ABSTRACT
There is a 10 years teaching experience for fourth year medical students and interns in a Chilean private hospital. The students attend an eight weeks practical course. The interns rotate during 16 weeks by specialties and make shifts. The hospital structure with Clinical Services and Medical-Surgical departments facilitates the teaching process. There are approximately 30,000 admissions per year with a mean stay of 3.7 days, that allow the students to be in touch with patients with different diseases that are managed with updated technology. We emphasize the ethical and clinical management of concrete problems of patients, self ¡earning and communication skills. The students evaluate their stay answering surveys and with semi structured interviews. Teaching is assessed by tutors and heads of departments, in clinical rounds, sometimes prepared by the students, by a thorough revision of problem oriented medical records and with practical and theoretical tests. The results of the program have been quite satisfactory for participants.
Subject(s)
Humans , Education, Medical, Undergraduate/methods , Internal Medicine/education , Chile , Education, Medical, Undergraduate/standards , Hospitals, Private , Hospitals, TeachingABSTRACT
Objetivo y método: Evaluar la correlación entre la electromiografía (EMG) y la ultrasonografía (US) de 19 pacientes con síndrome del túnel carpiano (STC) clínico. Resultados: Debieron ser descartados dos pacientes por presentar nervios medianos bíjidos. Se hallaron 15 nervios medianos con US alterada y18 nervios medianos con electromiografía alterada. Se encontró correlación positiva entre US y electromiografía en 12/24 túneles carpianos, y se observó una concordancia de lateralidad entre el tamaño del nervio y su alteración electrofisiológica en cinco pacientes. Se detectó sinovitis de muñeca en seis túneles carpianos (dos pacientes con artritis reumatoide, uno con osteoartritis erosiva). Conclusión: La US músculo-esquelética es una herramienta complementaria a la electromiografía en el estudio del STC en el paciente reumático, aportando información adicional con relación a la patología de base.
Objective: Compare high-resolution ultrasonography (US) and electromyography (EMG) of 19 patients with carpal tunnel syndrome (CTS) Results: Two patients were ruled out because of bifid median nerves. We found 15 median nerves with abnormal US appearance and 18 median nerve with abnormal EMG. We found a positive correlation between US and EMG in 12/24 carpal tunnels, and lateral agreement between nerve size and EMG alteration in 5 patients. Wrist synovitis was detected in six carpal tunnels (two patients with rheumatoid arthritis and one with osteoarthritis). Conclusion: Musculoskeletal ultrasound is a complementary tool to electromyography in the CTS study of rheumatologic patients, thus providing additional information in relation to the basal pathology.
Subject(s)
Humans , Female , Adult , Middle Aged , Electromyography , Carpal Tunnel Syndrome/diagnosis , Ultrasonography , Hand/innervation , Median Nerve/physiopathology , Median Nerve , Carpal Tunnel Syndrome/physiopathologyABSTRACT
Se presentan 17 casos de fracturas de Le Fort correspondientes al 3.18% de las 533 fracturas maxilo-faciales observadas en el Instituto Traumatológico y Clínica de las Condes en los 6 años comprendidos entre 1980 y 1986. La casuística se clasifica de acuerdo a edad, sexo, etiología, tiempo de evolución, tipo de fractura según la tipificación clásica de Le Fort, presentación clínica, lesiones asociadas, mortalidad y tratamiento. Se discuten las alternativas terapéuticas, las que varían ampliamente e incluyen medidas generales como reposo y analgésicos y maniobras quirúrgicas de reducción, inmovilización y reconstrucción primaria. Se concluye que el óptimo manejo de éstos pacientes se basa sobre un diagnóstico correcto, un tratamiento quirúrgico oportuno y la adecuada atención de las complicaciones debidas al trauma