Medical Professionalism and Its Association with Dropout Intention in Peruvian Medical Students during the COVID-19 Pandemic.

BACKGROUND: The COVID-19 pandemic introduced unprecedented challenges to medical education systems and medical students worldwide, making it necessary to adapt teaching to a remote methodology during the academic year 2020-2021. The aim of this study was to characterize the association between medical professionalism and dropout intention during the pandemic in Peruvian medical schools. METHODS: A cross-sectional online-survey-based study was performed in four Peruvian medical schools (two public) during the academic year 2020-2021. Medical students, attending classes from home, answered three scales measuring clinical empathy, teamwork, and lifelong learning abilities (three elements of medical professionalism) and four scales measuring loneliness, anxiety, depression, and subjective wellbeing. In addition, 15 demographic, epidemiological, and academic variables (including dropout intention) were collected. Variables were assessed using multiple logistic regression analysis. RESULTS: The study sample was composed of 1107 students (390 male). Eight variables were included in an explanatory model (Nagelkerke-R2 = 0.35). Anxiety, depression, intention to work in the private sector, and teamwork abilities showed positive associations with dropout intention while learning abilities, subjective wellbeing, studying in a public medical school, and acquiring a better perception of medicine during the pandemic showed a negative association with dropout intention. No association was observed for empathy. CONCLUSIONS: Each element measured showed a different role, providing new clues on the influence that medical professionalism had on dropout intention during the pandemic. This information can be useful for medical educators to have a better understanding of the influence that professionalism plays in dropout intention.

[Retinopathy as a sickle-cell trait: myth or reality?]. / La rétinopathie chez le porteur du trait drépanocytaire AS: mythe ou réalité?

INTRODUCTION: The retinopathy of sickle cell diseases is an ischemic retinopathy that occurs frequently in the major forms of HbSS and HbSC sickle cell diseases. The retinopathy of sickle trait HbAS has not been described extensively. PATIENTS AND METHODS: The aim of this study was to describe the retinal characteristics and thus gain better knowledge of sickle trait HbAS retinopathy. Seventy HbAS patients had a complete ocular examination including fluorescein angiography. RESULTS: Seventy percent of the patients had retinal lesions, with 49.3% non-vasoproliferative lesions, 22.7% prevasoproliferative lesions and 2.7% neovascular lesions. DISCUSSION AND CONCLUSION: Retinopathy is associated with the HbAS sickle cell trait, but it is less serious than in the major forms of sickle cell syndrome.

[Isolated palpebral tumor revealing Von Recklinghausen's neurofibromatosis: a case report]. / Tumeur palpébrale isolée révélatrice de la neurofibromatose de Von Recklinghausen.

INTRODUCTION: Von Recklinghausen's neurofibromatosis is the most frequent of phakomatoses. Its incidence is 1/2,500-3,000 births. It is inherited through a dominant autosomal mode with a strong prevalence and changing expression. Eye and skin signs are essential to diagnosis and this case provided a noteworthy example of a unilateral upper palpebral tumor revealing this disease. CLINICAL CASE: We report a case of a 6-year-old boy whose original clinical manifestation was a tumor on the upper eyelid of the right eye, present at birth. According to the anamnesis, this palpebral tumor gradually increased in size, causing a full ptosis. A biopsy exeresis of the tumor was carried out with an anatomicopathological study of the biopsy specimen, confirming the diagnosis. CONCLUSION: The anatomicopathological study of the biopsy specimen enabled diagnosis of a neurofibromatosis revealed by this isolated palpebral localization responsible for significant aesthetic and functional damage.

[Asymmetrical forms of primary open angle glaucoma]. / Les formes asymétriques du glaucome primitif à angle ouvert.

PURPOSE: The goal of this study is to describe asymmetrical forms of primary open angle glaucomas in black african originated patients. MATERIAL AND METHOD: Data of 514 glaucomatous patients (1022 eyes) followed between 1993 and 1997, and attending our hospital eye department are retrospectively analysed. All the participants were diagnosed as primary open angle glaucomas; asymetry was defined as a difference of 0.2 at least between the vertical cup disc ratio of the same patient. RESULTS: The mean age of all 514 glaucoma patients was 34.52 +/- 15.55 years; 254 patients (49.40%) had no differences between cup disc values while 260 remaining others had asymmetric glaucomas (50.58%). Of them, 189 (72.69%) had a difference of 0.2 between both eyes; 49 (18.8%) had 0.3 difference; 7 (2.69%) had 0.4 difference; 4 (1.53%) had 0.5 difference, and 11 (4.23%) a difference of 0.6. Besides, 114 eyes (11.15%) had a vertical ratio of 0.9 at the first diagnosis. CONCLUSION: Carefully recognition of asymmetric cup disc ratios is of great diagnostic value in the the early stages of primary open angle glaucoma because 50% of all patients presented with this clinical form in our experience. This strategy would improve early diagnosis of glaucoma in our areas.

[Retinal complications in AIDS patients at the Lomé (Togo) University Hospital]. / Les complications rétiniennes chez des patients atteints de SIDA au CHU de Lomé (Togo).

BACKGROUND: The purpose of this study was to describe retinal complications observed in patients presenting with AIDS at Lome teaching hospital. MATERIAL: All patients who met WHO AIDS clinical case diagnostic in Africa, admitted for various signs in hospital, were followed between December 1996 and May 1997 for ocular examinations. RESULTS: We surveyed 94 patients; 41 (43.6%) had retinal lesions. Retinal complications were cotton whool spots (30 cases), retinal hemorrhages (4 cases), papilloedema (4 cases), cytomegalovirus retinitis (8 cases). Mortality in patients with retinal complications occurred 10 months after the clinical diagnosis of AIDS. CONCLUSION: This study has found a high retinal morbidity contrasting with other studies in Africa. This could be explained by the longer period of follow-up larger than in previous similar studies.

[Retinal involvement in drepanocytosis in Togo. Correlation between age, genotype and retinopathy]. / Atteinte rétinienne au cours de la drépanocytose au Togo. Corrélation entre âge, génotype et rétinopathie.

PURPOSE: To evaluate different retinal complications, study correlation with age and links with genotypic forms in Togolese sickle cell patients. MATERIAL AND METHOD: Patients were recruited between 1994 and 1996 at the hospital, genotypic diagnosis by electrophoresis, systematic angiofluorography were performed and laser photocoagulation of retinal neovascularisation if needed. RESULTS: A total number of 190 patients were recruited, 84 (44.21%) had retinopathy, while 106 (55.79%) were normal. The SC form was most affected with 50 patients (26.3%), followed by the SS group in 11.05% (21 patients), and AS trait, 2.65% (5 patients). Patients most affected by proliferative retinopathy were aged 35-44 years (n = 30; 15%), 25-34 years in 23.8% and 15-24 years in 20.6%. CONCLUSION: Young Togolese sickle cell patients aged 35 to 44 year-old and the SC forms appear to have a relative high risk of proliferative retinopathy in this study.

Oeil et medecine tradipraticienne: a propos d'un cas de traitement intempestif

La medecine traditionnelle a survecu a l'epreuve du developpement de la medecine moderne dans nos pays et gagne meme de plus en plus de terrain. Malheureusement cette medecine mal dosee et surtout mal maitrisee peut provoquer des complications graves. Nous rapportons ici un cas qui illustre bien la gravite de la situation. Il s'agit du cas d'une exophtalmie maligne apparue chez un homme de 42 ans souffrant de maladie de Basedow. Il a ete traite par application des produits traditionnels. Les consequences sont effroyables

Glaucome a pression normale: probleme diagnostique

Les auteurs rapportent une serie de glaucomes a pression normale et soulignent les problemes diagnostiques qu'ils soulevent

[Treatment of a case of retinal detachment in morning glory syndrome]. / Traitement d'un cas de décollement de rétine secondaire à un syndrome de morning glory.

The association of Morning glory syndrome and retinal detachment has been described several times. The observation of one clinical case has led us to review all the proposed physiopathogenic hypotheses and to deduce an original therapeutic attitude. The possibility of an abnormal communication between the sub retinal and sub arachnoidal spaces has justified the use of acetazolamide to reduce the secretion of spinal fluid and the prevention of its subretinal diffusion by an ocular compression. The reapplication which has been obtained was followed by a wide spread retinopexy on the detached retina. In addition, an intravitreous injection of C3F8 has been used to treat of a retinal hole in the staphylomatous area.