Cuadernos Médico Sociales

SEMBLANZA (In Memoriam) DR. ALFREDO ESTRADA LARRAIN 1936-2025

Jaime Sepúlveda Salinas — Wed, 08 Oct 2025 00:00:00 +0000

Medical ethics and everyday ethics in dementia reflections and considerations for clinical practice

Andrea Slachevsky, Timothy Daly, Javier Moreno, Rodrigo Salinas — Wed, 08 Oct 2025 00:00:00 +0000

Dementias are responsible for a significant proportion of the population's disease burden. The characteristic cognitive decline poses ethical challenges in their care that must be addressed prudently. The most relevant effect is the progressive loss of autonomy, raising questions about how best to proceed, from the moment of communicating the diagnosis to obtaining informed consent for therapy, while balancing respect for their dignity and the beneficence sought. This article discusses the ethical dilemmas affecting people with dementia's daily lives and civic participation.

Primary Health Care in Chile: a reinterpretation from the porosity of living bodies

Reinaldo Bustos Domínguez — Wed, 08 Oct 2025 00:00:00 +0000

This article offers a critical and constructive analysis of the main contemporary approaches to Universal Primary Health Care (U-PHC) in Chile, based on a review of contributions published in volume 65(1) of Cuadernos Médico Sociales. It identifies points of convergence and tension among institutionalist perspectives, structural critiques, and clinical-operational approaches. In response to these frameworks, we present the “porous body” proposal—also published in the same volume—as an ontological, epistemological, and political alternative that redefines PHC as a relational, territorial, and democratizing practice of care. The concept of porosity enables a transcendence of the traditional biomedical model, challenges institutional verticality, and promotes a care ecology grounded in interdependence and embodied justice. The article argues that a PHC model informed by this perspective is better equipped to address current challenges in Chile's health system in a more holistic, participatory, and equitable manner.

Ecopoiesis and aging

Wed, 08 Oct 2025 00:00:00 +0000

This article offers a reconceptualization of aging as a relationally configured phenomenon, shaped by epigenetic, social, and symbolic processes. The objective is to analyze how neoliberalism, by dismantling community ties, undermines the biological and emotional viability of older adults. A transdisciplinary hermeneutic methodology was used, combining theoretical review, epigenetic integration, and third-order cybernetic analysis. Results indicate that chronic structural stress in neoliberal environments alters DNA methylation, accelerates aging, and causes eco-relational deregulation. Aging is thus reframed as a degenerative spiral marked by the loss of ecostasis and meaning. It is concluded that aging under neoliberalism entails not only functional decline but also a collapse of the vital bonds that sustain life. A care policy grounded in ecopoiesis, epigenetic justice, and community restoration is proposed.

Situation and analysis of hospital beds in Chile

Dagoberto Duarte Quapper — Wed, 08 Oct 2025 00:00:00 +0000

This article presents the current situation of public and private hospital beds in Chile, with a brief analysis of their functioning, focusing specifically on their productivity. A historical account of the availability of public and private beds from 1978 to 2023 is provided. The figures used come mostly from MINSAL records, and in some cases other sources, such as the Clínicas de Chile association, were considered. The study of hospital bed functioning is based on the Occupational Index (OI) for two selected years. The most relevant results show the shortage of hospital beds according to international parameters (OECD). The conversion of hospital beds, particularly in the public sector, is also shown. The study of hospital bed productivity shows that this shortage is most critical in those that, in our judgment, are most necessary to resolve the waiting list. Some alternatives to address this situation are discussed. The need to incorporate this element into the discussion about public sector productivity and the need to improve the quality of the information available at the official level are highlighted.

Health Geography: concepts, approaches, and opportunities for public health

Italo Lanio Hormazabal, Manuel Fuenzalida Díaz — Wed, 08 Oct 2025 00:00:00 +0000

Health geography has evolved from a biomedical perspective focused on the physical space of disease to a perspective that integrates social, economic, and territorial variables. This paper explores the theoretical and practical concepts and contributions of geography to public health, highlighting the role of territory as a structural determinant and describing specific applications. The potential of geographic information systems as a strategic tool for territorialized and equitable public health is specifically discussed. Geography offers a theoretical framework and methods that better address the social determinants and guide the design of interventions and public policies.

Towards the use of Critical Epidemiology in the territories

Mario Parada-Lezcano, Jaunita Fernández-Álamos — Wed, 08 Oct 2025 00:00:00 +0000

Traditional epidemiology studies disease risk factors at the individual level, while social epidemiology, which uses multilevel analysis, raises theoretical and methodological problems that remain to be resolved. Critical epidemiology is an alternative model of objectivity, necessary to position social class inequality within the construction of epidemiological studies. The objective of this article is to show, through a real experience—the 2022 health emergency due to contamination in the municipalities of Quintero and Puchuncaví—how to move beyond the use of traditional epidemiology, using social epidemiology, and advancing toward critical epidemiology.

Cuadernos Botánico Sociales. Editorial. Alianzas mínimas de lo Botánico con lo Social

Yuri Carvajal Bañados, Mirtha Parada Valderrama — Wed, 08 Oct 2025 00:00:00 +0000

Conociendo plantas y saberes en Altos de Cantillana

Mirtha Parada Valderrama — Wed, 08 Oct 2025 00:00:00 +0000

Se relata una salida de reconocimiento botánico, en la que participaron Yuri Carvajal, Maite Rodríguez y Mirtha Parada. Recorrimos un sendero que bordea el cordón montañoso de los Altos de Cantillana. Con la orientación del profesor y otros conocedores de la flora nativa, nos adentramos en un mundo de plantas, musgos, flores y árboles en su mayoría endémicos. Un mundo desconocido y al alcance de la mano que es importante saber de su existencia para valorar y preservar.

The use of medicinal plants in the Afro-Yapatera community of Piura: ancestral knowledge and biocultural heritage

Maite Rodríguez Díaz — Wed, 08 Oct 2025 00:00:00 +0000

Within the framework of the XIII Latin American Congress of Medicinal Plants (COLAPLAMED) recently held in the city of Chulucanas, province of Morropón, department of Piura, northern Peru, the Chilean delegation represented by professors and students from the Diego Portales University, University of Chile, Metropolitan Technological University and the Institute of Public Health (ISP), was invited by the president of the Yapatera Cultural House Association, Abelardo Alzamora Arévalo, to visit the medicinal garden and typical museum in the Yapatera community near the city of Chulucanas. The purpose of the visit was to share experiences regarding the recognition of the cultural legacy that is traditional medicine, the use of medicinal plants in the area and especially in the community's medicinal garden.

Historia ambiental del caribe: una alerta para nuestro sur sur

Cuadernos Botánico Sociales (CBS) — Wed, 08 Oct 2025 00:00:00 +0000

Oral and topical application of 2% cannabidiol in a cat with squamous cell carcinoma. Case Report

Sylvia Arrau Barra — Wed, 08 Oct 2025 00:00:00 +0000

We present the case of a cat with depigmented lesions on the face and auricles, diagnosed by biopsy with superficial squamous cell carcinoma. This neoplasia, common in felines, is associated with prolonged UV exposure and genetic factors. Surgical treatment is usually indicated in advanced cases, but carries risks in geriatric patients. In this case, multimodal therapy with meloxicam, gabapentin, and 2% cannabidiol (CBD) in oral and topical drops was chosen. In four months, complete resolution of the lesions was achieved without recurrence. The use of CBD is based on its antitumor, anti-inflammatory, and analgesic effects, with synergistic action with NSAIDs.

Nurses and cooperation: lessons learned between nature and society

Milen Duarte Muñoz — Wed, 08 Oct 2025 00:00:00 +0000

This paper aims to share similarities between plant-plant facilitation by nurses and social cooperation, through a review of specialized scientific and technical literature. Nurse plant facilitation is a positive interaction in which one species benefit another, potentially favoring the germination, establishment, and species richness of a community, especially in harsh environments. Similarly, in humans, wet nurse improves infant survival, while cooperation strengthens networks beneficial to society. Thus, facilitation, both ecological and social, generates favorable conditions for the long-term maintenance of communities and societies. This discussion sheds light on the development of both approaches, building bridges between ecological and social knowledge.

Museo de Historia Natural Río Seco

Yuri Carvajal Bañados — Wed, 08 Oct 2025 00:00:00 +0000

Calvino: los vegetales del Barón rampante

Yuri Carvajal Bañados — Wed, 08 Oct 2025 00:00:00 +0000

Editorial. La apropiación de la revista de parte de los equipos de salud

Jorge Lastra Torres — Wed, 08 Oct 2025 00:00:00 +0000

Revista de Libros y Revistas

Jorge Lastra Torres, Mario Parada-Lezcano — Wed, 08 Oct 2025 00:00:00 +0000

Narratives on the contributions of Health and Society I and II to medical practice

Wed, 08 Oct 2025 00:00:00 +0000

Introduction: Twelve cohorts have graduated from the School of Medicine – San Felipe Campus at the University of Valparaíso (UV). The aim of this study was to explore the contributions of the curricular seminars Health and Society I (HSI) and Health and Society II (HSII) to the development of the Graduate Profile between 2011 and 2021.

Methods: This is a qualitative study with a narrative design. Semi-structured individual and group interviews were conducted, supported by didactic materials that included the graduate profile, degree competencies, bachelor's competencies, and the UV institutional seal. The sampling was purposive, based on defined theoretical-conceptual criteria, allowing the participation of thirty-two graduates. The analysis plan followed thematic content analysis, linking various theoretical dimensions and applying technique triangulation.

Results: Graduates identified contributions from the HSI and HSII seminars in terms of Bachelor's Competencies, Degree Competencies, and UV Seal Competencies, and their connection to the School’s Graduate Profile. Community-based work with a health promotion and prevention approach emerged as the most meaningful and necessary learning experience to be developed across different levels of mastery.

Conclusions: It is necessary to strengthen the relationship between the pedagogical proposal and the content of other subjects, both horizontally and vertically, in a bidirectional manner with medical practice, interprofessional collaboration, and the networked work carried out by public health services in the Aconcagua Valley.

Environmental sentinel doctors in Chile: an opportunity to strengthen health, community, territory, and resilience

Wed, 08 Oct 2025 00:00:00 +0000

The relationship between environment and health has become increasingly evident in Chile due to climate change, pollution, vector-borne diseases, wildfires, and drought. The Chilean health model, based on Primary Care and with strong territorial roots, offers a unique opportunity to integrate environmental prevention into healthcare and community practice.

This article, the result of the Climate Change Conference organized by the Talcahuano Health Service (August 2025), analyzes the feasibility of implementing in Chile a network of Environmental Sentinel Physicians (ESP), inspired by international experiences such as the Italian Network (RIMSA). ESPs act as privileged observers of early warning signs of environmental risk and their effects on health, connecting clinical data with environmental and climate information.

Evidence is presented regarding the impact of climate change in Chile, the reemergence of arboviruses, climate migration, wildfires, and megadrought, and the strategic role of Primary Care in anticipating, communicating, and coordinating responses is discussed. Likewise, the importance of doctor–patient communication, community awareness, and institutional advocacy is highlighted in transforming knowledge into preventive action.

As an operational proposal, the creation of a National School of Environmental Sentinel Physicians, or alternatively, Sentinel Family Health Centers, is suggested, with three objectives: professional training, integrated surveillance under the One Health approach, and strengthening communication and health resilience. This initiative could position Chile as a regional leader in environmental health and climate change adaptation.

Invitación al II. Simposio en Chiloé. Identidad y Pertenencia Sociocultural Castro – 27-30 de noviembre de 2025

Cuadernos Médico Sociales — Wed, 08 Oct 2025 00:00:00 +0000

80 aniversario CESFAM Andes

Cuadernos Médico Sociales — Wed, 08 Oct 2025 00:00:00 +0000

Derechos humanos y medio ambiente: entrelazamientos al sur del antropoceno

Yuri Carvajal Bañados — Wed, 08 Oct 2025 00:00:00 +0000

Colmed Antofagasta en Gobierno Regional: el agua requiere de nuestros cuidados

Pamela Schellman J., Michel Marin E. — Wed, 08 Oct 2025 00:00:00 +0000

Ética y salud pública: al sur del antropoceno

Yuri Carvajal Bañados — Wed, 08 Oct 2025 00:00:00 +0000

Del cerebro a la máquina: similitudes, límites y la búsqueda de la plasticidad

Javier Bascuñán Ahumada, César Jara Vargas — Wed, 08 Oct 2025 00:00:00 +0000