Consecuencias de la fluoración del agua potable en la salud humana / The impact of tap water fluoridation on human health

The purpose of this review is to describe the osteological, neurological, endocrine and dermatological effects of fluoride ingestion. Additional aims are to evaluate whether the Chilean tap water fluoridation program has had any impact on dental health, and analyze the basis for the Chilean elementary school milk fluoridation program, which is targeted at children living in places where tap water has a fluoride concentration less than 0.3 mg/L, without any artificial fluoridation process. We discuss the finding that both public measures have no direct or remarkable effect on dental health, since topical dental hygiene products are the main and most effective contributors to the prevention of dental decay. We also suggest that the permanent and systematic ingestion of fluorides imposes health risks on the population. Therefore, we recommend reevaluating the national fluoridation program for public tap water and the elementary school milk program.

Oculo-peritoneal shunt: draining aqueous humor to the peritoneum / Derivação óculo-peritoneal: drenagem do humor aquoso para o peritônio

In 2010, there were estimated to be approximately 60.5 million people with glaucoma. This number is expected to increase to 79.6 million by 2020. In 2010, there were 8.4 million people with bilateral blindness caused by glaucoma, and this number is expected in increase to 11.2 million by 2020. Filtering implants are special devices that have been developed to reduce intraocular pressure in patients with refractory glaucoma. The success rate of these implants is relatively low, and they continue to fail over time. To avoid failure caused by the formation of scar tissue around the implants, attempts have been made to drain the aqueous humor to various sites, including the venous system, lacrimal sac, sinuses, and conjunctival fornix. Recently, a system to shunt aqueous humor from the anterior chamber to the peritoneum has been developed. The surgical technique involved in this system is a modification of the technique currently used by neurosurgeons for the treatment of hydrocephalus. We present the first case operated using this technique.

Calcula-se que em 2010 havia provavelmente 60,5 milhões de pessoas com glaucoma, com aumento previsto para 79,6 milhões em 2020; a cegueira bilateral por glaucoma era detectada em 8,4 milhões de pessoas, em 2010, e com aumento estimado para 11,2 milhões em 2020. Dispositivos especiais foram desenvolvidos para reduzir a pressão intraocular em pacientes com glaucoma refratário, chamados implantes de filtragem. A taxa de sucesso destes implantes é relativamente baixa, e sabe-se que elas continuam a diminuir ao longo do tempo. Para evitar as falhas produzidas pela cicatrização de tecido em torno dos implantes, foram feitas tentativas de drenagem do humor aquoso para diferentes locais, tais como o sistema venoso, saco lacrimal, os seios paranasais e fórnice conjuntival. Revendo o tratamento atual da hidrocefalia, uma técnica de derivação a partir da câmara anterior para o peritônio foi desenvolvida. A técnica cirúrgica desenvolvida é uma modificação da técnica atualmente utilizada por neurocirurgiões para o tratamento de hidrocefalia. Apresentamos o primeiro caso operado com esta técnica.

Propuesta de políticas públicas que relacionen el ambiente como determinante del estado de salud poblacional e individual: resumen ejecutivo de propuestas para los candidatos a la presidencia de la república y al parlamento / Public politics proposal considering environment as population and individual health determinant executive summary of proposals to the candidates to the republic presidency and parliament

El Departamento de Medio Ambiente del Colegio Médico de Chile ha concordado una serie de medidas que a su juicio deben ser implementadas por las nuevas autoridades políticas de Chile elegidas, con el fi n de corregir aquellos problemas ambientales que son determinantes de salud poblacional e individual. La implementación de estas medidas deberá impactar positivamente en la salud y calidad de vida de los habitantes de Chile, disminuir la mortalidad aguda y o diferida causada por exposición a diversos contaminantes ambientales. En especial, deberá afectar positivamente a las futuras generaciones al disminuir la exposición prenatal o infantil temprana a agentes que determinan el desarrollo de enfermedades o cambios conductuales más tarde en la vida. Estas proposiciones fueron entregadas a todos los candidatos presidenciales y explicadas en reuniones con cada uno de los 4 candidatos presidenciales que tienen las mejores opciones de de ser electos, de acuerdo a encuestas realizadas en el país.

The Environment Department of the Colegio Médico de Chile (Chilean College of Physicians) agreed a series of measures that should be implemented by the new elected Chilean political authorities, with the purpose of correction the environmental problems which are population and individual health determinants. The implementation of these measures should positively impact Chilean population health and quality of life and decrease acute or delayed mortality caused by exposure to various pollutants. Especially, it should positively affect future generations preventing prenatal or infant exposure to agents determining the development of diseases or behavioural changes later in life. These proposals were delivered to all presidential candidates, and explained in meetings with each of the four presidential candidates with the best perspectives to be elected, according to opinion polls carried out in the country.