Experiencia del internado de medicina durante la pandemia por Covid-19 / Medical internship experience during the Covid-19 pandemic

Introducción: la pandemia por SARS-CoV-2 ha causado cambios en la formación médica a nivel mundial. Se han suspendido todas las actividades presenciales buscando reducir el contagio y, además, dada la creciente demanda hospitalaria, ha generado la necesidad de buscar nuevas formas de mantener la docencia y a la vez, balancear ésta con las necesidades hospitalarias. Desarrollo: revisamos la experiencia de estudiantes de medicina en otros países, tanto las similitudes como diferencias respecto a lo vivido en Chile, bajo nuestra formación. El interno de medicina, a diferencia del estudiante o del médico, se encuentra en un rol intermedio como práctica profesional y consideramos que tiene un rol positivo en el apoyo a los servicios de salud durante la crisis actual. Presentamos nuestra experiencia como internos de medicina voluntarios en los distintos campos clínicos que se encuentran bajo el alero de nuestra universidad y como hemos experimentado la creciente sobrecarga hospitalaria, incertidumbre, soledad y experiencia con la muerte en nuestra práctica. Conclusión: la experiencia como internos durante esta pandemia y como voluntarios en los distintos servicios de nuestros campos clínicos ha alterado profundamente nuestra formación médica. Nos ha permitido interiorizarnos no solo en aspectos técnicos, sino también en el área más humana de la medicina, en aprender sobre trabajo en equipo, la incertidumbre y el fin de la vida. Creemos que todo esto nos ha preparado y nos ha dado una experiencia invaluable para nuestra futura práctica médica.

Introduction: The SARS-Cov-2 pandemic has changed medical training worldwide. All face-to-face activities have been suspended seeking to reduce contagion, and also, given the growing hospital demand, it has generated the need to find new ways to keep tea-ching and, at the same time, balance it with hospital needs. Body: We review the experience of medical students in other countries, both similarities and differences from what has been experienced in Chile under our training. Medical interns, unlike other students or physicians, are in an intermediate role in their professional practice, and we consider that we have a positive role in supporting health services during the current crisis. We present our experience as volunteer medical interns in the different clinical facilities that are as-sociated with our university and how we have experienced the increasing hospital overload, uncertainty, loneliness, and experience with death in our practice. Conclusion: The experience as interns during this pandemic and as volunteers in the different departments from our clinical facilities has profoundly affected our medical training. It has allowed us to understand not only technical aspects but also the most humanitarian areas of medicine, by learning about teamwork, living with uncertainty, and the end of life. We believe that all of this has prepared us and given us invaluable experience for our future medical practice.

Esofagitis eosinofílica: diagnóstico y manejo / Diagnosis and management of eosinophilic esophagitis

Eosinophilic esophagitis (EoE) is a chronic, immune-mediated disease, induced by food allergens, clinically characterized by symptoms of esophageal dysfunction. Pathologically there is a predominant eosinophilic inflammation. This disease is relatively new, and its definitions have evolved over time. Its prevalence and incidence are increasing and causes clinical problems both in children and adults. Its symptoms include food impaction, dysphagia, symptoms that resemble gastroesophageal reflux, abdominal pain, and vomiting. It can also have extra-digestive symptoms such as rhinosinusitis, chronic cough, recurrent croup and hoarseness. EoE can be associated with other atopic conditions, such as asthma, eczema and food allergies. The diagnosis is made by the analysis of endoscopic biopsies (> 15 eosinophils per high power field). Proton pump inhibitors (PPIs) are currently accepted as a treatment for EoE. The clinical and pathological improvement with the use PPIs ceased to be a criterion to define Esophageal eosinophilia responsive to PPIs as a differential diagnosis, since this condition is currently considered within the EoE spectrum. There are three main treatment approaches for EoE: diet, drugs and dilation. Its diagnosis and early treatment are key to avoid or delay its complications, such as stenosis and severe esophageal dysfunction.