Scielo RSS <![CDATA[Revista médica de Chile]]> https://scielo.conicyt.cl/rss.php?pid=0034-988720020007&lang=es vol. 130 num. 7 lang. es <![CDATA[SciELO Logo]]> https://scielo.conicyt.cl/img/en/fbpelogp.gif https://scielo.conicyt.cl <![CDATA[La Revista Médica de Chile y la educación en medicina]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872002000700001&lng=es&nrm=iso&tlng=es With this issue, Revista Médica de Chile will have been published uninterruptedly, for 130 years. Formal medical education had an early development since Chile became independent from Spain (1817). The first Medical Sciences Course was organized in 1833 by the Irish physician William C Blest. The Santiago Medical Society was founded in 1869 and its journal -Revista Médica de Chile- in 1872. Its first director was Dr. German Schneider. Revista Medica is the oldest serial publication in South America and the second oldest in the Spanish speaking world. This is a remarkable fact for a comparatively young country. With the creation of the Medical Society and Revista Medica, a process of continuous medical education was started and they became a real Graduate School. The Journal has adopted the main changes in knowledge and technology. Some important milestones of its development, during the second half of the 20th century, were the definition of its objectives and structure, the incorporation of peer review of manuscripts (even with foreign reviewers) the adoption of international guidelines for publication, its incorporation into the main biomedical journal indexes, the modernization of its printing process, the making of a computer generated index of all papers published since 1872, its incorporation into a digital library in INTERNET and the active participation of its editors in the World Association of Medical Journal Editors. The success of the journal is influenced by the independence that the Medical Society has conferred to the editors (all outstanding University Professors), as well as to the characteristics of an educational campus "invisible and without tumult" (Ingelfinger) (Rev Méd Chile 2002; 130: 719-22) <![CDATA[Historia natural de la colelitiasis: Incidencia de colecistectomía en un área urbana y una rural mapuche, en la última década]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872002000700002&lng=es&nrm=iso&tlng=es Background: Cholelithiasis is the second cause of hospital admissions in Chile. Aim: To study the prevalence of symptomatic gallstone disease and opportunity of cholecystectomy in La Florida, Santiago and among Mapuche Indians in Huapi Island. Patients and methods: In the period 2000-2001, we contacted to 71% (1127 subjects) and to 61% (145 subjects) patients of La Florida and Huapi Island, respectively, that had previously participated in an epidemiological study on cholelithiasis in 1993. We defined symptomatic gallstone patients as those with a history of biliary colic. Each patient was subjected to gallbladder ultrasound. Results: In 1993, 30-35% of gallstone patients were symptomatic (~70% women). During the lapse 1993-2001, only 50% of subjects from La Florida and 25% of patients from Huapi Island were cholecystectomized (p <0.05). Fifty percent of cholecystectomies were emergency operations. In 38 symptomatic Mapuche Indians from Huapi, cholecystectomy was indicated in 2001. After five months of the indication, only one of these subjects had been operated. Laparoscopic cholecystectomy represented 40% of all cholecystectomies performed in the National Health Service Hospitals. Conclusions: This study demonstrates an unacceptable high prevalence of symptomatic gallstone patients remaining non-operated in both the urban and rural communities. This reciprocally correlates with the high frequency of emergency cholecystectomies and the high incidence of gallbladder cancer among Chileans. This study contrasts negatively with the situation of Scotland, where 73.5% of cholecystectomies were laparoscopic in 1998-1999. To reach Scotland standards, the Chilean Public Health System should increase the number of cholecystectomies from 27,000 in 2001 to 57,510 (Rev Méd Chile 2002; 130: 723-30) <![CDATA[Obesidad: factor de riesgo para esteatohepatitis y fibrosis hepática]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872002000700003&lng=es&nrm=iso&tlng=es Background: Nonalcoholic fatty liver (NAFL) has been recognized as a cause of chronic liver disease. Its main risk factor is obesity. Aim: To describe the clinical and liver pathological findings in a group of patients who underwent surgery as obesity treatment. Patients and Methods: Sixty eight patients with severe or morbid obesity were subjected to surgery as obesity treatment. Each patient was evaluated with a complete clinical and laboratory medical assessment. A wedge of liver was excised during surgery. Liver biopsies were analyzed without knowledge of clinical and laboratory findings. The presence of steatosis, inflammation (portal or lobular), fibrosis and cirrhosis were recorded in the pathological analysis. Age and body mass index (BMI) were correlated with pathological data. Significance was set at a p value of less than 0.05. Results: Ninety one percent of patients had steatosis, 45% inflammation and 47% fibrosis. One patient had cirrhosis (1,4%). There was a statistically significant association between BMI and moderate or severe steatosis (p <0.03). There was also an association between BMI and portal (p=0.017) and lobular inflammation (p=0.034). A BMI over 40 kg/m2 (morbid obesity) was significantly associated with the presence of fibrosis (p=0.032). Moreover, the presence of moderate or severe steatosis was a risk factor for the development of hepatic fibrosis (p=0.026). Conclusions: Obesity is a major and independent risk factor for steatohepatitis and fibrosis. The degree of steatosis in the liver biopsy, is a risk factor for the development of fibrosis (Rev Méd Chile 2002; 130: 731-6) <![CDATA[Estudio piloto de la fusión PML/RAR<FONT FACE=Symbol>a</FONT> por el método de hibridación <I>in situ </I> con fluorescencia (FISH) en leucemia aguda promielocítica]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872002000700004&lng=es&nrm=iso&tlng=es Background: Acute promyelocytic leukemia (APL) is characterized cytogenetically by t(15;17) (q22;q21) and its molecular consequence, fusion of PML and RARalpha genes. The detection of this genetic marker confirms the diagnosis and allows monitoring of the leukemic clone during treatment, which has prognostic value. Cytogenetics fails in some cases due to the absence of metaphases in cultures or their bad morphology. Southern blot and PCR methods require trained personnel and adequate equipment. FISH method allows the identification of chromosomic rearrangements in 24 to 48 h and is simple to set up in a cytogenetics laboratory. Aim: To evaluate the FISH method to detect PML/RARalpha fusion, compared to cytogenetic analysis. Patients and methods: Fifteen bone marrow specimens from APL patients with previous cytogenetic analysis were studied, using a commercial probe to detect PML/RARalpha fusion. Results: We obtained a normal cut-off value of 9.1%. Specificity and sensibility were 100%. Six positive cytogenetic cases at diagnosis were FISH positive. Six negative cytogenetic cases, one APL at diagnosis and five normal controls were FISH negative. One case in remission, that was negative by cytogenetics, was positive near the cut-off value by FISH. Two other cases in remission, not conclusive by cytogenetics, were negative by FISH. Conclusions: FISH is a reliable, rapid and relatively low cost method that can be used as an adjunct to conventional cytogenetics (Rev Méd Chile 2002; 130: 737-44) <![CDATA[Evolución menstrual y reproductiva favorable en mujeres adultas, que presentaron en la adolescencia trastornos menstruales por disfunción hipotalámica con respuesta alterada al clomifeno]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872002000700005&lng=es&nrm=iso&tlng=es Background: Hypothalamic dysfunction is a cause of menstrual disturbances in women, in whom other diseases have been discarded. This condition is characterized by a failure of the GNRH pulse generation system and is associated to psychological and environmental factors. A lack of ovulatory response to the administration of clomiphene can be a sign of bad prognosis in hypothalamic dysfunction. Aim: To report the natural history of patients with hypothalamic dysfunction and a bad or deficient response to the administration of clomiphene. Patients and methods: Fifty patients with hypothalamic dysfunction, that consulted for menstrual disturbances at the age of 15 to 20 years old, were studied. All received clomiphene and 31 had an ovulatory response, 12 had menses without ovulation and 7 did not menstruate. Of these 19 women eleven were interviewed again about their menstrual and reproductive history, after a lapse of 9 to 17 years of loss from follow up. Results: Eight of the eleven women had stressful events during adolescence (going away from family house in 3, starting university studies in 3, migration out of the natal country in one and non competitive physical activity in one). All restarted their menses and eight with active sexual life had spontaneous pregnancies, giving birth from two to five children. Ovulatory cycles were documented in women without active sexual life. Conclusions: In teenagers with hypothalamic dysfunction and menstrual disturbances, a deficient or bad response to clomiphene does not necessarily indicate a bad prognosis in terms of menses or fertility (Rev Méd Chile 2002; 130: 745-52) <![CDATA[Análisis de las interconsultas de pacientes nuevos recibidas en un policlínico de reumatología de un hospital terciario]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872002000700006&lng=es&nrm=iso&tlng=es Background: The prevalence of rheumatic diseases is approximately 15% in the general population. Aim: To assess the concordance between the original and final diagnosis of patients referred to a rheumatology unit. Patients and methods: During 2000, all new patients referred to the rheumatology section of Temuco General Hospital were recorded. The concordance between the referral diagnosis given by general practitioners or general internists and the final diagnosis reached at the rheumatology unit was analyzed using the Kappa index. The modified version of the American College of Rheumatology nomenclature was used as reference. Results: The clinical records of 787 outpatients, 83% females, aged 54.7±14 years old, were analyzed. Twenty seven percent of patients were referred with the diagnosis of connective tissue diseases, 26% with extra articular diseases and 24% with osteoarthritis. The concordance between referral and final diagnosis reached at the rheumatology unit had a kappa of 0.6 for general practitioners and 0.72 for general internists. Conclusions: Although the overall concordance between referral diagnosis, given by general practitioners or general internists, and final rheumatological diagnosis is good, there are still major discrepancies that should be improved (Rev Méd Chile 2002; 130: 753-9) <![CDATA[Análisis acústico de las sibilancias en lactantes con obstrucción bronquial aguda: Estudio de seguimiento]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872002000700007&lng=es&nrm=iso&tlng=es Background: There is some information about wheeze characteristics in infants, however it is not clear whether the different wheeze patterns relates to prognosis and evolution during the first two years of life. Objectives: To characterize wheezing and spectral pattern of lung sounds in infants with acute bronchiolitis (AB) and in infants with recurrent wheeze (RW) as well as to compare these parameters with the clinical evolution 2 years after admission. Methods: Seventy six AB infants (48 boys), aged 5.5±0.7 months (mean ± SD), 62 RSV (+) and 32 RW infants (20 boys), aged 11.4±2 months were studied during the first week of admission at the hospital. Patients were studied during spontaneous sleep, breathing with a face mask connected to a pneumotachograph at flows of 0.1±0.02L/s. Sounds were registered at baseline and 20 minutes after salbutamol using 2 contact sensors placed at both lower lobes levels. Signals were low-pass filtered, amplified and a Fourier analysis was applied to sounds within a target flow range. Spectral analysis was done between 100 and 1000 HZ. Results: In 40/76 (53%) AB vs 30/34 (88%) RW sinusoidal wheezing (p <0.01; chi2) were observed and a positive bronchodilator response was obtained in 37/76 (49%) AB vs 32/34 (94%) RW (p <0.01; chi²). Patients with sinusoidal wheezing (s-w) had more wheezing episodes in follow-up, 26/40 vs 8/36 in complex wheezing (c-w), (p <0.01: chi²) and 30/34 in RW (p <0.01; chi²). IgE values at 18 months were higher in s-w compared to c-w (63±7 vs 24±5 Iu/mL (p <0.01) and 96±11 Iu/mL in RW (p <0.01). Conclusions: a) Wheezing characteristics in acute bronchiolitis vs recurrent wheezing are different; b) Bronchodilator response relates to wheeze characteristics and c) Higher IgE and more recurrent wheezing episodes are seen in acute bronchiolitis with sinusoidal wheezing. These findings suggest that lung sounds analysis is useful in assessing wheezy patients and have a value to identify infants on risk of developing asthma (Rev Méd Chile 2002; 130: 760-7) <![CDATA[Hemofiltración continua en pacientes con complicaciones abdominales del síndrome hemolítico urémico: <B><I>Report of ten cases</B></I>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872002000700008&lng=es&nrm=iso&tlng=es Background: Close to one half of patients with hemolytic uremic syndrome (HUS) will require a dialytic therapy, mainly peritoneal dialysis (PD). In some cases, PD may have relative or absolute contraindications, usually when HUS is associated to severe intra-abdominal complications. Aim: To report the results of continuous hemofiltration use, in children with abdominal complications of HUS. Material and methods: Retrospective review of the files of 40 patients that were admitted to our pediatric unit with HUS, since 1995. Six children had relevant intra-abdominal complications and were treated with continuous hemofiltration (CHF). Four additional children, with similar HUS related complications and treated with CHF before 1995, were included in the analysis. Results: The age of the patients ranged from 5 to 66 months old. An arterio-venous CHF was performed in four and veno-venous CHF in six children. The duration of CHF was 93.2 hours in average. Adequate control of volemia was achieved in every patient; diafiltration with peritoneal dialysis solution was added in five patients, to improve azotemia. Four patients had complications related to the vascular access or the anticoagulation procedure. The procedure was terminated due to improvement of diuresis in five cases, transfer to PD in four and a cardiorespiratory arrest in one. Only one patient developed a chronic renal failure during the follow up. Conclusions: CHF is an effective and safe alternative of acute renal replacement therapy in the management of renal failure in pediatric cases with HUS, aggravated with abdominal complications (Rev Méd Chile 2002; 130: 768-72). <![CDATA[Autoría en la Revista d e Otorrinolaringología y Cirugía de Cabeza y Cuello: Análisis de tres décadas]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872002000700009&lng=es&nrm=iso&tlng=es Background: The number of authors of scientific papers has increased significantly in the last decade. The increasing complexity of medical research but also vicious practices are possible causes of this trend. Aim: To analyze the number of authors and type of papers published in the Chilean Journal of Otorhinolaryngology and Head and Neck Surgery in the last three decades. Material and methods: A review of all manuscripts published between 1970 and 1999. The number of authors and the type of paper was registered. Results: Five hundred nineteen papers were reviewed. The mean number of authors per paper increased from 1.9 to 3 (p <0.001). Research reports decreased from 79% to 61% and the number of review articles and case reports increased. No multicentric work was published in the period. Conclusions: A significant increase in the number of authors per manuscript was observed in this review (Rev Méd Chile 2002; 130: 773-8) <![CDATA[Trasplante hepático en adultos: casuística de Clínica Alemana de Santiago]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872002000700010&lng=es&nrm=iso&tlng=es Background: The success of orthotopic liver transplantation (OLT) has resulted in its widespread use for different liver diseases. Aim: To report our 8 years experience with adult OLT at Clinica Alemana de Santiago. Patients and methods: In all transplantations done at the center, we recorded patient's overall data and survival, postoperative medical and surgical complications and causes of death. Results: Between November 1993 and September 2001, 51 consecutive OLT were performed in 44 patients (22 females, median age 45 years old). Thirty eight patients presented with chronic and 6 with acute or sub-acute liver failure. Cryptogenic cirrhosis and hepatitis C infection were the most common causes for OLT. Postoperative bleeding and extra-hepatic biliary complications were seen in 17.6 and 21.5% of cases respectively. Acute rejection, bacterial infections, CMV infection or disease and post OLT hemodialysis were the most common medical complications (51, 31, 19.6 and 19.6% of cases respectively). The overall 1 and 5 years survival rates were 80% and 73% respectively. Considering exclusively the last 22 OLT performed since January 1999, the 1 year survival rate has improved to 91%. Conclusions: Liver transplantation in Chile provides a good long term survival with acceptable morbidity, due to a multidisciplinary approach management. The survival rates have improved over the last few years probably due to better surgical techniques, ICU care and immunosuppression. These overall results are comparable with those from other Centers in developed countries (Rev Méd Chile 2002; 130: 779-86) <![CDATA[<I>Vibrio vulnificus</I>: una causa infrecuente de shock séptico]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872002000700011&lng=es&nrm=iso&tlng=es Vibrio vulnificus is a lactose positive Gram negative rod that lives in warm seas and can infect wounds and produce sepsis. Its infection is acquired after eating oysters or other filtering marine organisms. We report a 53 years old diabetic male who started with fever after a voyage to Central America. He was admitted febrile, hipotense, dehydrated and polypneic. Painful erythematous lesions and lumps were observed in his upper and lower limbs. After 72 hours of evolution, the lesions became violaceous, with crepitating vesicles full of hemorrhagic exudate. He developed a renal failure and a disseminated intravascular coagulation. Blood cultures demonstrated the presence of Vibrio vulnificus and the patient died 68 hours after admission (Rev Méd Chile 2002; 130: 787-91) <![CDATA[Siliconomas: Caso Clínico]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872002000700012&lng=es&nrm=iso&tlng=es In the early 1950s, the liquid silicone breast injection technique was developed in Japan. This breast augmentation method had local and systemic complications. Nevertheless, this technique is still used in some countries like Chile. We report a 41 years old woman, consulting due to breast pain and a nodule in her left breast. The clinical work up confirmed the presence of siliconomas, caused by silicone breast injections one year before. The physical and radiological findings (mammograms, ultrasound and breast MRI) of this woman are reported (Rev Méd Chile 2002; 130: 793-7) <![CDATA[Aplasia medular asociada al uso de ticlopidina: <B><I>Report of one case</B></I>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872002000700013&lng=es&nrm=iso&tlng=es We report a 58 years old male that developed a bone marrow aplasia associated to the use of ticlopidine, prescribed after coronary artery stenting. The patient developed a pneumonia as a complication. He was admitted to the Intermediate Treatment Unit, receiving wide spectrum antimicrobial therapy and a granulocyte colony stimulating factor (Neupogen(r)) with favourable response. Ticlodipine is an effective anti-platelet agent, but has serious hematological and other side effects. Its prescription requires a close follow up and search for complications (Rev Méd Chile 2002; 130: 798-802). <![CDATA[Constipación crónica pertinaz: ¿un problema quirúrgico?]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872002000700014&lng=es&nrm=iso&tlng=es Severe chronic constipation is defined as less than two bowel movements per week, hard stools, non productive urgency and the need of digital maneuvers in more than 25% of bowel evacuations. The best studied causes of chronic severe constipation are slow bowel transit constipation and pelvic floor dysfunction. However, there are mixed forms that cross link with irritable colon syndrome. The main diagnostic tests are anorrectal manometry, bowel evacuation, X-ray studies and anorrectal sphincteromyomectomy, that can be therapeutic. Five percent of patients are surgical candidates. In cases of slow bowel movement, total colectomy with ileorectal anastomosis has satisfactory results in 80 to 90% of patients. Some patients with pelvic floor dysfunction have an occult rectal prolapse, rectocele or sigmoidocele and obtain benefits with the correction of these conditions. The remaining patients require a training of bowel evacuation, known as biofeedback. We have performed a total colectomy in 10 patients with slow bowel movements with good functional results in 80%. After 56 months of follow-up, a mean 2.6 bowel movements per day is reported by the patients. Four patients were also operated due to a solitary rectal ulcer and two patients due to a sigmoidocele, with satisfactory results (Rev Méd Chile 2002; 130: 803-808) <![CDATA[Un análisis de la situación actual de las especialidades médicas en Chile]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872002000700015&lng=es&nrm=iso&tlng=es During the fifties and sixties, physicians were mostly prepared as general practitioners. However, the progress in scientific knowledge and the introduction of complex technologies required the training of specialists. A number of sub specialties have been progressively added to the four basic specialties, namely Internal Medicine, Pediatrics, Obstetrics and Gynecology and General Surgery. The Post Graduate Schools of the traditional universities devised courses and training periods to teach these sub specialties. The Association of Medicine Schools has been in charge of the accreditation of the new training centers. Since the training of new specialists required the collaboration of hospitals of the public National Health Service, there is a special commission that coordinates the relationships between teaching requirements and medical attention in these hospitals. There is still a controversy on the exact proportion of general practitioners and specialists that the country needs, the role of Family Practice and the role of prevention and health promotion (Rev Méd Chile 2002; 130: 809-815) <![CDATA[Aplicación del Examen Clínico Objetivo Estructurado (OSCE) en la evaluación final del internado de pediatría en dos escuelas de medicina]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872002000700016&lng=es&nrm=iso&tlng=es Background: The Objective Structured Clinical Examination (OSCE) has become a respected and widely used tool for the assessment of clinical competence in medical education. Aim: To describe the first experience of an OSCE as a summative assessment in undergraduate Pediatric Internship, in two universities. Material and Methods: The OSCE was structured by a committee of faculty members of the 5 campi of University of Chile and I campus of the Catholic University. A 21 station OSCE was administered simultaneously to 124 Pediatric Interns (University of Chile =104, Catholic University=20), in 3 centers. A total of 50 faculty members participated in the examination. The OSCE consisted of 20 clinical problems, including videotape recordings, photographs, x-rays and laboratory exams, phantoms and 7 simulated standardized parents. Results: The average total OSCE score was 67.3% (range: 84.5%-43.5%). The maximum theoretic score was achieved in 19 stations. A significant correlation between station and total score, was found for 18 of the 20 clinical problems. Conclusions: The experience of using OSCE has been a success. The OSCE was an adequate procedure to assess a large number of interns simultaneously and it allowed us to measure the main objectives in all domains and a wide range of clinical competence of Pediatric Internship Programs (Rev Méd Chile 2002; 130: 817-824). <![CDATA[La autonomía del paciente]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872002000700017&lng=es&nrm=iso&tlng=es Background: The Objective Structured Clinical Examination (OSCE) has become a respected and widely used tool for the assessment of clinical competence in medical education. Aim: To describe the first experience of an OSCE as a summative assessment in undergraduate Pediatric Internship, in two universities. Material and Methods: The OSCE was structured by a committee of faculty members of the 5 campi of University of Chile and I campus of the Catholic University. A 21 station OSCE was administered simultaneously to 124 Pediatric Interns (University of Chile =104, Catholic University=20), in 3 centers. A total of 50 faculty members participated in the examination. The OSCE consisted of 20 clinical problems, including videotape recordings, photographs, x-rays and laboratory exams, phantoms and 7 simulated standardized parents. Results: The average total OSCE score was 67.3% (range: 84.5%-43.5%). The maximum theoretic score was achieved in 19 stations. A significant correlation between station and total score, was found for 18 of the 20 clinical problems. Conclusions: The experience of using OSCE has been a success. The OSCE was an adequate procedure to assess a large number of interns simultaneously and it allowed us to measure the main objectives in all domains and a wide range of clinical competence of Pediatric Internship Programs (Rev Méd Chile 2002; 130: 817-824). <![CDATA[¿Por qué los errores médicos?]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872002000700018&lng=es&nrm=iso&tlng=es Background: The Objective Structured Clinical Examination (OSCE) has become a respected and widely used tool for the assessment of clinical competence in medical education. Aim: To describe the first experience of an OSCE as a summative assessment in undergraduate Pediatric Internship, in two universities. Material and Methods: The OSCE was structured by a committee of faculty members of the 5 campi of University of Chile and I campus of the Catholic University. A 21 station OSCE was administered simultaneously to 124 Pediatric Interns (University of Chile =104, Catholic University=20), in 3 centers. A total of 50 faculty members participated in the examination. The OSCE consisted of 20 clinical problems, including videotape recordings, photographs, x-rays and laboratory exams, phantoms and 7 simulated standardized parents. Results: The average total OSCE score was 67.3% (range: 84.5%-43.5%). The maximum theoretic score was achieved in 19 stations. A significant correlation between station and total score, was found for 18 of the 20 clinical problems. Conclusions: The experience of using OSCE has been a success. The OSCE was an adequate procedure to assess a large number of interns simultaneously and it allowed us to measure the main objectives in all domains and a wide range of clinical competence of Pediatric Internship Programs (Rev Méd Chile 2002; 130: 817-824). <![CDATA[CRÓNICA]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872002000700019&lng=es&nrm=iso&tlng=es Background: The Objective Structured Clinical Examination (OSCE) has become a respected and widely used tool for the assessment of clinical competence in medical education. Aim: To describe the first experience of an OSCE as a summative assessment in undergraduate Pediatric Internship, in two universities. Material and Methods: The OSCE was structured by a committee of faculty members of the 5 campi of University of Chile and I campus of the Catholic University. A 21 station OSCE was administered simultaneously to 124 Pediatric Interns (University of Chile =104, Catholic University=20), in 3 centers. A total of 50 faculty members participated in the examination. The OSCE consisted of 20 clinical problems, including videotape recordings, photographs, x-rays and laboratory exams, phantoms and 7 simulated standardized parents. Results: The average total OSCE score was 67.3% (range: 84.5%-43.5%). The maximum theoretic score was achieved in 19 stations. A significant correlation between station and total score, was found for 18 of the 20 clinical problems. Conclusions: The experience of using OSCE has been a success. The OSCE was an adequate procedure to assess a large number of interns simultaneously and it allowed us to measure the main objectives in all domains and a wide range of clinical competence of Pediatric Internship Programs (Rev Méd Chile 2002; 130: 817-824).