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Introducción: La educación médica debería garantizar la formación de profesionales competentes que posean los conocimientos, las destrezas y las actitudes planificados en la capacitación. En general, los programas no tienen en cuenta a la urgencia, que no figura como materia específica en los programas de grado. Objetivos: Cuantificar las competencias adquiridas por los internos en el Departamento de Urgencias y en Terapia Intensiva, estableciendo el grado de cumplimiento entre lo planificado y lo logrado; desglosar el grado de cumplimiento según las diferentes áreas de la competencia clínica. Materiales y Métodos: Diseño prospectivo, de observación, longitudinal, analítico. Se incluyeron 93 alumnos del ciclo clínico que realizaron el internado rotatorio (2000-2009). Se valoró el cumplimiento de 37 competencias que se clasificaron por área: actitudes, conocimientos y destrezas, en números de 9, 5 y 23, respectivamente. Resultados: El cumplimiento global de las competencias en el área de emergentología y terapia intensiva es del 61,18% (IC95% 59,20-63,13). Al desglosar por área de la competencia clínica, se halla que las actitudes fueron del 66,26%; los conocimientos, del 63,28% y las destrezas, del 58,15%. Clasificándolas según el grado de cumplimiento, se establece una escala con cumplimiento alto (76-100%), medio (51-75%) y bajo (<51%). Conclusiones: Los aspectos actitudinales y cognitivos de las competencias tuvieron un cumplimiento medio. La mitad de las competencias vinculadas a destrezas tuvo un cumplimiento medio-alto.(AU)

Introduction: Medical education should guarantee the formation of competent professionals with the knowledge, skills and attitudes planned in training. Generally programs do not bear in mind the urgency, which does not appear as a specific subject in the university. Objectives: To quantify the competitions acquired by the boarders in the Emergency Department and the Intensive Care Unit, establishing the degree of fulfillment between what was planned and what was achieved; to perceive the degree of fulfillment according to the different areas of clinical competition. Materials and Methods: Prospective, observational, longitudinal and analytical study. We included 93 students from the clinical cycle who performed rotating boarding school (2000-2009). Fulfillment of 37 competitions classified by area: attitudes, knowledge and skills, in numbers of 9, 5 and 23, respectively, was evaluated. Results: The global fulfillment of the competitions was 61.18% (CI95%: 59.20-63.13). Specifically, in each area of the clinical competition, we found that the attitudes were 66.26%, knowledge 63.28% and skills 58.15%. Classifying them according to the degree of fulfillment, a scale is established: high (76-100%), medium (51-75%) and low (<51%). Conclusions: Attitude and cognitive aspects of the competitions had average fulfillment. Half of the competitions linked to skills had average-high fulfillment.(AU)

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Taking into account both the importance of microalbuminuria (MA) as a predictive parameter of clinical nephropathy in diabetic patients and the efficiency of exertion to show and/or to increase MA in both diabetic patients and normal individuals, we studied 37 type I diabetic patients divided into two groups: group A, with no MA at rest (n = 19), and group B, with MA at rest (n = 18). Group C comprised 10 healthy volunteers as controls. Changes of basal MA during exercise and postexercise were studied in all three groups. Normotensive patients with no metabolic disorders, normal renal function, and no proteinuria underwent an ergometric test up to 600 kg. This test was repeated after the administration of 20 mg enalapril in a single daily dose for 60 days. Body weight, systolic and diastolic arterial pressure, creatinine, and creatinine clearance were determined and showed no significant variations either between groups or with treatment. Microalbuminuria was studied in the three groups with and without administration of enalapril throughout the 2 months of the study. Determinations were performed under conditions of rest, exercise, and postexercise. Mean baseline MA values +/- SEM were as follows: at rest, 5.22 +/- 0.49, 58.36 +/- 13.24, and 4.73 +/- 0.45 micrograms/min for groups A, B, and C, respectively; with exercise, 15.19 +/- 4.43, 74.70 +/- 14.89, and 16.76 +/- 4.62 micrograms/min for groups A, B, and C, respectively; and postexercise, 32.04 +/- 6.64, 253.15 +/- 63.88, and 9.23 +/- 3.25 micrograms/min, respectively. The geometric means of the baseline to posttreatment MA ratio were as follows: at rest, 0.95, 1.59 (P < 0.01), and 1.03 for groups A, B, and C, respectively; with exercise, 1.53 (P < 0.01), 1.91 (P < 0.01), and 1.69 for groups A, B, and C, respectively; and postexercise, 2.94 (P < 0.01), 3.24 (P < 0.01), and 1.03 for groups A, B, and C, respectively. In conclusion, in the early diagnostic suspicion of diabetic nephropathy, the screening of postexercise MA during an ergometric test could be of help. Treatment with enalapril decreased MA in diabetic groups A (no MA at rest) and B (MA at rest) during exercise and postexercise, and also decreased MA in group B while at rest.

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