Brain metastases: a learning curve


Brain metastases has a clear pattern inside a doctor ´s mind: headache (40-50%), focal neurologic dysfunction (20-40%) with hemiparesis as the most common symptom, cognitive dysfunction, seizures (10-20%) and stroke (5-10%) (uptodate).But there is a “learning” curve composed of small details in my own experience related with the affected area. Continue reading

Prostate drug ruling ‘a fiasco’


Prostate drug ruling ‘a fiasco’

Medicine nowdays is based in a therapeutic revolution. Cancer Medicine is an example,but cost is an important issue in time of economical crisis. What is the value of two months of life for one patient? This is not only an economical issue, ethics must play also a key role


Yes, we must change medical teaching


A “popular” medical journal, The New England Medical Journal, has just published an editorial about Innovation in Medical Education. This last sentence summarize the article: “The care we deliver to patients with cancer may require chemotherapy, radio therapy, or surgery, and each of those treatments has an evidence base behind  it-one that´s supported by a research investment that allows us to innovate and improve. Behind each of these treatments are also clinicians, and their development is also worthy of innovation“.

A non-fault diagnostic error? A second neoplasia “mimicking” metastases


Dr. Mark Graber specified the categories of factors contributing to diagnostic error. Non-fault diagnosis, is  present when a correct diagnosis may not be immediately apparent due to special difficulties, because there is not a definitive or an unusual test for diagnosis is needed or the clinical case is related to a very uncommon disease… What do you think about these two clinical situations?

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Patient safety: business or politics? Could be Medicine?


Patient safety and sex have something in common: no one knows how to define them but everyone recognize them when is present. The Patient Safety movement changed some medical landscape dramatically (anesthesia for instance) but now the progression is slow. What are the reasons for that?……

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Nipple retraction: don,t stop your reasoning

CLINICAL CASE: A 45-year-old woman was attending the oncology clinic in a normal follow-up for a sarcoma on her left leg, now disease-free for at least three years. At the last visit she referred a nipple retraction. Her oncologist could have considered this finding as something common and without importance…but she didn,t stop thinking

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