Analysis of perception of training in graduates of the Faculty of Medicine at Universidad de Castilla-Mancha.

INTRODUCTION: Problem-based learning has been a key component of the teaching method employed at the Faculty of Medicine at the University of Castilla La Mancha (UCLM) in Albacete, Spain since its creation. The aim of this study was to evaluate perceptions of training among residents who graduated from the first three years of the UCLM Degree in Medicine. METHODS: Using the Jefferson Medical College postgraduate rating form, residents rated their performance in four areas of clinical competency (medical knowledge, data gathering skills, clinical judgment, and professional attitudes) at the beginning of residency training in comparison with colleagues from other faculties. The construct validity of responses was evaluated using Cronbach's alpha and exploratory factor analysis. RESULTS: Over half the respondents (57.8%) considered that they had received better training than peers from other medical schools, and 98.5% felt that their general performance in the four competencies analyzed was similar or superior to that of their colleagues. Factor analysis revealed two major factors: "the physician as scientist" and "the physician as manager and communicator". CONCLUSIONS: Our study shows that graduates from the UCLM Faculty of Medicine perceive their training, which is largely based on problem-based learning, as satisfactory.

Síndrome de Herlyn-Werner-Wunderlich / Herlyn-Werner-Wunderlich syndrome

Presentamos el caso de una paciente de 18 años que consultó por oligomenorrea, flujo menstrual maloliente y dolor pélvico tipo cólico. Ante la sospecha de alteración menstrual por defecto en el tracto de salida se realizó ecografía ginecológica y resonancia magnética con el resultado de útero doble, hemivagina obstruida o ciega derecha acompañado de agenesia renal derecha, síndrome Herlyn-Werner-Wunderlich. Tras el diagnóstico se realizó escisión del septo y drenaje de las colecciones que suprimen la sintomatología de la paciente mejorando la capacidad reproductiva (AU)

We report the case of an 18-year-old woman who consulted for oligomenorrhea, chronic pelvic pain and malodorous vaginal discharge. Ultrasonography and magnetic resonance imaging demonstrated uterus didelphys with right-sided hematometrocolpos and absent right kidney (Herlyn-Werner- Wunderlich syndrome). The patient underwent resection of the septum and drainage of collections, with complete symptom resolution (AU)

Encefalopatía hipóxico-isquémica tras hematoma espontáneo de cordón umbilical / Hypoxic-ischemic encephalopathy following a spontaneous umbilical cord hematoma

Objetivo. Exponer el caso de una gestante que presentó un hematoma espontáneo de cordón umbilical, así como revisión de la literatura. Sujetos y métodos Primigesta, sin antecedentes de interés, con control gestacional normal, que ingresó por fase latente de parto. La MNE fue no satisfactoria, realizándose una cesárea de urgencia. Resultados. Nacimiento de una mujer de 3.050g, Apgar 1/3, que ingresó en la UCI y fue dada de alta con diagnóstico de encefalopatía hipóxico-isquémica. Conclusiones. La presencia de un patrón de monitorización fetal no satisfactorio debe alertar hacia la patología de cordón umbilical, debiéndose revisar este histológicamente (AU)

Objective. To present the case of a pregnant woman with a spontaneous umbilical cord hematoma and to provide a review of the literature. Subjects and methods. A primigravida, with no antecedents of interest and uneventful pregnancy, was admitted to our hospital in the latent phase of labor. Cardiotocography was unsatisfactory, and an urgent cesarean section was performed. Results. A 3050g girl was born, with an Apgar score of 1/3, and was admitted to the intensive care unit. The neonate was discharged with a diagnosis of hypoxic-ischemic encephalopathy. Conclusions. Umbilical cord abnormalities should be suspected when the results of fetal monitoring are unsatisfactory. Histological analysis of the umbilical cord should be performed (AU)

Laparoscopia frente a laparotomía para el tratamiento quirúrgico del cáncer de endometrio / Laparoscopy versus laparotomy for the surgical treatment of endometrial cancer

Objetivo: Comparar la supervivencia global y específica para cáncer de endometrio en el abordaje laparoscópico y laparotómico. Sujetos y métodos: Estudio de cohortes retrospectivo que incluyó 235 pacientes con diagnóstico de carcinoma de endometrio y tratadas quirúrgicamente entre 2001 y 2010, bien mediante abordaje laparoscópico (104 pacientes) o mediante abordaje laparotómico (131 pacientes). Resultados: La supervivencia global, la supervivencia específica y el intervalo libre de enfermedad fueron similares en ambos grupos, obteniendo para el grupo laparoscópico una supervivencia libre de enfermedad del 85,5% y una supervivencia del 80,2%; y para el grupo laparotómico supervivencia libre de enfermedad del 77,9% y supervivencia del 82,3% sin diferencias estadísticamente significativas. En el grupo de laparoscopia se obtuvo un mayor tiempo operatorio y menor estancia hospitalaria. Salvo la lesión a órganos, las complicaciones quirúrgicas y posquirúrgicas fueron similares. Conclusión: La laparoscopia para el tratamiento del cáncer de endometrio presenta igual supervivencia e intervalo libre de enfermedad, y teniendo en cuenta los riesgos quirúrgicos, constituye una buena alternativa a la cirugía tradiciona (AU)

Objective: To compare overall survival and disease-specific survival for endometrial cancer with the laparoscopic and laparotomy approaches. Subjects and methods: We performed a retrospective cohort study that included 235 patients with a diagnosis of endometrial carcinoma who were surgically treated between 2001 and 2010 either by the laparoscopic approach (104 patients) or by laparotomy (131 patients) in our hospital. Results: Overall survival, disease-specific survival and the disease-free interval were similar in the two groups. In the laparoscopic group, disease-free survival was 85.5% and survival was 80.2%, while in the laparotomy group, disease-free survival was 77.9% and survival was 82.3%, with no statistically significant differences. In the laparoscopy group, operating time was longer and hospital stay was shorter. Except for organ injury, surgical and postoperative complications were similar. Conclusions: There were no differences in survival or the disease-free interval between the laparoscopy and laparotomy groups. Considering the risks of surgery, laparoscopy is a good alternative to traditional surgery (AU)