[Acute Liver Failure in patient with liver amyloidosis associated to multiple myeloma].

We report a 67 years old woman admitted to the hospital for the study of a cholestatic jaundice and massive hepatomegaly. On admission, the patient did not have liver failure. During hospital stay, the patient experienced a progressive deterioration of liver function and a monoclonal gammopathy was detected.

[Organizational structure of internal medicine in Chile].

Internal Medicine, as a comprehensive discipline, has become increasingly dismembered during the last decades due to several reasons, some of which are the growing complexities of its practice, its obstinate confinement to hospital-based practice, its generation of and subsequent disfunction from general internal medicine and the medical subspecialities. In Chile internal medicine is currently organized in three levels of patient care, each of anarchical and distortioned proportions. These levels do not constitute a fluent network of progressive patient care but rather an heterogeneous combination of ironclad compartments in search of their own autonomy.

[The university hospital and the affiliated teaching hospital].

University hospitals and affiliated teaching hospitals have been operating in Chile for many years. A critical analysis of advantages and disadvantages of these institutions is necessary including a standardized national examination of graduates trained in each kind.