Impact of the COVID-19 pandemic on the clinical training of last year medical students in Mexico: a cross-sectional nationwide study.

BACKGROUND: The COVID-19 pandemic has brought unprecedented changes to medical education. However, no data are available regarding the impact the pandemic may have on medical training in Mexico. The aim of our study was to evaluate and identify the medical school students' perceptions of the changes in their clinical training due to the pandemic in Mexico. METHODS: This was a cross-sectional study where a previous validated online survey was translated and adapted by medical education experts and applied to senior medical students from March to April of 2021. The 16-item questionnaire was distributed online combining dichotomous, multiple-choice, and 5-point Likert response scale questions. Descriptive and multivariate analyses were performed to compare the student's perceptions between public and private schools. RESULTS: A total of 671 responses were included in the study period. Most participants were from public schools (81%) and female (61%). Almost every respondent (94%) indicated it was necessary to obtain COVID-19 education, yet only half (54%) received such training. Students in private schools were less likely to have their clinical instruction canceled (53% vs. 77%, p = 0.001) and more likely to have access to virtual instruction (46% vs. 22%, p = 0.001) when compared to students from public schools. Four out of every five students considered their training inferior to that of previous generations, and most students (82%) would consider repeating their final year of clinical training. CONCLUSIONS: The impact of the COVID-19 on medical education in Mexico has been significant. Most final-year medical students have been affected by the cancellation of their in-person clinical instruction, for which the majority would consider repeating their final year of training. Efforts to counterbalance this lack of clinical experience with virtual or simulation instruction are needed.

[Sevestre-Jacquet posterosive syphilitic dermatitis associated with the use of reusable diapers: A clinical case]. / Dermatitis sifiloide posterosiva de Sevestre-Jacquet asociada al uso de pañales reutilizables: caso clínico.

BACKGROUND: Diaper dermatitis is a skin problem that has decreased with the development of new technologies in disposable diapers that prevent excessive moisture in the perianal region. The following clinical case shows the relationship between the use of cloth reusable diapers and the appearance of Jacquet erosive diaper dermatitis, a serious and rare complication of diaper dermatitis. CLINICAL CASE: We present the case of a 1-year-11-month-old patient, taken to the Dermatology department due to the presence of a lesion in the gluteal region. The mother reported the onset of the condition four months ago after the presence of semi-liquid stools. Localized dermatosis is observed on both lower limbs, affecting the genital region in the labia majora and the perianal region at the level of the intergluteal folds bilaterally and symmetrically. In the histopathological study, a posterosive Sevestre-Jacquet syphilid was diagnosed. CONCLUSION: Sevestre-Jacquet's posterosive syphilitic dermatitis is a rare dermatological condition and its risk of occurrence is greater due to the use of ecological cloth diapers.

INTRODUCCIÓN: la dermatitis de pañal es un problema cutáneo que ha disminuido con el desarrollo de nuevas tecnologías en los pañales desechables, los cuales impiden la humedad excesiva en la región perianal. En el siguiente caso clínico se muestra la relación entre el uso de pañales de tela y la aparición de dermatitis sifiloide posterosiva de Sevestre-Jaquet, una complicación grave y poco frecuente de la dermatitis de pañal. CASO CLÍNICO: presentamos el caso de una paciente de 1 año y 11 meses de edad, llevada a la consulta externa de Dermatología por la presencia de una lesión en la región glútea. La madre refirió inicio del padecimiento cuatro meses atrás y posterior a la presencia de evacuaciones semilíquidas. Se observa dermatosis localizada en ambos miembros inferiores, que afecta la región genital en labios mayores y región perianal a nivel de pliegues interglúteos de forma bilateral y simétrica. En el estudio histopatológico se emite el reporte diagnóstico de sifiloide posterosivo de Sevestre-Jacquet. CONCLUSIÓN: la dermatitis sifiloide posterosiva de Sevestre-Jacquet es una condición dermatológica poco frecuente y su riesgo de ocurrencia es mayor debido al uso de pañales ecológicos de tela.