Human monkeypox disease (MPX).

Monkeypox is a rare viral infection, endemic in many central and western African countries. The last international outbreak of monkeypox reported outside Africa occurred back in 2003. However, monkeypox has reemerged at a global scale with numerous confirmed cases across the globe in 2022. The rapid spread of cases through different countries has raised serious concerns among public health officials worldwide prompting accelerated investigations aimed to identify the origins and cause of the rapid expansion of cases. The current situation is reminiscent of the very early stages of the still ongoing COVID-19 pandemic. Overlapping features between these, two seemingly alike viral entities include the possibility for airborne transmission and the currently unexplained and rapid spread across borders. Early recognition of cases and timely intervention of potential transmission chains are necessary to contain further outbreaks. Measures should include rapid and accurate diagnosis of cases meeting case definitions, active surveillance efforts, and appropriate containment of confirmed cases. Governments and health policymakers must apply lessons learned from previous outbreaks and start taking active steps toward limiting the recent global spread of monkeypox. Herein, we discuss the status of the current monkeypox outbreaks worldwide, the epidemiological and public health situation at a global scale and what can be done to keep at bay its further expansion and future global implications.

Trastorno desmielinizante agudo por parvovirus B19 / Acute demyelinating disorder by parvovirus B19

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Percepción de los estudiantes de Medicina sobre la utilización de los pacientes simulados como estrategia para el entrenamiento en el manejo integral de pacientes / Perception of medical students on the use of simulated patients as a strategy for training in the comprehensive management of patients

INTRODUCCIÓN: El paciente estandarizado (PE) o simulado es una herramienta globalmente aceptada dentro de la enseñanza médica. Se trata de un actor altamente entrenado que simula una o más enfermedades, desempeñándose como una herramienta integradora de conocimientos. METODOLOGÍA: Se evaluó la percepción del estudiante de Medicina sobre el manejo integral de pacientes, utilizando PE como estrategia, a través de una encuesta de satisfacción. El análisis incluyó el uso de medidas de frecuencia como medias y proporciones para todas las preguntas del cuestionario. RESULTADOS: La gran mayoría de los estudiantes de la carrera de Medicina (95,8%; 45 de 47) manifestaron estar de acuerdo en que la práctica con PE les permitió integrar conocimientos. El 95,8% (45 de 47) percibió esta estrategia como útil para el desarrollo de habilidades de comunicación con pacientes. CONCLUSIONES: Al utilizar la estrategia del PE en simulación clínica, las habilidades de comunicación fueron percibidas como las más desarrolladas dentro del aprendizaje del manejo integral clínico

INTRODUCTION: The standardized patient (SP) or simulated patient is a globally accepted tool within the medical education. Usually, a highly-trained actor simulates one or more diseases performing as an integrative tool in the learning process. METHODOLOGY: We evaluated the perception of knowledge gaining after using the SP strategy in a group of medical students through a satisfaction survey. The analysis included the use of frequency measures as means and proportions for all questions in the questionnaire. RESULTS: Most medical students (95.8%; 45 from 47) expressed agreement that the SP practice allowed them to integrate knowledge. Also, 95,8% (45 from 47) agreed that this strategy was useful for the development of communication skills with patients. CONCLUSIONS: When using the SP strategy in clinical simulation, communication skills were perceived as the most developed within the learning of clinical integral management

Afectación pancreática en infección por leptospirosis / Pancreatic involvement in leptospirosis infection

La leptospirosis en fase ictérica o enfermedad de Weil es una vasculitis zoonótica endémica de la Costa ecuatoriana. Sin embargo, la pancreatitis aguda como parte de esta entidad es una complicación rara vez documentada. En este reporte de caso se presenta a un adulto varón de 63 años con signos de falla multiorgánica y amilasa con rápido ascenso inicial. La leptospirosis no fue tomada como primera opción diagnóstica. El paciente fue tratado debido a un cuadro de SDRA como un shock séptico de foco pulmonar, con falla renal aguda que requirió hemodiálisis, permaneciendo en UCI con antibioticoterapia empírica. El objetivo de este caso es remarcar que la leptospirosis debe siempre estar considerada en el diagnóstico diferencial de ictericia y pancreatitis, sobre todo en nuestro medio.

The icteric presentation of Leptospirosis, also known as Weil's disease, is a zoonotic vasculitis endemic to Ecuador's coastal region. However, reports of pancreatic affection due to this entity are rarely documented. We chose to present the case of a 63 years old male with signs of catastrophic organic failure, associated with a rapid increase in serum amylase concentrations. Due to this presentation, Leptospirosis was not held as the primary culprit of the disease, and was treated at the ICU as septic shock of pulmonary origin with ARDS associated with acute kidney injury that required hemodialysis. Thus this case aims to highlight the importance of Leptospirosis as an important differential diagnosis in any patient hailing from a tropical region with jaundice and pancreatitis.