Scielo RSS <![CDATA[Revista médica de Chile]]> https://scielo.conicyt.cl/rss.php?pid=0034-988720120003&lang= vol. 140 num. 3 lang. <![CDATA[SciELO Logo]]> https://scielo.conicyt.cl/img/en/fbpelogp.gif https://scielo.conicyt.cl <![CDATA[<strong>A screening program for colorectal cancer in Chilean subjects aged fifty years or more</strong>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872012000300001&lng=&nrm=iso&tlng= Background: Mortality from colorectal cancer (CCR) in Chile has nearly doubled over the past 15 years. International studies have shown that CCR screening programs based on fecal occult blood test (FOBT) reduce CCR mortality. Aim: To analyze the results from a CCR screening model in people over 50 years. Material and Methods: Between 2007 and 2009, a prospective multicenter study was performed in seven major Chilean cities. FOBT using an immunological method, was measured in asymptomatic subjects aged 50 years or more, without risk factors. In patients with a positive FOBT, with symptoms or with family risk factors, a colonoscopy was indicated. Results: A total of 6348 subjects were assessed, FOBT was performed in 4938 of them, with a compliance of 77%. The result was positive in 9.6%. A total of 2359 colonoscopies were ordered, with an overall compliance of 50.1%. Of the 1184 colonoscopies performed, adenomas and high risk adenomas were found in 304 (26%) and 75 (6%) patients, respectively. Thirteen patients were diagnosed with stage I and IICCR. Three of these lesions were excised endoscopically and 10 surgically. The detection rate of polyps, high risk adenomas and cancer was 75, 12 and 2 per 1000 screened individuals, respectively. Conclusions: This program allowed the early detection of an important number of high risk colon lesions, and all patients with CCR were diagnosed at early stages. <![CDATA[<strong>Frequency of chronic kidney disease among ambulatory patients with type 2 diabetes</strong>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872012000300002&lng=&nrm=iso&tlng= Background: Type 2 diabetes mellitus is the main cause of chronic kidney disease in developed countries. Aim: To study the prevalence of chronic kidney disease among adults with diabetes mellitus attended at a public primary health care clinic in southern Chile. Material and Methods: One hundred patients with type 2 diabetes mellitus, aged more than 15 years participated in this cross sectional study. Chronic kidney disease was defined as the presence of a urine albumin/creatinine ratio over 30 mg/g or an estimated glomerular filtration rate of less than 60 mL/min/1,73 m², detected in at least two opportunities, separated at least by three months. Results: Thirty four percent of participants had chronic kidney disease (17% stage 1 or 2 and 17% stage 3). Thirty percent of participants had an abnormal urinary albumin/creatinine ratio. Halfof the patients with an estimated glomerular filtration rate below 60 mL/min/1,73 m², had a normal urinary albumin/creatinine ratio. Conclusions: The rates of chronic kidney disease in this group of diabetic patients are very similar to those reported elsewhere. <![CDATA[<strong>Causes of death with a functioning graft among kidney allograft recipients</strong>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872012000300003&lng=&nrm=iso&tlng= Background: Death with a functioning graft (DWGF) is now one of the main causes of renal transplant (RTx) loss. Aim: To determine whether the causes of DWGF, characteristics of donors and recipients and complications of RTx have changed in the last two decades. Subjects and Methods: Cooperative study of a cohort of 418 kidney grafts performed between 1968 and 2010. Patients were divided into two groups according to whether their kidney transplants were performed between 1968 and 1992 (Group 1) or 1993 and 2010 (Group 2). Results: Sixty eight patients experienced DWGF. Infections were the leading cause of DWGF in both groups (38 and 41%, respectively), followed by cardiovascular diseases (24 and 23% respectively), gastrointestinal disorders (21 and 26% respectively) and cancer (17 and 10% respectively). There were no significant differences in causes of death between the two groups according to the time elapsed since the renal transplantation. In patients in Group 1, the interval between diagnosis of renal failure and dialysis (HD) and the interval between the start of HD and kidney transplantation were significantly lower than in Group 2. The former had also an increased number of acute rejections in the first five years of kidney transplantation (p < 0.001). In Group 2, patients more often received their kidneys from deceased donors, had previous kidney transplantation, higher rate of antibodies to a panel of lymphocytes and an increased incidence of cardiovascular disorders after five years of RTx. Conclusions: The proportion of graft loss due to DWGF has increased over the last 2 decades, but its causes have not changed significantly. Infections are the most common causes of DWGF followed by cardiovascular and digestive diseases. <![CDATA[<strong>Changes in processed food expenditure in the population of Metropolitan Santiago in the last twenty years</strong>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872012000300004&lng=&nrm=iso&tlng= Background: During recent decades household incomes have increased steadily, leading to changes in dietary habits and food expenditure. Aim: To report changes in household food expenditure focusing on trends in processed food across income quintiles in Metropolitan Santiago. Material and Methods: Information obtained from the Fourth (1986-1987), Fifth (1996-1997) and Sixth National Institute of Statistics (INE) Surveys (2006-2007) were used. Food expenditure data over the study periods was extracted from household expenditure surveys (HES) after verifying and adjusting food prices registered by the INE to current 2007prices. Results: Absolute food expenditure over the study period increased for all groups; the largest increase was found in lowest income quintiles; however, the proportion of total family budget spent on food decreased in all groups. The largest increases in food expenditure corresponded to sweetened beverages, processed fruit juices, alcoholic drinks, ready meals and "eating out". Expenditure on fish rose slightly whereas the absolute spending on legumes, eggs and oils decreased. Expenditure in processed food as percentage of total food expenditure increased from 42% to 57% of total for mean household. For the 2nd quintile it rose from 31% to 48% and for the lowest quintile increased from 53% to 68% over the three decades (1987-2007). Changes were greatest in energy rich processed foods such as bread, pastries, confectioneries and granulated sugar. These particular foods are of high energy density and contain high amounts of saturated fat, sodium and added sugars. Conclusions: These results confirm that food consumption patterns over the past decades have progressively departed from the recommended dietary guidelines given by national and international health organizations. <![CDATA[<strong>Characterization of paracetamol overdose</strong>: Report of a poison information center in Chile]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872012000300005&lng=&nrm=iso&tlng= Background: Paracetamol (acetaminophen) is an analgesic and antipyretic drug widely used across the world. Its ingestion is one of the most common causes of drug overdose. In the United States is the first cause of acute hepatitis in adults. Aim: To describe the epidemiological profile of paracetamol overdose in Chile. Material and Methods: Cross sectional retrospective study that included all the phone call inquiries received at the Poison Control Center of the Pontificia Universidad Catolica de Chile (CITUC) during 2009. Results: Nine hundred fifty nine inquiries involving acute paracetamol exposures were received. Women represented a 63.1% of the cases. Half of the cases were suicide attempts, of which 74.8% were women. Accidental exposures occurred mainly in children. In 29.3% of the patients, the exposure was considered to involve a hepatotoxic dose. Women had 2.7 times the risk of men to ingest a toxic dose of paracetamol with suicidal purpose (Odds ratio (OR) = 2.7; 95% confidence interval (Cl): 2.1-3.6; p < 0.001). Adolescents had 3.4 times the risk of the general consultants (OR: 3.4; 95% Cl: 2.4-4.7; p < 0.001). Conclusions: Paracetamol overdose is common in Chile. Authorities should carry out preventive measures. Antidotes and the capacity to measure plasma levels of paracetamol should be available in healthcare centers. <![CDATA[<strong>Unpredicted pregnancy among Chilean young women</strong>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872012000300006&lng=&nrm=iso&tlng= Background: Unpredictedpregnancy is an evolution of the concepts undesired and unplanned pregnancy. It is more common among vulnerable strata of our society and related to lack of education. Aim: To explore the prevalence and social concomitants of unpredicted pregnancy among young women. Material and Methods: Analysis of the databases of the Sixth National Youth Survey carried out by the Instituto Nacional de la Juventud in Chile during 2009. The universe corresponds to 7570 participants aged between 15 and 29 years, of both genders. Results: Unpredicted pregnancy occurred in 43% of sexually active surveyed women. It was more common among women with a lower educational level and those aged 15 to 24 years, especially during the onset of active sexual life. There was also an inverse relationship between the degree of education, the use of contraception and the age when sexual activity starts. Conclusions: Unpredicted pregnancy is frequent among teenagers and more common among less educated individuals. The frequency of use of contraception is associated in greater measure to the degree of education rather than the age of onset of sexual activity. <![CDATA[<strong>Commitment and development of competences in clinical research in residency training programs in Chile</strong>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872012000300007&lng=&nrm=iso&tlng= Background: In Chile, residency training programs (RTP) take place in a stimulating academic environment for the promotion of clinical research skills. However, research is not a frequent curricular outcome. Accreditation of these programs by the National Accreditation Commission is an opportunity to improve the trainee's research competences. Aim: To analyze in the RTP curricula, the explicit intention to carry out clinical research and its correlation with the scientific productivity of professors and residents. Material and Methods: Fifty six training study programs corresponding to six primary specialties and six derived specialties, offered by seven universities holding accreditation tenure for RTP from the Chilean Association of Medicine Faculties (ASOFAMECH) up to 2005, were analyzed. The analysis included each academic program, courses and/or rotations and professors and residents' productivity, measured as publications accredited in the Institute for Scientific Information (ISI), between 1999 and 2007. Results: RTP are based on a tutorial educational model, where the close relationship between professors and residents is essential for the expected final outcome. Simultaneously, the programs' curricula revealed a high intentionality towards clinical research. However, professors' publications of ISI indexed articles showed a low and irregular scientific productivity. Conclusions: The gap between the declared training in clinical research and the effective ISI productivity is an awareness call with respect to the contribution that RTP could provide to accreditation, to professors and residents, and in general to health improvement in the country. <![CDATA[<strong>Risk factors for metabolic syndrome in a case control study in Temuco, Chile</strong>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872012000300008&lng=&nrm=iso&tlng= Background: Metabolic syndrome is becoming an important public health problem in affluent societies. Aim: To identify factors associated to metabolic syndrome in a Southern Chilean city. Material and methods: Using a case control design, 200 participants, aged 35 to 70 years with at least three criteria for metabolic syndrome according to the National Cholesterol Education Program (NCEP_ATPIII) and 200 subjects with less than three criteria, were studied. Both groups were compared in terms of ethnic background, educational level, family history of diabetes and coronary artery disease, menopausal status, smoking, stress and depression, physical activity, changes in body mass index in the last five years and diet. Results: Among subjects aged more than 54 years, among males and among overweight individuals, having a Mapuche origin was a risk factor with odds ratios (OR) of 7.2; 88 and 3.9 respectively. Among subjects aged more than 54 years, among women and among overweight individuals, a family history of diabetes was a risk factor with OR of 17.7; 3.2 and 3.9 respectively. Among subjects aged more than 54 years and among women a change in body mass index of more than three points was a risk factor with OR of 12.5 and 7.4, respectively. Depression also was a risk factor among subjects aged more than 54 years (OR 3.3). Regular consumption of wine was a protective factor among participants of more than 54 years, with an OR of 0.17. Conclusions: The risk factors for metabolic syndrome detected in this group of participants, were having a Mapuche origin, a family history of diabetes mellitus and depression. Wine consumption was associated with a lower risk. <![CDATA[<strong>Validation of a Spanish version of the International Consultation on Incontinence Questionnaire Short-Form</strong>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872012000300009&lng=&nrm=iso&tlng= Background: The International Consultation on Incontinence Questionnaire Short-Form (ICIQ-SF) allows the assessment of urinary incontinence management results. Aim: To validate the ICIQ-SF in a Chilean population. Material and Methods: An approved Spanish version of the ICIQ-SF was applied in two opportunities (separated by a mean of 44 days) to 52 women consulting for urinary incontinence in a public hospital and to 25 asymptomatic female workers of the same hospital. Content validity, internal consistency and construct validity of the ICIQ-SF were evaluated. Results: The ages of surveyed women ranged from 21 to 80 years. Internal consistency measured using Cronbach alpha was 0.87. Intra observer agreement, measured using pondered Kappa, was 0.84. 0.86 and 0.8 for each of the three components of the questionnaire, respectively. Conclusions: This Spanish version of the ICIQ-SF meets the requirements to be used in the Chilean population. <![CDATA[<strong>The influence of smoking habits of Chilean physicians on the use of the structured medical advice about smoking</strong>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872012000300010&lng=&nrm=iso&tlng= Background: Structured medical advice on smoking is the prevention strategy with better cost-effectiveness ratio. Aim: To evaluate smoking among health care providers affect the application of this preventive strategy. Material and Methods: We surveyed 235physicians working in public and private hospitals in different cities over the country, about their smoking habits, their views on smoking as cardiovascular risk factor and the implementation of three key points of the structured medical advice about smoking. Results: Physicians aged less than 44 years had the lower frequency of smoking and the higher frequency of ex-smokers concentrated among those aged 60 years or more. All surveyed physicians agreed that smoking is a cardiovascular risk factor. However, 21% considered that this risk appears only among those that smoke more than three cigarettes per day. Independent of their smoking habits, 18% of physicians not always ask their patients about smoking, 25% do not warn about the risk of smoking and 22% not always give advice about quitting. This last action is carried out with a significantly lower frequency by smoking physicians. Conclusions: To improve physician's compliance with their preventive role in clinical practice, it is essential to consider their own smoking habits, and the information and attitudes that they have towards smoking as a cardiovascular risk factor. <![CDATA[<strong>Doege-Potter syndrome</strong>: hypoglycemia secondary to solitary fibrous tumor of the pleura. Report of one case]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872012000300011&lng=&nrm=iso&tlng= Doege-Potter syndrome is characterized for hypoglycemia associated with solitary pleural fibrous tumors. We report a 38-year-old woman with a history of weight loss, malaise and edema. After an episode of symptomatic hypoglycemia, she was admitted to the hospital, where she had new episodes of hypoglycemia. A Chest X ray and scan showed a right pleural tumor that was surgically excised. After surgery the episodes of hypoglycemia subsided. The pathological study of the tumor revealed a solitary fibrous pleural tumor. After 15 months of follow up, the patient is symptom free and without evidence of tumor relapse. <![CDATA[<strong>Brain hydatidosis</strong>: Report of four cases]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872012000300012&lng=&nrm=iso&tlng= In only 2% of all cases of hydatidosis, the cysts are located in the brain. We report a 12-year-old male, a 5-year-old girl and a 19-year-old female consulting for intracranial hypertension and a 13-year-old male consulting for a left hemiparesis. Imaging studies found intra-cerebral cysts with characteristics of hydatidosis in all. All lesions were completely removed surgically and the pathological study of the excised piece confirmed the diagnosis of hydatidosis. <![CDATA[<strong>Endoscopic band ligation, for gastric antral vascular ectasia</strong>: Report of two cases]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872012000300013&lng=&nrm=iso&tlng= Gastric antral vascular ectasia is an uncommon cause of chronic anemia, occasionally associated with cirrhosis. The most accepted therapy is argon plasma coagulation (APC), however there are refractory cases. We report two females with cirrhosis, aged 60 and 72 years, in whom management with APC was insufficient and in whom the need for hospital admissions and transfusions were reduced using the technique of endoscopic band ligation. <![CDATA[<strong>Primary cutaneous aggressive epidermotropic cytotoxic CD8 positive T cell lymphoma</strong>: <strong>Report of one case</strong>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872012000300014&lng=&nrm=iso&tlng= Primary cutaneous aggressive epidermotropic cytotoxic CD8 positive T cell lymphoma, is an uncommon disease, with an aggressive clinical behavior. Differentiation with other types of cutaneous T-cell lymphoma (CTCL) that express a CD8+ cells, is based only on clinical grounds and in certain morphological characteristics, such as a marked epidermotropism with squamous cell necrosis. We report a 50-year-old male presenting with painless cutaneous lesions appearing in trunk, limbs, scalp and face, suggestive of cutaneous lymphoma. He was admitted to the hospital in bad conditions, with confluent papules and tumors, some of them ulcerated and with foul smelling honey-colored crusts, involving the complete body surface. Cutaneous biopsy demonstrated a CD8 positive epidermotropic cytotoxic T cell lymphoma. He was treated with chemotherapy with an excellent initial response, but cutaneous lesions reappeared after four cycles. He did not respond to rescue chemotherapy and died seven months after diagnosis. <![CDATA[<strong>The role of endothelial lipase in atherogenesis</strong>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872012000300015&lng=&nrm=iso&tlng= Endothelial lipase (EL) is synthetized by endothelial cells and its main substrates are lipoprotein phospholipids. Over expression of EL reduces high density lipoprotein (HDL) cholesterol and phospholipids, in vivo and in vitro. Inhibition of the enzyme achieves the opposite effects. The synthesis of the enzyme is regulated by interleukin 1 and tumor necrosis factor a. These inflammatory cytokines play a role in diabetes and vascular disease. An increase in vascular mechanical forces, that play a role in atherogenesis, also increase the synthesis of EL. There is expression of EL in endothelial cells, macrophages and muscle cells of atherosclerotic lesions of coronary arteries of humans. This evidence leads to the suspicion that EL plays a role in atherogenesis. There are also higher plasma levels of EL in subjects with type 2 diabetes, who are especially susceptible to the development of vascular lesions. Therefore the inhibition of EL could play an important role in HDL metabolism and could be a new therapeutic strategy for the prevention of atherosclerosis. <![CDATA[<strong>Prognostic heterogeneity of attention deficit/hyperactivity disorder in adults</strong>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872012000300016&lng=&nrm=iso&tlng= Attention Deficit/Hyperactivity Disorder (ADHD) is a clinical syndrome characterized by an onset in early life. More than 65% of patients persist with manifestations of ADHD in adulthood. These symptoms may interfere in activities of daily-living, interpersonal relationships and professional and academic achievement. Nevertheless, the observation of an important group of adults with ADHD who do not show significant difficulties in the areas mentioned before puts into evidence the prognostic heterogeneity of this disorder. One of the current, most accepted explanations is the Double-Pathway Model: two double-dissociated deficits (Executive Disorders and Delayed-Reward Processing impairments) are involved in the genesis of ADHD, which explains the existence of different behavioral phenotypes. Moreover, personality traits like tenacity or perseverance are associated with higher levels of achievement in adults. On these grounds, we propose the hypothesis that the neurobiological correlate of tenacity/perseverance is a preserved Delayed-Reward Processing capacity, although further studies are needed to verify this idea. <![CDATA[ <strong>Preparation of forensic reports of injuries</strong>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872012000300017&lng=&nrm=iso&tlng= This article makes recommendations, based on good clinical practice, for the elaboration of forensic reports of injuries, required during the administration of justice. According to the new legislature in Chile, physicians must participate in the examination of victims of violent acts or accidents. <![CDATA[Scientific ethics and the use of human material or data]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872012000300018&lng=&nrm=iso&tlng= A scientific article censured by superposing obstacles to its reading remembers the censure of Galileo made by the Inquisition. The censure followed the failure to obtain the informed consent (IC) to disclose results of old samples. At present, the use of collected data or samples for a new research needs a new IC, in most ethical protocols. The Helsinki Code allows the research ethics committees the authorization for the use of that information. This norm is founded rather in commercial, legal or protective arguments than in ethical bases. This article criticizes this norm from the Scientific Ethics viewpoint because: i) the ownership of the genome and environment that originate a person is not of such person but of the human society and Homo sapiens species, ii) a person is not the unique owner of that information; laboratories, institutions, health services and research teams add constituents to it, iii) several violations to this norm occurring in medical, labor, legal and social practice show it as biased against science, iv) if this stored information and its use are beneficial for humankind (its proper owner) it is ethically obligatory to use it. It is proposed to create an anonymous World Bank for Human Information with open access and universal transparency. This universal collection of data handled under universal accepted ethical norms should prevent exclusive private use of public information, non-publication of negative results, illicit and unethical use of human data. <![CDATA[Learning doctor-patient communication: does co-teaching help?]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872012000300019&lng=&nrm=iso&tlng= Background: The first part of the medical interview is perhaps one of the most significant components of the doctoras role. How to collect relevant information and how to build a therapeutic relationship with the patient must be taught during the undergraduate curriculum. Clinical teachers have little experience in the teaching skills required to help students learn about doctor-patient communication. Aim: To measure outcomes and perceptions of using a co-teaching model in a course on interviewing during the third year of medical school in the Pontificia Universidad Católica de Chile. Material and Methods: A mixed methods controlled study in which the intervention group participated in a co-teaching workshop with a clinical teacher and a specialist in doctor-patient communication skills (SDPC). The control group participated in a workshop with one clinical teacher. All students completed a questionnaire measuring perception of their learning in communication skills. Semi-structured interviews were used to collect the clinical teachers' perception. At the end of the course, the clinical and communication skills of all the students were measured in an objective structured clinical examination. Results: Students and teachers agreed that co-teaching allows greater emphasis and practice in communication skills. The results of the objective structured clinical examination show that despite this greater emphasis, no deleterious effect on the clinical skills was demonstrated during the exam. Conclusions: The use of co-teaching in a course on interviewing allows students to perceive a higher level of learning in communication skills, and possibly enhances their skills. The clinical teachers felt that the co-teacher was an important support. <![CDATA[<b><i>Patient empowerment</i></b>: <b><i>A new dimension in doctor-patient relationship</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872012000300020&lng=&nrm=iso&tlng= Background: The first part of the medical interview is perhaps one of the most significant components of the doctoras role. How to collect relevant information and how to build a therapeutic relationship with the patient must be taught during the undergraduate curriculum. Clinical teachers have little experience in the teaching skills required to help students learn about doctor-patient communication. Aim: To measure outcomes and perceptions of using a co-teaching model in a course on interviewing during the third year of medical school in the Pontificia Universidad Católica de Chile. Material and Methods: A mixed methods controlled study in which the intervention group participated in a co-teaching workshop with a clinical teacher and a specialist in doctor-patient communication skills (SDPC). The control group participated in a workshop with one clinical teacher. All students completed a questionnaire measuring perception of their learning in communication skills. Semi-structured interviews were used to collect the clinical teachers' perception. At the end of the course, the clinical and communication skills of all the students were measured in an objective structured clinical examination. Results: Students and teachers agreed that co-teaching allows greater emphasis and practice in communication skills. The results of the objective structured clinical examination show that despite this greater emphasis, no deleterious effect on the clinical skills was demonstrated during the exam. Conclusions: The use of co-teaching in a course on interviewing allows students to perceive a higher level of learning in communication skills, and possibly enhances their skills. The clinical teachers felt that the co-teacher was an important support. <![CDATA[<b><i>Relationship Between Bladder Cancer and Infection by Human Papillomavirus</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872012000300021&lng=&nrm=iso&tlng= Background: The first part of the medical interview is perhaps one of the most significant components of the doctoras role. How to collect relevant information and how to build a therapeutic relationship with the patient must be taught during the undergraduate curriculum. Clinical teachers have little experience in the teaching skills required to help students learn about doctor-patient communication. Aim: To measure outcomes and perceptions of using a co-teaching model in a course on interviewing during the third year of medical school in the Pontificia Universidad Católica de Chile. Material and Methods: A mixed methods controlled study in which the intervention group participated in a co-teaching workshop with a clinical teacher and a specialist in doctor-patient communication skills (SDPC). The control group participated in a workshop with one clinical teacher. All students completed a questionnaire measuring perception of their learning in communication skills. Semi-structured interviews were used to collect the clinical teachers' perception. At the end of the course, the clinical and communication skills of all the students were measured in an objective structured clinical examination. Results: Students and teachers agreed that co-teaching allows greater emphasis and practice in communication skills. The results of the objective structured clinical examination show that despite this greater emphasis, no deleterious effect on the clinical skills was demonstrated during the exam. Conclusions: The use of co-teaching in a course on interviewing allows students to perceive a higher level of learning in communication skills, and possibly enhances their skills. The clinical teachers felt that the co-teacher was an important support. <![CDATA[<b><i>Physicians and arts</i></b>: <b><i>a duality with potential reciprocal benefits</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872012000300022&lng=&nrm=iso&tlng= Background: The first part of the medical interview is perhaps one of the most significant components of the doctoras role. How to collect relevant information and how to build a therapeutic relationship with the patient must be taught during the undergraduate curriculum. Clinical teachers have little experience in the teaching skills required to help students learn about doctor-patient communication. Aim: To measure outcomes and perceptions of using a co-teaching model in a course on interviewing during the third year of medical school in the Pontificia Universidad Católica de Chile. Material and Methods: A mixed methods controlled study in which the intervention group participated in a co-teaching workshop with a clinical teacher and a specialist in doctor-patient communication skills (SDPC). The control group participated in a workshop with one clinical teacher. All students completed a questionnaire measuring perception of their learning in communication skills. Semi-structured interviews were used to collect the clinical teachers' perception. At the end of the course, the clinical and communication skills of all the students were measured in an objective structured clinical examination. Results: Students and teachers agreed that co-teaching allows greater emphasis and practice in communication skills. The results of the objective structured clinical examination show that despite this greater emphasis, no deleterious effect on the clinical skills was demonstrated during the exam. Conclusions: The use of co-teaching in a course on interviewing allows students to perceive a higher level of learning in communication skills, and possibly enhances their skills. The clinical teachers felt that the co-teacher was an important support.