Catherina Moll-Manzur

Cuánto investigan los estudiantes de medicina en pregrado

Sr. Editor: El desarrollo de nuevo conocimiento es esencial para el progreso de la medicina. Una carta al editor publicada en esta revista, mostro preocupacion por el estado actual de la investigacion de los estudiantes de pregrado1. Se comento una disminucion catastrofica del numero de trabajos presentados en el Congreso Cientifico Nacional de Estudiantes de Medicina (CCNEM) entre los anos 2005 y 2013. A partir de esos datos se podria concluir que los estudiantes de medicina estan investigando menos. Sin embargo, consideramos que dicha afirmacion puede ser limitada y no atenerse a la realidad. Muchos factores influyen en que los alumnos de pregrado presenten o no sus trabajos en el CCNEM: desconocimiento de su existencia, presentacion en otros congresos nacionales o internacionales, falta de interes, entre otras2,3. ?Significara realmente que investigan menos? En Chile no hay estudios publicados que evaluen la participacion de los estudiantes de pregrado en investigacion biomedica. Por tanto, nos parece necesario complementar con algunos datos obtenidos por nosotros: revisamos retrospectivamente los articulos publicados online en la Revista Medica de Chile durante los anos 2006 a 2010. Se consideraron “articulos de investigacion”, “casos clinicos”, “articulos de revision” y “otros articulos” (incluyendo articulos especiales, etica-medica, medicina basada en evidencia, educacion medica y salud publica). Por cada articulo registramos el numero de autores, numero de autores correspondientes a estudiantes de medicina y numero de estudiantes de medicina como primer autor. Se identificaron 1014 articulos (539 articulos de investigacion, 209 casos clinicos, 121 articulos de revision y 135 catalogados como “otros articulos”). En el 14,1% del total de articulos participaron estudiantes de medicina. Solo 2,3% figuraron como primer autor. Del total de 5140 autores, 257 eran estudiantes de medicina (5,0%). No hubo diferencias estadisticamente significativas por grupo de articulos. Considerando la baja participacion de los estudiantes de medicina en una de las principales revistas medicas de nuestro pais, urge evaluar las causas del hecho y potenciales soluciones. Leer mas...

Aspergilosis renal posterior a trasplante hepático: informe de un caso infrecuente

Invasive aspergillosis (IA) with a compromised urinary tract is extremely rare. We present the case of a patient who developed renal abscesses due to Aspergillus fumigatus following liver transplant (LT). 28-year-old man who had an LT 6 months ago due to autoimmune fulminant liver failure. User of tacrolimus (0.1 mg/kg/day), prednisone 12.5 mg/day and trimethoprim--sulfamethoxazole. He was admitted after experiencing dull lower back pain for two days, extending to the flank and right iliac fossa. He had no fever or vomiting. On admission, he was haemodynamically stable, afebrile and lucid. On the physical examination by anatomical region, the abdomen was sensitive to deep palpation and fist percussion of the flank and right iliac fossa. The patient presented with no palpable masses or signs of peritoneal irritation. The lab tests showed preserved liver and kidney function. Urinalysis revealed leukocyturia (more than 50 white blood cells/mm) with no bacteriuria. The CT scan of the abdomen and pelvis showed mild right-sided nephromegaly, with multiple irregular cystic lesions that spread into the pyelocalyceal system towards the third lower and middle segments. On the left side, a cystic lesion with slightly thickened walls was observed in the upper pole, measuring 2.5 cm in diameter. The urine culture and bacilloscopies were negative. The chest CT scan revealed no pathological findings. The kidney fluid collections were drained and significant amounts of purulent material were found. Neither bacteria nor microbacteria were investigated during the microbiological tests. The Kinyoun stain was negative. However, A. fumigatus was isolated in the culture. Voriconazole was initiated with a loading dose, followed by 4 mg/kg every 12 h, with a good initial clinical response. One month later, the patient developed fever and abdominal pain. Urinalysis showed persistence of the aseptic leukocyturia. The control CT scan revealed significant progression of the right kidney fluid collections. It was decided to perform

Concomitant poroma and porocarcinoma

Eccrine poromas and porocarcinomas are adnexal tumors derived from the sweat duct epithelium. However, eccrine poroma is benign in nature, whilst eccrine porocarcinoma is regarded as its malignant counterpart. We report the case of a man who presented simultaneously with an eccrine poroma and eccrine porocarcinoma. Both lesions had no clear distinctive features, enhancing the need of high-level clinical suspicion together with surgical excision and histopathology for prompt diagnosis confirmation.

Efectos adversos de finasteride: mitos y realidades. Una revisión actualizada

Finasteride is a 5-α reductase inhibitor that is widely used in the management of benign prostate hyperplasia and male pattern hair loss. It is well known that these agents improve the quality of life in men suffering from these conditions. However, they are associated with some transient and even permanent adverse effects. The aim of this article is to clarify the controversies about the safety of finasteride by analyzing the evidence available in the literature.

Ectima gangrenoso secundario a Staphylococcus aureus

Ecthyma gangrenosum is an uncommon necrotizing vasculitis, in most cases secondary to sepsis by Pseudo-mona aeruginosa in immunocompromised patients. However, there have been several reports of ecthyma gangre-nosum caused by other infectious etiologies. We report an unusual case of ecthyma gangrenosum associated with methicillin-resistant Staphylococcus aureus infection in a patient without the classic immunological risk factors described in the literature.

[Acute generalized exanthematous pustulosis associated with Mycoplasma pneumoniae infection: a case report].

Acute generalized exanthematous pustulosis is an uncommon skin eruption, characterized by fever and the rapid onset of disseminated, non-follicular, sterile pustules, over an erythematous skin background. It is usually classified as a severe cutaneous adverse drug reaction, whose most relevant triggers are antibiotics and anticonvulsants. However, viral and bacterial infections have also rarely been associated with this dermatosis. We report the case of a patient, who developed lesions of acute generalized exanthematous pustulosis as an extrapulmonary manifestation of Mycoplasma pneumoniae infection.

[Urticaria pigmentosa: clinical and therapeutic aspects for the paediatrician].

Urticaria pigmentosa, also known as maculopapular mastocytosis, is the most common type of paediatric mastocytosis. It presents with yellow to brown macules or papules, usually located on trunk and extremities. Regarding its diagnostic and therapeutic implications, the objective of this article is to serve as an update for the paediatrician on the most relevant aspects of this pathology.