Eleven Danish patients diagnosed with Scabies and treated with Tenutex®.

Treatment with Tenutex® should be considered in patients diagnosed with scabies if the first-line treatment with 5% permethrin fails. Treatment failure with 5% permethrin may be due to tolerance or resistance in scabies mites.

A Danish case of bleomycin-induced flagellate erythema.

Patients who are undergoing treatment with bleomycin and develop prurigo or rash should be suspected of bleomycin-induced flagellate erythema and treated early with antihistamines, topical, and oral corticosteroids.

Factores asociados a la dependencia de alcohol y tabaco en estudiantes de ocho facultades de medicina peruanas, 2015 / Factors associated with alcohol and tobacco dependence on students of eight peruvians medical schools, 2015

Introduction: The uses of legal drugs are common among university students, but have not done local research to reveal dependence on them. The objective was to determine the factors associated with consumption of tobacco and alcohol in students from eight Peruvian medical schools. Methods: Multicenter cross-sectional study of secondary data, a self-applied questionnaire was used in Peruvian medicine students, the test Cage and Fagerströmwas used to define tobacco consumption and alcohol habit, respectively; in addition to measuring other socio-educational variables. It was obtained statistical association and p values. Results: Of the 1,918 students tested, 55% (1,046) were women and the median age was 20 years. 34% of students consumed regularly tobacco; 9% (178) showed tobacco dependence, increased frequency of alcohol consumption (RPa: 8.39, IC 95%: 4.99-14.09; p < 0.001) and coffee (RPa: 1,72; IC 95%: 1.312.27; p < 0.001); receiving money from family decreased tobacco consumption (RPa: 0.68; IC 95%: 0.49-0.94, p = 0.019). 28% (537) consumed alcohol regularly, increasing its frequency being male (RPa: 1.51; IC 95%: 1.09-2.09, p = 0.012), having failed a course (RPa: 1,17; IC 95%: 1.02-1.33, p = 0.021), the academic semester coursing (RPa: 1.04; IC 95%: 1.01-1.08, p = 0.014) and consumption of tobacco (RPa: 2.89; IC 95%: 2.40-3.47; p < 0.001); also it decreased the frequency of alcohol comsuption daily hours studying (RPa: 0.96; IC 95%: 0.94-0.97;p < 0.001 ). Conclusions: Although the frequency of alcohol consumption and tobacco was not high, this associated some modifiable factors, which may intervene to reduce the frequency and potential consequences.

Introducción: El consumo de drogas lícitas es común entre los universitarios, no se han realizado investigaciones locales que revelen dependencia a las mismas. El objetivo fue determinar los factores asociados a la dependencia alcohólica y al tabaco en estudiantes de ocho facultades de medicina peruanas. Método: Estudio transversal analítico multicéntrico de datos secundarios, se utilizó un cuestionario auto-aplicado en los estudiantes de medicina peruanos, se usó los test de Cage y Fagerstrom para definir dependencia alcohólica y al tabaco, respectivamente; además de medir otras variables socio-educativas. Se obtuvo estadísticos de asociación y valores p. Resultados: De los 1.918 estudiantes evaluados, el 55% (1.046) fueron mujeres y la mediana de edades fue 20 años. El 34% de estudiantes consumía tabaco regularmente; el 9% (178) mostró dependencia al tabaco, aumentando la frecuencia el consumir alcohol (RPa: 8,39; IC95%: 4,99-14,09;p < 0,001) y café (RPa: 1,72; IC95%: 1,31-2,27;p < 0,001); el recibir dinero de su familia disminuyó la frecuencia de consumo de tabaco (RPa: 0,68; IC95%: 0,49-0,94; p: 0,019). Consumían alcohol regularmente un 49%; mostrando dependencia alcohólica un 28% (537), aumentando su frecuencia el ser varón (RPa: 1,51; IC95%: 1,09-2,09; p: 0,012), el haber desaprobado un curso (RPa: 1,17; IC95%: 1,02-1,33; p: 0,021), el semestre académico que cursaban (RPa: 1,04; IC95%: 1,01-1,08; p: 0,014) y la dependencia al tabaco (RPa: 2,89; IC95%: 2,40-3,47;p < 0,001 ); asimismo, disminuyó la dependencia alcohólica, las horas diarias que estudia (RPa: 0,96; IC95%: 0,94-0,97;p < 0,001). Conclusiones: Si bien la dependencia al alcohol y tabaco no fue alta, a esto se asoció algunos factores modificables, en los que se pueden intervenir para disminuir la frecuencia y sus posibles consecuencias.

[Functional dyspepsia in students of eigth peruvians medical schools. Influence of the habits]. / Dispepsia funcional en estudiantes de ocho facultades de medicina peruanas. Influencia de los hábitos.

Functional dyspepsia impacts on quality of life. Due to its multifactorial etiology its characterization proves difficult, especially in populations at risk such as medical students. Objetives: To determine if behavioral and harmful habits of medical students from eight universities of Peru were associated to functional dyspepsia. Methods: Multicentric, cross-sectional study. A self-administered questionnaire was taken among students enrolled in eight medical faculties in Peru. Functional dyspepsia was measured using a validated test; diet characteristics, alcohol, tobacco, coffee or energy drinks consumption were considered behavioral habits. Furthermore, others from the social and educational sphere were measured. Bivariate and multivariate statistical analyses were made. Results: From a total of 1.923 students, the median of the ages was 20, 55% were women and 24% suffered from functional dyspepsia. Factors which diminished the frequency of functional dyspepsia were masculine gender (aPR:0,75; 95%CI:0.64-0.87; p < 0,001), hours spent studying (aPR:0,97; 95%CI:0,96-0,99; p < 0,001) and eating following a fixed schedule (aPR:0,80; 95%CI:0,67- 0,95; p = 0,013); however, having failed a course increases the frequency of functional dyspepsia (aPR:1.24; 95%CI:1.13-1.37; p < 0,001)adjusted for age, as well as difficulties to fall asleep and depression. Conclusion: Many medical students suffered from functional dyspepsia, this being related to several behavioral variables; therefore further studies as well as educational institutions' intervention is required, due to the short and long term problems that may arise from this situation.

Pregnancy, anaesthesia and Guillain Barré syndrome.

Two case histories of pregnant women with Guillain Barré syndrome (acute demyelinating polyradiculoneuritis) are reported. The first required anaesthesia during the second trimester for a minor surgical procedure. The second woman was admitted to the Intensive Care Unit in the first trimester and was ventilated for 18 weeks. Both babies were carried to term and delivered by Caesarean section. A review of the management of Guillain Barré syndrome in pregnancy discusses anaesthetic management, intensive care and the use of plasmapheresis and gamma-globulins. The care of pregnant women recovered from Guillain Barré syndrome is also discussed.

Clinical presentation of suspected malignant hyperthermia during anaesthesia in 402 probands.

As anaesthetists have become more aware of malignant hyperthermia the mortality rate has fallen, but concommitantly the number of dubious and aborted cases has increased. All probands who developed a suspected malignant hyperthermia reaction during anaesthesia and subsequently underwent muscle biopsy were classified according to the clinical presentation. A probability for malignant hyperthermia can be calculated, using the classification, for each type of clinical presentation; this varied from 0.96 to 0.07. Certain clinical features were found to be of more value as predictors than others; these included a high creative kinase and myoglobinuria. The accuracy of prediction depends on a clear contemporaneous description of the clinical events.

Is there a relationship between masseteric muscle spasm and malignant hyperpyrexia?

The occurrence of masseteric muscle spasm (MMS) in children is thought to be frequent and to be associated usually with malignant hyperpyrexia (MH). We have found a lower incidence of MMS in children and 50% had no muscle abnormality. Clinical features that support a diagnosis of MH include high serum creatine kinase (CK) concentration and the presence of myoglobinuria. There is evidence to suggest that suxamethonium does increase jaw tone in adults and children, and an exaggerated response may be taken clinically to be MMS. However, MMS should still be regarded as an early warning sign of MH.