Evaluación de la Utilización de Materiales Didácticos en los Hospitales del Area Sur del Departamento de Pediatría de la Facultad de Medicina de la UBA / Evaluation of the Use of Teaching Material in the Metropolitan Southern Area of the Department of Pediatrics of the Faculty of Medicine of the University of Buenos Aires

Durante la cursada en la UBA, cada unidad entrega material didáctico: un CD con bibliografía y un DVD de semiología en las distintas edades pediátricas. El objetivo fue evaluar la accesibilidad y la utilización de distintos recursos pedagógicos. Se realizó una encuesta a 119 alumnos pertenecientes a los hospitales británico, Garrahan, Churruca, Fiorito, Elizalde, Meléndez de Adrogué y Ramos Mejía, la cual investigaba si el alumno recibía el material y si lo utilizaba. Los resultados se analizaron con técnicas de estadistica descriptiva. El 91 por ciento de los alumnos contestó la encuesta. el 82 por ciento afirmó haber recibido el CD de bibliografía y el 56 por ciento el DVD de semiología. El 83% afirma haber utiizado el material, el 71 por ciento contestó que es útil porque responde al programa y el 66 por ciento porque está actualizado. El 34 por ciento afirmó que los contenidos del CD no se encuentran en otra bibliografía accesible a los alumnos, el 48 por ciento consideró amena su lectura. El 83 por ciento respondio haber visto el DVD, aunque en distintas semanas de la cursada y no necesariamente en la primera como es indicación del Departamento de Pediatría. La gran mayoría de los alumnos utilizó el material y lo considera útil. Los alumnos que no utilizaron el material comentan que usan textos tradicionales, en otros pese a haberlo recibido al comienzo de la sursada no consideraron la consulta del mismo. Sorprende aun más, que en el caso de los DVD de semiología difieran la consulta del mismo al final de la cursada ante la inminencia del examen práctico. Aún queda abierto el debate si la entrega de bibliografía preseleccionada es útil y necesria o es preferible brindar oportunidades para el autoaprendizaje y el estudio independiente

Evaluación de la Utilización de Materiales Didácticos en los Hospitales del Area Sur del Departamento de Pediatría de la Facultad de Medicina de la UBA / Evaluation of the Use of Teaching Material in the Metropolitan Southern Area of the Department of Pediatrics of the Faculty of Medicine of the University of Buenos Aires

Durante la cursada en la UBA, cada unidad entrega material didáctico: un CD con bibliografía y un DVD de semiología en las distintas edades pediátricas. El objetivo fue evaluar la accesibilidad y la utilización de distintos recursos pedagógicos. Se realizó una encuesta a 119 alumnos pertenecientes a los hospitales británico, Garrahan, Churruca, Fiorito, Elizalde, Meléndez de Adrogué y Ramos Mejía, la cual investigaba si el alumno recibía el material y si lo utilizaba. Los resultados se analizaron con técnicas de estadistica descriptiva. El 91 por ciento de los alumnos contestó la encuesta. el 82 por ciento afirmó haber recibido el CD de bibliografía y el 56 por ciento el DVD de semiología. El 83% afirma haber utiizado el material, el 71 por ciento contestó que es útil porque responde al programa y el 66 por ciento porque está actualizado. El 34 por ciento afirmó que los contenidos del CD no se encuentran en otra bibliografía accesible a los alumnos, el 48 por ciento consideró amena su lectura. El 83 por ciento respondio haber visto el DVD, aunque en distintas semanas de la cursada y no necesariamente en la primera como es indicación del Departamento de Pediatría. La gran mayoría de los alumnos utilizó el material y lo considera útil. Los alumnos que no utilizaron el material comentan que usan textos tradicionales, en otros pese a haberlo recibido al comienzo de la sursada no consideraron la consulta del mismo. Sorprende aun más, que en el caso de los DVD de semiología difieran la consulta del mismo al final de la cursada ante la inminencia del examen práctico. Aún queda abierto el debate si la entrega de bibliografía preseleccionada es útil y necesria o es preferible brindar oportunidades para el autoaprendizaje y el estudio independiente (AU)

Acute bilateral postoperative endophthalmitis in a HLA-DQ5-positive patient: possible susceptibility to infections.

An unusual case of bilateral acute endophthalmitis in association with the HLA-DQ5 histocompatibility antigen is reported. A 35-year-old woman with high myopia and cataracts in both eyes underwent phacoemulsification procedures performed in separate sessions using different viscoelastic substances and following the same strict prophylactic measures. After each surgical procedure, she developed S. epidermidis acute endophthalmitis in the right eye and Propionibacterium acnes acute endophthalmitis in the left eye; both were successfully treated with capsular bag irrigation and intracameral vancomycin (1 mg/0.1 mL). She tested positive for the HLA-DQ5 (DQ1), DQ2 antigen. The question is raised as to whether the HLA-DQ5 histocompatibility antigen may be a predisposing factor for both staphylococcal and P. Acnes acute endophthalmitis. A multicenter prospective study is proposed to identify this HLA antigen in all patients scheduled for cataract surgery who have a history of postoperative endophthalmitis in the fellow eye.

Corneal topography of spontaneous perforation of acute hydrops in keratoconus.

An unusual case of spontaneous corneal perforation of acute hydrops in the left eye of a 21-year-old man is presented. The patient had a history of atopic diseases. To evaluate the status of the other eye, corneal topographic analysis was performed. This confirmed a subclinical keratoconus in the fellow eye and the association with atopy, eye rubbing, and rapid progression of the ectasia leading to perforation.

Hemolytic uremic syndrome in families-an Argentinian experience.

Six hundred and thirty-one patients with hemolytic uremic syndrome (HUS) were treated from 1960 to 1992; 19 (3%) were familial cases, of which 9 were classified as concomitant (including twins), 6 as non-concomitant, and 4 as recurrent. In the recurrent group there were 15 HUS episodes, 10 being concomitant in 2 patients. Prodromal diarrhea was present only in concomitant and non-concomitant cases. Patients with recurrences were sisters from a single family. Concomitant and non-concomitant cases had clinical features, course, and age similar to typical endemoepidemic forms of HUS, in which an association with verocytotoxin-producing Escherichia coli has been reported. There may be a genetic determinant in concomitant cases; these occurred outside the season during which endemoepidemic forms are typically detected. In patients with recurrent disease a genetic factor which may lead to the development of the disease when triggered by viral infections is likely.

Verocytotoxin-producing Escherichia coli infection in family members of children with hemolytic uremic syndrome.

Thirty-four hemolytic uremic syndrome (HUS) patients and ninety-five family members were studied to determine the frequency of infection with verocytotoxin-producing Escherichia coli (VTEC) in household contacts using three diagnostic criteria: VTEC strains isolation and characterization, detection of free fecal VT (FVT) and VT-neutralizing antibodies (VT-NAbs). Gastrointestinal tract symptoms occurred in one to six family members in 8 (23.5%) of the index cases, the week before admission to hospital or simultaneously. The control group consisted of 34 children with acute gastroenteritis who did not develop HUS. Cumulative evidence of VTEC infection was found in 13 (38.2%) of 34 HUS patients, in 30 (31.6%) of 95 family members and in 10 (29.4%) of 34 control children. The serotypes of VTEC isolated were O157: H7 and O25: H2. The prevalent VT type was VT2 in VTEC and FVT; and VT1 in VT-NAbs. Both parents had the same infection rate by fecal toxin or serological data (11.1% FVT, 32% VT-NAbs). These were higher than those detected in siblings (6.2% FVT, 23.5% VT-NAbs) and grandparents (0% FVT, 18% VT-NAbs). Of 16 patients without evidence of infection, 3 had household contacts with FVT and 13 with VT-NAbs. Our results show the wide dissemination of VTEC in the population of Argentina and that family members of HUS patients are usually infected. Therefore, person-to-person transmission may play an important role in the high incidence of HUS in our country.

Hemolytic uremic syndrome: co-infection with two different serotypes of Shiga-like toxin producing Escherichia coli.

We report a case of a child who developed Hemolytic Uremic Syndrome in whom two Shiga-like toxin (SLT)-producing Escherichia coli strains of different serotypes and genotypes, were simultaneously isolated from stools. In addition, one of these strains represented a new toxin producing serotype. Strain 1 belonged to serotype O157: H7, biotype D, produced SLT II and was susceptible to all antibiotics tested. This strain hybridized with gene probes for SLT II, fimbrial adhesion (EHEC factor) and attaching and effacing factor (eae). Strain 2 belonged to serotype 025: K2: H2, produced SLT II and had a multiresistant antibiotic susceptibility pattern. This strain hybridized with the EHEC gene probe but not with SLT I, SLT II and eae gene probes. Free fecal SLT II cytotoxin was detected in stools of the child and his father, suggesting that the infection may have been acquired from a household contact.

Hemolytic uremic syndrome: co-infection with two different serotypes of Shiga-like toxin producing Escherichia coli.

We report a case of a child who developed Hemolytic Uremic Syndrome in whom two Shiga-like toxin (SLT)-producing Escherichia coli strains of different serotypes and genotypes, were simultaneously isolated from stools. In addition, one of these strains represented a new toxin producing serotype. Strain 1 belonged to serotype O157: H7, biotype D, produced SLT II and was susceptible to all antibiotics tested. This strain hybridized with gene probes for SLT II, fimbrial adhesion (EHEC factor) and attaching and effacing factor (eae). Strain 2 belonged to serotype 025: K2: H2, produced SLT II and had a multiresistant antibiotic susceptibility pattern. This strain hybridized with the EHEC gene probe but not with SLT I, SLT II and eae gene probes. Free fecal SLT II cytotoxin was detected in stools of the child and his father, suggesting that the infection may have been acquired from a household contact.

Incidence of postoperative posterior capsular opacification with types of senile cataracts.

The most frequent postoperative complication in extracapsular cataract surgery is opacification of the posterior capsule. The purpose of this study was to correlate the frequency of capsular opacification with each kind of senile cataract. A total of 566 eyes with cataracts were studied. They had been operated on between 1980 and 1990 using the extracapsular, intercapsular, and phacoemulsification techniques. Our results confirm that senile complete cataracts (mature cataracts) had a significantly lower tendency to produce postoperative capsular opacification than other cataract types (nuclear, cortical, posterior subcapsular).