An international, multicenter, retrospective study on the positive impact of cutaneous involvement on the clinical outcome of adult T-cell leukemia/lymphoma.

Adult T-cell leukemia/lymphoma (ATLL) is a largely incurable disease. Cutaneous involvement is common and could be first symptom of the disease. We analyzed 169 patients with ATLL of whom 63 had cutaneous involvement. Cutaneous involvement was found in 48, 27, 17, and 60% of acute, lymphomatous, chronic and smoldering ATLL cases, respectively. Eight cases had primary cutaneous tumoral variant. Erythroderma (24%) and plaques (22%) were the most frequent skin lesions. The presence of cutaneous involvement was associated with better overall survival compared to non-cutaneous involvement (aHR 0.55 [95% CI: 0.37-0.82], p < 0.01; 1-year OS 53 vs. 27%, respectively, p = 0.012). Combination zidovudine and interferon-alpha (AZT-IFN) yielded high response rates (overall response, OR = 100%, n = 8; complete response 62.5%) compared to chemotherapy (OR = 33.3%, n = 12/36). In conclusion, cutaneous involvement was associated with better survival in Latin American patients with ATLL. AZT-IFN demonstrated encouraging responses in ATLL patients with cutaneous involvement.

Factores determinantes del nivel de carrera médica en un hospital nacional nivel III-1 / Determinants of the level of medical career at a national hospital level III-1

Objetivo: describir los factores determinantes del nivel de la carrera médica en los servicios de medicina, obtenidos en el proceso de ascenso del personal médico de un Hospital Nacional nivel III-1 en el año 2010. Materiales y métodos: estudio transversal. Se incluyó a todos los médicos de las especialidades de medicina y se excluyó a los médicos que ya habían alcanzado el nivel máximo de ascenso. Los factores que se tomaron en cuenta fueron: tiempo de servicio, calificación profesional y evaluación semestral. Se empleó el programa Ms Excel 2007 para el análisis descriptivo. Resultados: se estudiaron 71 médicos pertenecientes a 13 servicios de Medicina, 21 médicos pertenecían al servicio de Medicina Interna. El servicio de Psiquiatría presentó el mayor tiempo de servicio con una media de 26.3 años; Dermatología presentó el mayor puntaje en el rubro de calificación profesional con una media de 24.3; y Hematología el mayor puntaje en la evaluación semestral con una media de 92.2 puntos. Dermatología obtuvo el mayor puntaje total de los factores intervinientes en la progresión de la carrera médica con 89 puntos. Conclusiones: el servicio de Dermatología cuenta con el mayor puntaje total de los factores determinantes en la progresión de la carrera médica.

Aim: to describe the determinants factors of the medical career level achieved in medical departments, during the process of promotion of medical staff at a national reference hospital in 2010. Methods: Cross-sectional study. We included physicians from every specialty, doctors who had already reached the maximum level of promotion were excluded. Factors taken into account were: length of work, professional training and evaluation every six months. Ms Excel 2007 program was used for descriptive analysis. Results: We studied 71 physicians from 13 medical departments; 21 of them were from the Internal Medicine Department. Psychiatry Department had the highest length of work with anaverage of 26.3 years; Dermatology had the highest score in the area of professional qualification with a mean of 24.3 points and Hematologyhad the highest score in semi-annual evaluation with a mean of 92.2 points. Dermatology had the highest total score of the factors involved in the progression of the medical career with 89 points. Conclusions: Dermatology Department had the highest total score of determinants in the progression of the medical career.