Autoevaluación sobre formación en medicina paliativa en una cohorte de residentes / Self assessment about proficiency on palliative care in a cohort of residents

Background: Little is known about the status and level of medical education on palliative care, symptom control and aspects of end of life care provided by medical school programs in Chile. Aim: To determine if a cohort of residents had palliative care and end of life care education during pre graduate and post graduate training. Residents were also asked to self assess their proficiency in these areas. Material and Methods: In 2002, we contacted 200 of a total of 327 residents of the postgraduate programs of the Pontificia Universidad Catolica de Chile. They were asked to anonymously answer a preformed questionnaire addressing different aspects related to palliative care, symptom control and end of life issues. Results: Less than 25 percent of residents received some degree of palliative care education during their studies, and approximately half of them considered that the level of proficiency reached was less than 25 percent. This contrasted with a good self assessment in the management of pain and gastrointestinal symptoms. For the treatment of the anorexia-cachexia syndrome and delirium, approximately 50 percent of the cohort had a mean self assessment score of 3 in a scale of 1 to 7. More than 80 percent of residents considered that palliative medicine education is important for their medical career. Conclusions: Chilean medical schools must improve palliative care and end of life training as part of their mandatory curriculum in both the pre and post graduate levels.

Osteoporosis regional transitoria y distrofia simpática refleja: ¿entidades distintas o variantes clínicas de una misma enfermedad? / Transient regional osteoporosis and reflex sympathetic dystrophy: different entities or clinical variants of the same disease?

We report a 50 years old male that evolved with alternating episodes of osteoporosis with pain, edema and erythema of both feet. The patient presented clinical and radiological evidences of both transient regional osteoporosis and reflex sympathetic dystrophy. The clinical evolution was documented with magnetic resonance imaging. The hypothesis that bothe entities could be different expressions of a same syndrome is discussed