Rendimiento académico e inserción laboral de los titulados en medicina por la Universitat de Barcelona. Un estudio longitudinal / Academic achievement and work insertion of Barcelona University medical graduates. A longitudinal study

Introducción: El proceso de Bolonia ha provocado cambios en la estructura universitaria dando protagonismo a los conceptos de competencia y calidad. Esta situación planteó el reto de querer mostrar la contribución de la Universitat de Barcelona (UB) en la formación de médicos para la sociedad catalana y la distribución de estos titulados en relación a todo el colectivo de profesionales colegiados en la provincia de Barcelona. Sujetos y métodos: Estudio longitudinal de cuatro promociones de alumnos de la Facultad de Medicina de la UB, que ingresaron entre 1994 y 2001. Para cada cohorte se calcularon estadísticas de rendimiento académico, de formación especializada y de colegiación después de consultar diferentes bases de datos y utilizando el programa informático R. Resultados: El 85-96% de los alumnos que ingresaron en la Facultad de Medicina obtuvieron el título de licenciado en un plazo inferior a siete años. Del total de licenciados, un 83% constaba registrado en el colegio oficial de médicos de la provincia (COMB). Comparadas con la población colegiada de profesionales, estas promociones destacan por una tasa de feminización mayor (tres de cada cuatro) y tasas de extranjería prácticamente nulas. Conclusiones: Los titulados en medicina por la UB demostraron un alto rendimiento de estudio y se insertaron a la profesión en su entorno geográfico

Introduction: The Bologna process has brought about changes in the structure of the Spanish University giving prominence to the concepts of competence and quality. This posed the challenge of showing the contribution of the University of Barcelona (UB) in the training of doctors to Catalan society, and the distribution of these graduates in relation to the entire group of professional associations in the province of Barcelona. Subjects and methods: Longitudinal study of four classes of freshman students of the Faculty of Medicine, UB, who were admitted between 1994 and 2001. For each cohort academic performance, specialized training and licensing statistics were obtained after looking up different databases and using the R software. Results: Between 85% and 96% of students who entered medical school obtained a degree in Medicine in a period shorter than seven years. Of all graduates comprised 83% recorded in medical professional association of the province (COMB). In comparison with the total professional members, these classes highlighted by a greater proportion of women (3 out of 4) and virtually no immigration rates. Conclusions: Graduates in Medicine from the UB demonstrated high performance of their studies and inserted into the profession in its geographical area

Generalized cutis laxa and fibrillar glomerulopathy resulting from IgG Deposition in IgG-lambda Monoclonal Gammopathy: pulmonary hemorrhage during stem cell mobilization and complete hematological response with bortezomib and dexamethasone therapy.

The case of a 52-years-old man with generalized acquired cutis laxa associated with IgG-lambda monoclonal gammopathy and nephrotic syndrome with renal failure (due to fibrillar glomerulopathy resulting from IgG deposition) is reported. A peripheral blood autologous stem cell transplant was planned, but the procedure was complicated by severe pulmonary hemorrhage during stem cells mobilization with granulocyte colony-stimulating factor (G-CSF). Treatment with bortezomib and dexamethasome was subsequently started and a complete hematological response was achieved. Finally, the complete hematological response with the disappearance of the toxic M-protein allows the possibility of a long-term benefit with a kidney transplant followed by an autologous bone marrow transplant.

Extracorporeal albumin dialysis: a procedure for prolonged relief of intractable pruritus in patients with primary biliary cirrhosis.

BACKGROUND AND AIMS: Pruritus is a distressing symptom in patients with primary biliary cirrhosis, and when uncontrollable it is an indication for liver transplantation. Since pruritus can result from unknown substances that accumulate systemically as a consequence of impaired biliary secretion, we have assessed whether a new extracorporeal albumin dialysis (ECAD) procedure, the molecular-adsorbing recirculating system-MARS, has any effect on pruritus of cholestasis. METHODS: Four patients with primary biliary cirrhosis and resistant pruritus were treated with two 7-h ECAD sessions 1 day apart. Pruritus was recorded from 15 days before the first session, before and after each session, and during the follow-up using a visual analogue scale (VAS). Standard liver tests as well as serum bile acid levels were also measured. RESULTS: There was a clear association between ECAD treatment and relief of itching, which promptly disappeared in two patients, or decreased markedly in the other two. One patient was free of pruritus for 18 months except for short periods with mild pruritus. The second patient experienced amelioration of itching, which almost disappeared completely and recurred mildly 4 months later. In the other two patients pruritus was alleviated markedly after ECAD but gradually recurred. These two patients were treated again 9 and 7 months later with favorable effects on pruritus. The scratching skin lesions improved or disappeared in parallel with the alleviation of itching. The albumin dialysis procedure did not result in liver test changes, except for circulating bile acids, which decreased in all the patients. No significant adverse effects were observed. CONCLUSIONS: The ECAD procedure seems to be an effective alternative for the treatment of patients with pruritus of cholestasis who do not respond to other therapeutic methods.

Chronic overexposure to cadmium fumes associated with IgA mesangial glomerulonephritis.

BACKGROUND: Cadmium is a metal used in the zinc, copper and steel industries, and in the manufacture of electric batteries and solar cells. Acute cadmium poisoning is characterized by irritation of the respiratory tract, while in chronic poisoning the main target organ is the renal tubule. AIMS: We report a patient with chronic work overexposure to cadmium, who presented a IgA mesangial glomerulonephritis with no respiratory or renal tubule involvement. Case report A 39-year-old patient was referred to our hospital for evaluation of a glomerular nephropathy. For the past 12 years he had worked as a welder, using cadmium electrodes. The patient had no respiratory symptoms and the chest X-ray was normal. Tests showed a proteinuria of 2 g in 24 h with microhaematuria [150 red blood cells/high power field (rbc/hpf)], with preservation of the renal function (creatinine clearance of 137 ml/min). The concentrations of cadmium in blood and urine were 45 micro g/l and 25 micro g/g creatinine, and an environmental study showed that levels of cadmium in the workplace were 52 micro g/m(3). A renal biopsy showed an IgA mesangial glomerulonephritis. The patient ceased to work with cadmium, and 1 year later cadmium levels had decreased and renal function was found to be stable. CONCLUSIONS: IgA mesangial glomerulonephritis is a disease of unknown aetiology which has been associated with other diseases. Chronic overexposure to cadmium may contribute to the development of this nephrophathy.