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Introduction: it is during Medical Residency Training (MIR) that knowledge, abilities and habits are acquired, which will shape professional activity in the future. It is therefore very likely that residents who do not acquire the necessary habits and knowledge for research activities will eventually not carry out these activities in the future. The aim of this study was to analyze the level of satisfaction of residents with his or her scientific and research training, and to determine any deficiencies with respect to this training. Materials and methods: the aim of the questionnaire used was to determine the level of satisfaction of residents regarding their scientific and research training during their residency period. Questionnaires were usually distributed via internal mail to all residents (MIR physicians) registered at a third level teaching hospital, with a completion rate of 78% (n = 178). Results: as far as the evaluation of scientific training is concerned, 68% of residents were dissatisfied or very dissatisfied. With respect to scientific studies carried out, 49% of residents had not taken part in any, but the number of studies carried out increases as the residency progresses. On the other hand, 22% of residents reported not having started their doctoral thesis, 50% having attended doctorate courses, 24% having a title for their thesis, and only 4% having written a thesis. Doctorate courses, thesis topics, and written theses increase with the year of residency, and a greater activity may be seen in this respect in surgical departments. If we analyze help available to residents for their carrying out scientific activities, 55% reported that only selected assistant doctors would offer help, and 21% reported that no doctors would offer help. Dissatisfaction with research training increases with the year of residency. With regard to main specialist fields, it can be seen that residents in surgical fields carry out more theses, whereas central fields report less facilities. Finally, if we evaluate the influence that these variables may have on the general satisfaction of residents with his or her residency, these variables are seen to be significant factors of dissatisfaction. Conclusions: most residents are dissatisfied with their scientific training and have relatively few facilities for developing such skills, which in turn results in a scarce number of scientific studies and doctoral theses.Introducción: durante la residencia MIR se van a adquirir los conocimientos, habilidades y hábitos que van a marcar la actividad profesional en el futuro. Por ello, es muy probable que los residentes que no adquieran el hábito y los conocimientos necesarios para realizar actividades investigadoras no realicen dichas actividades en el futuro. El objetivo es analizar la satisfacción de los MIR con su formación científica e investigadora, y determinar los déficits al respecto en su formación. Material y método: se aplicó un cuestionario destinado a constatar la satisfacción de los residentes respecto a su formación científica e investigadora durante el transcurso de su residencia. Los cuestionarios se distribuyeron nominalmente por correo interno a todos los MIR registrados en un hospital de tercer nivel acreditado para docencia, siendo el grado de cumplimentación del 78% (n=178). Resultados: en cuanto a la valoración de la formación científica, el 68% están insatisfechos o muy insatisfechos. Respecto a la realización de trabajos científicos, el 49% de los residentes no han escrito ninguno, aunque aumenta el número de trabajos realizados conforme avanza el tiempo de residencia. Por otro lado, el 22% refiere no tener iniciada la tesis doctoral, el 50% haber realizado los cursos de doctorado, el 24% tiene tema de tesis, y sólo el 4% la ha escrito. Los cursos, el tema de tesis y el haberla escrito van aumentando con el año de residencia, y se observa una mayor actividad en este sentido en los servicios quirúrgicos. Si analizamos las facilidades que tienen los residentes para realizar actividades científicas, el 55% refieren que sólo con determinados adjuntos, y el 21% que ninguna. La insatisfacción con la formación investigadora aumenta conforme aumenta el año de residencia. En cuando al área troncal de la especialidad, se observa que realizan más tesis los residentes de las áreas quirúrgicas, y que los de áreas centrales refieren menos facilidades. Por último, si se valora la influencia que estas variables pueden tener en la satisfacción general del residente con su residencia, se observa que son factores significativos de insatisfacción. Conclusiones: la mayoría de los residentes están insatisfechos con su formación científica y tienen relativamente pocas facilidades para poder desarrollarla, lo cual se plasma en un escaso número de trabajos científicos y tesis doctorales.

La ecografía ha adquirido gran importancia en el diagnóstico de los tumores ováricos, de manera que resulta de gran utilidad en la práctica ginecológica. Se realizó una revisión de la bibliografía biomédica acerca de la patogenia, el cuadro clínico y el diagnóstico ecográfico e histopatológico de dichos tumores, con vistas a crear un importante material de consulta acerca de esta enfermedad, cuyo descubrimiento en etapas tempranas es vital para las pacientes.Echography has acquired great importance in the diagnosis of the ovarian tumors, so that it is of great usefulness in the gynecological practice. A review of the biomedical literature on the pathogenia, the clinical pattern and the echographic and histopathological diagnosis of these tumors was carried out , aimed at creating an important reference tool dealing about this illness, which finding in early stages, is vital for the patients.

Aim: To evaluate the clinical effectiveness and safety of glatiramer acetate for use in routine clinical practice., Patients and Methods: A retrospective, observational study was conducted on patients with multiple sclerosis who were treated with glatiramer acetate in clinical practice. The primary outcome was the clinical effectiveness of glatiramer acetate treatment., Results: The study included a total of 104 patients (women, 59.6%; age at onset of glatiramer acetate treatment, 39.9 ± 10.9 years; prior treatment for multiple sclerosis, 30.8%). The patients had received glatiramer acetate treatment for an average of 3.6 ± 1.9 years. During the first year of glatiramer acetate treatment, the relapse rate decreased by 60%. At this time, the number of relapses had decreased for 47 patients (45.1%), 67 patients (68.4%) had not suffered a relapse and 78 patients (75.0%) showed no signs of progression. During the second year of glatiramer acetate treatment, the relapse rate decreased by 70%. At this time, the number of relapses had decreased for 43 patients (41.3%), 63 patients (75.9%) had not suffered a relapse and 59 patients (56.7%) showed no signs of progression. There were no reported relapses or progression in 56 patients (53.8%) and 41 patients (39.4%) during the first and second years of treatment, respectively. Discontinuation of glatiramer acetate was necessary in only three patients. The most common adverse effects included fatigue (28.9%) and spasticity (7.7%)., Conclusion: This evaluation of glatiramer acetate use in clinical practice supports the effectiveness and the safety profile observed in previously published clinical trial studies.

Sarcoidosis is a multisystemic disease which diagnosis depends on the presence of nonnecrotizing granulomas in the biopsy. However there are variants such as necrotizing sarcoidal granulomas or nodular sarcoidosis which have atypical findings and make difficult the differential diagnosis with other infectious processes. We describe a case of a man who develops granulomas with extensive necrosis in a systemic sarcoidosis that affected the lung and the central nervous system. This finding made us to make the diagnosis of tuberculosis and delay the specific treatment.

Introduction: It is during Medical Residency Training (MIR) that knowledge, abilities and habits are acquired, which will shape professional activity in the future. It is therefore very likely that residents who do not acquire the necessary habits and knowledge for research activities will eventually not carry out these activities in the future. The aim of this study was to analyze the level of satisfaction of residents with his or her scientific and research training, and to determine any deficiencies with respect to this training., Materials and Methods: The aim of the questionnaire used was to determine the level of satisfaction of residents regarding their scientific and research training during their residency period. Questionnaires were usually distributed via internal mail to all residents (MIR physicians) registered at a third level teaching hospital, with a completion rate of 78% (n = 178)., Results: As far as the evaluation of scientific training is concerned, 68% of residents were dissatisfied or very dissatisfied. With respect to scientific studies carried out, 49% of residents had not taken part in any, but the number of studies carried out increases as the residency progresses. On the other hand, 22% of residents reported not having started their doctoral thesis, 50% having attended doctorate courses, 24% having a title for their thesis, and only 4% having written a thesis. Doctorate courses, thesis topics, and written theses increase with the year of residency, and a greater activity may be seen in this respect in surgical departments. If we analyze help available to residents for their carrying out scientific activities, 55% reported that only selected assistant doctors would offer help, and 21% reported that no doctors would offer help. Dissatisfaction with research training increases with the year of residency. With regard to main specialist fields, it can be seen that residents in surgical fields carry out more theses, whereas central fields report less facilities. Finally, if we evaluate the influence that these variables may have on the general satisfaction of residents with his or her residency, these variables are seen to be significant factors of dissatisfaction., Conclusions: Most residents are dissatisfied with their scientific training and have relatively few facilities for developing such skills, which in turn results in a scarce number of scientific studies and doctoral theses.

Objectives: To make a retrospective analysis of the synthesis of antibodies to the MOMPS and LPS antigens of Chlamydia pneumoniae in patients with occlusive disease of the peripheral arteries (ODPA) and multiple sclerosis (MS)., Patients and Methods: We studied 190 samples of plasma from patients included in the following groups: group 1:66 samples from 66 patients with ODPA; group 2:74 samples from 31 patients with MS (20 remittent-relapsing and 11 secondarily progressive), followed over time; and group 3:50 samples from persons acting as controls. In all cases determinations were made using ELISA, of the IgG anti-MOMP and the IgG and IgA anti-LPS. Comparison of the continuous variables was made using the Mann-Whitney U Test. Discrete variables were analysed using the exact bilateral Fisher Test. The Wilcoxon Test over ranges was used to compare the evolution of antibodies in the patients with MS., Results: The percentage of positive results in groups 1 to 3 for anti-LPS IgG were: 24.6%, 18.9% and 20.8%, respectively, with no differences between patients and controls; nor were there any differences with IgA (29%, 29.7% and 25%, respectively). However differences were seen in the anti-MOMP IgG between patients and controls (group 1:80.3%, group 2:37.8% and group 3: 33.3%). In patients with MS the results of the evolution of the antibodies did not reflect a uniform tendency of the levels of the different antibodies., Conclusion: A higher level of IgG anti-MOMP was seen in ODPA and MS, although this did not occur with anti-LPS or IgA.

We have studied the WB reliability for the Lyme disease (LD) serological diagnosis. Twenty five samples (20 sera and 5 CSF) from 5 patients with LD, according to CDC criteria were analyzed. The syphilis was excluded in every patient. Borrelia burgdorferi antibodies were assessed by an indirect ELISA (IgG + IgM, B31 strain). Intrathecal antibodies in CSF were studied in patients with neurological diseases. Positive samples by ELISA were reanalyzed by WB according to the manufacturer, Tilton and Dressler criteria and presence either 93, 39, 34 or 23 kDa band for IgG. Four patients were controlled and one of them (25%) became negative the antibodies (serorreversion). Three of them, who had neurological symptoms, displayed intrathecal antibodies. WB sensibility for LD according to the manufacturer, Tilton, Dressler and any of the four IgG bands was 26.31%, 42.1%, 21% and 84% for IgG and 52.6%, 47.3% and 42.1% for IgM respectively. Tilton and Dressler criteria may not be as sensible as 93, 39, 34 or 23 kDa IgG bands for the diagnosis of LD in our environment.

Data are presented on hospital stay for the population 65 years-old and over, measured in percentage over the total for Spain, for the 1978 to 1988 period, by gender, for each province and autonomous region (Comunidad Autónoma). The country's total for the last available year was 35%. Except in Baleares and Murcia, the proportion of hospital stays increased in all Regions, especially in Navarra, where it increased from 23% to 51%. After adjusting for age, the increase in the proportion of hospital stays in the study population was due to an increase in utilization per person. The proportion, which was 13.3% in 1978, raised to 23.8% in 1988, with an adjusted value of 21.3%.