[Teaching Bioethics to Students of Medicine with Problem-Based Learning (PBL)]. / Enseñar Bioética a Estudiantes de Medicina Mediante el Aprendizaje Basado en Problemas (ABP).

We present the experience of the introduction of the subject of bioethics in a medical school in order to give to the 73 students of 5th degree skills to handle ethical conflicts in their practice. The main teaching method used was problem-based learning (PBL). Skills objectives are described. The course was structured with a theoretical seminar (2 hours of duration), a workshop (2 hours of duration), 4 cases of PBL (24 hours of duration in total) and a role playing workshop (2 hours of duration). The seminar was aimed at the acquisition of theoretical knowledge. The PBL cases provided critical appraisal, obtaining knowledge, and application. The Role Playing set out for the practical demonstration of skills acquired in a simulated environment. A continuous assessment of students was performed throughout their practice on the PBL cases (40% of the final score) and also a final evaluation of the course was carried out via exam (60% of the final score). Students completed a course and faculty evaluation anonymously, which came out with positive results (median score of 8.5/10).

Enseñar bioética a estudiantes de medicina mediante el aprendizaje basado en problemas (ABP) / Teaching bioethics to students of medicine with problema-based learning (PBL)

Se describe la implantación de la asignatura de Bioética en una Facultad de Medicina con el objetivo de dotar a los 73 alumnos de quinto curso de competencias para manejar conflictos éticos en su práctica profesional. El método docente utilizado principalmente fue el aprendizaje basado en problemas. Se describen las competencias y objetivos docentes marcados. El diseño de la asignatura consistió en un seminario teórico (2 horas), un taller práctico (2 horas), cuatro casos de aprendizaje basado en problemas (ABP) (24 horas en total) y un taller de dramatizaciones (Role Playing) (2 horas). El seminario se orientó a la adquisición de conocimientos teóricos básicos sobre bioética. Los casos ABP facilitaron la valoración crítica, la obtención de conocimiento, y su aplicación. Los Role Playing se encaminaron a la demostración práctica de las competencias adquiridas en un entorno simulado. Se realizó una evaluación continuada de los alumnos durante su trabajo en los casos ABP (40% de la nota), y una evaluación final de la asignatura mediante un examen (60% de la nota). Los alumnos evaluaron la asignatura y al profesorado de forma anónima, siendo los resultados positivos (8,5/10)

We present the experience of the introduction of the subject of bioethics in a medical school in order to give to the 73 students of 5th degree skills to handle ethical conflicts in their practice. The main teaching method used was problem-based learning (PBL). Skills objectives are described. The course was structured with a theoretical seminar (2 hours of duration), a workshop (2 hours of duration), 4 cases of PBL (24 hours of duration in total) and a role playing workshop (2 hours of duration). The seminar was aimed at the acquisition of theoretical knowledge. The PBL cases provided critical appraisal, obtaining knowledge, and application. The Role Playing set out for the practical demonstration of skills acquired in a simulated environment. A continuous assessment of students was performed throughout their practice on the PBL cases (40% of the final score) and also a final evaluation of the course was carried out via exam (60% of the final score). Students completed a course and faculty evaluation anonymously, which came out with positive results (median score of 8.5/10)

Complete remission in a pancytopenic HIV negative, HHV-8 positive patient with Multicentric Castleman’s Disease induced with anti-CD20

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A 75-year-old woman was diagnosed of MCD plasmacell (PC) variant with B symptoms. Diffuselymph-node enlargement, splenomegaly and pancytopeniawere detected. Induction with Rituximabwas made because pancytopenia was present.Actually patient is free of disease. This is the firstcomplet reponse of MCD published, VIH negative,induced with anti CD20

[5-Fluorouracil-induced small bowel toxicity in a patient with colorectal cancer]. / Toxicidad en el intestino delgado inducida por 5-fluorouracilo en un paciente con carcinoma colorrectal.

5-Fluorouracil-induced gastro-intestinal toxicity predominantly affects the upper and the lower gastro-intestinal tract. Although 5-fluorouracil (5-FU) can cause severe small-bowel toxicity, this has been reported only in 6 patients with colon carcinoma receiving 5-FU-based therapy. The presentation was extensive ulceration and inflammation of the small bowel with no involvement of the colon. We report another case of this toxicity, and discuss the diagnosis and mechanisms by which 5-FU can induce small-bowel toxicity.

Toxicidad en el intestino delgado inducida por 5-fluorouracilo en un paciente con carcinoma colorrectal / 5-Fluorouracil-induced small bowel toxicity in a patient with colorectal cancer

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5-Fluorouracil-induced gastro-intestinal toxicity predominantly affects the upper and the lower gastro-intestinal tract. Although 5-fluorouracil (5-FU) can cause severe small-bowel toxicity, this has been reported only in 6 patients with colon carcinoma receiving 5-FU-based therapy. The presentation was extensive ulceration and inflammation of the small bowel with no involvement of the colon. We report another case of this toxicity, and discuss the diagnosis and mechanisms by which 5-FU can induce small-bowel toxicity

[Paralytic ileus due to vinorelbine]. / Ileo paralítico por vinorelbina.

Intestinal obstruction is very common in cancer patients and occurs in 80% of cases with malignant aetiology. Hence, aggressive treatment is needed in most cases. The occlusion can be caused by luminal obstruction, paralysis of the intestinal muscle or carcinomatosis with mesentery involvement. The clinical case we present is that of a patient diagnosed as having lung cancer and who was admitted with paralytic ileus following treatment with vinorelbine; a vinca alkaloid whose main characteristic toxicities include neutropenia and peripheral neuropathy. Also, on rare occasions, the drug can cause paralysis of the ileum due to autonomic neuropathy. Hence, before administering aggressive treatment to an occlusive syndrome, cases that could benefit from conservative treatment should be ruled out.

Íleo paralítico por vinorelbina / Paralytic ileus due to vinorelbine

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Intestinal obstruction is very common in cancer patients and occurs in 80% of cases with malignant aetiology. Hence, aggressive treatment is needed in most cases. The occlusion can be caused by luminal obstruction, paralysis of the intestinal muscle or carcinomatosis with mesentery involvement. The clinical case we present is that of a patient diagnosed as having lung cancer and who was admitted with paralytic ileus following treatment with vinorelbine; a vinca alkaloid whose main characteristic toxicities include neutropenia and peripheral neuropathy. Also, on rare occasions, the drug can cause paralysis of the ileum due to autonomic neuropathy. Hence, before administering aggressive treatment to an occlusive syndrome, cases that could benefit from conservative treatment should be ruled out

Necrotic cellulitis by Serratia plymuthica.

This case report describes an uncommon cellulitis caused by Serratia plymuthica in a patient treated with steroids. The evolution was favorable after surgical exploration with debridement and antibiotic treatment. This is the first case of necrotic cellulitis caused by S. plymuthica described in the literature.