fornecido pelo paciente ou responsável. Esta ficha servirá aos profissionais que atuam tanto no ambiente hospitalar ou domiciliar, como em consultório privado ou público. A proposta também serve como instrumento pedagógico para utilização em clínicas de Odontogeriatria para ensino de graduação e pós-graduação.

Semiotécnicas aplicadas en la práctica odontológica. Investigación documental / Semi-techniques applied in dental practice. Documentary research

La presente investigación documental denominada "Semiotécnicas aplicadas en la práctica odontológica" tiene como finalidad revisar las técnicas semiológicas que pueden ser aplicadas en la profesión odontológica, así también dar a conocer algunos aspectos como el ético, social, cultural, etc., que entran en juego en la relación odontólogo-paciente; de igual manera se estudiaron algunos exámenes complementarios como por ejemplo: exámenes de laboratorio y técnicas radiográficas, que contribuyen a realizar un diagnóstico certero. Para llevar a cabo esta investigación documental se recopilo información sobre el tema consultando libros, revistas, páginas de Internet, folletos, etc.; y reclasificando la información de acuerdo al tema en estudio. Concluyendo las semiotécnicas que se aplican en la práctica odontológica deben ser siempre complementadas con una adecuada anamnesis y exámenes de laboratorio y radiográficos complementarios para realizar un buen diagnóstico y dar un tratamiento integral al paciente.

The present documentary research called "Semiotechnics applied in dental practice" aims to review the semiological techniques that can be applied in the dental profession, as well as to make known some aspects such as ethical, social, cultural, etc., that enter into play in the dentist-patient relationship; in the same way, some complementary tests were studied, such as: laboratory tests and radiographic techniques, which contribute to making an accurate diagnosis. To carry out this documentary research, information on the subject was collected by consulting books, magazines, Internet pages, brochures, etc .; and reclassifying the information according to the subject under study. Concluding the semi-techniques that are applied in dental practice, they must always be complemented with an adequate anamnesis and complementary laboratory and radiographic examinations to make a good diagnosis and give a comprehensive treatment to the patient.

L'interrogatoire dans une consultation d'allergologie / Anamnesis in an allergy and immunology consultation

L'interrogatoire, dans une consultation d'allergologie reste un des moments cles de la consultation. Il constitue l'element essentiel d'orientation vers un mecanisme allergique, et, plus qu'une veritable enquete policiere, el se doit de creer le climat de confiance necessaire a l'etablissement du traitement le mieux adapte au patient, qu'il soir allopathique ou homeopathique.(AU)

Avaliação do preenchimento das fichas de exame clínico usadas nas Disciplinas de Odontologia comparando-as com as da Disciplina de Clínica Integrada (Ficha nova-UNIP) / Evaluation of the filing-out of clinical examination forms used during dentistry classes as compared to a newly proposed form used during integrated practice classes giving at Paulista University (UNIP)

Avaliação quantitativa e qualificativa da ficha clínica das Disciplinas, usadas na clínica odontológica, comparando-as com uma nova, elaborada pela disciplina de Clínica Integrada. A deficiência desse preenchimento envolve o acadêmico e o docente, mostrando a necessidade de uma reciclagem periódica e uma melhor qualificação do docente

Estudio clínico inicial: primera entrevista / Initial clinical study: first interview

La primera entrevista del estudio clínico inicial (ECI) comienza una importane relación interpersonal. Su objetivo consiste en formular simultáneamente un diagnóstico, un pronóstico y un plan de tratamiento. El (la) entrevistador/a definirá y mantendrá el encuadre, con posibilidad de atender oportunamente cualquier urgencia. Antes de concluirla solicitará exámenes de laboratorio, interconsultas y otras medidas complementarias. Al terminar concertará una segunda entrevista, la que suele concluir con una devolución