Effects of Smallanthus sonchifolius Flour on Metabolic Parameters: A Systematic Review.

Smallanthus sonchifolius, popularly known as yacon, is a member of the Asteraceae family. Due to its medicinal and edible value, yacon is consumed by different populations. Yacon is unique due to its high fructo-oligosaccharide and inulin content, as well as flavonoids, sesquiterpene lactones, and phenolic acids. Roots can be used to produce flour, which is less perishable and can be applied in various industrial products. This systematic review focuses on the effects of yacon flour on metabolic parameters. PubMed, Cochrane, Embase, Science Direct, Scopus, Web of Science, and Google Scholar databases were consulted, and PRISMA guidelines were followed in the selection of the studies. In total, 526 articles were found in the databases, and of these, only 28 full texts were eligible for inclusion. After applying the inclusion and exclusion criteria, seven studies were finally included. The results showed that the use of yacon flour can reduce glycemia, HbA1c, advanced glycation ends, plasma lipids, body fat mass, body weight, and waist circumference and improve intestinal microbiota and the antioxidant status. Further exploration of the effects of yacon flour is warranted, and additional clinical trials are necessary to determine the optimal daily consumption levels required to assist in improving metabolic parameters.

Garlic: A systematic review of the effects on cardiovascular diseases.

Allium sativum (garlic) certainly is one of the oldest horticultural crops in the world and presents bioactive compounds that are related to the garlic's effects on human health. Several authors have shown beneficial effects on diabetes, hypertension, dyslipidemia, obesity, and cardiovascular diseases (CVD), which are among the most relevant causes of mortality in the world. The aim of this systematic review was to evaluate the effects of garlic in the risk factors of CVD and evaluate its economic importance. MEDLINE-PubMed, COCHRANE, EMBASE, and Google Scholar databases were searched. The included studies showed that the use of garlic can reduce blood pressure, waist circumference, body mass index, LDL-c, non-HDL-c, total cholesterol, triglycerides, and inflammatory markers. It also can increase the levels of HDL-c and can improve cardiovascular parameters such as coronary artery calcium, microcirculation, epicardial and periaortic adipose tissue, post occlusive reactive hyperemia, low attenuation plaque, carotid intima-media thickness; and carotid intima-media thickness. Due to these reasons, garlic can be considered in the prevention and treatment of CVD risk factors.

HDL-C and non-HDL-C levels are associated with anthropometric and biochemical parameters.

BACKGROUND: Dyslipidemias are associated with atherosclerosis and cardiovascular diseases. Recently, non-high-density lipoprotein cholesterol (non-HDL-c) has emerged as a new target for assessment and prediction of risk of cardiovascular disease (CVD) and is closely associated with atheroma plaque progression. OBJECTIVES: To evaluate associations between HDL-c and non-HDL-c levels and anthropometric and biochemical parameters and with the Castelli risk indexes I and II. METHODS: 300 randomly selected people were subdivided into two groups: patients with normal values for non-HDL-c and patients with altered values for non-HDL-c. These parameters were analyzed for associations with glycemia, total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL-c), Castelli Index I (CI-I), Castelli Index II (CI-II), waist circumference (WC), body mass index (BMI) and presence of metabolic syndrome (MS). RESULTS: Glycemia, TC, TG, LDL-c, CI-I, CI-II, WC and BMI were all significantly different between subjects with normal and altered values of HDL-c and non-HDL-c. TC and WC both exhibited significantly higher values among patients with abnormal non-HDL-c when compared to patients with abnormal HDL-c. A significant difference was observed in occurrence of MS among patients with altered values of HDL-c and non-HDL-c. CONCLUSIONS: Our results show that both HDL-c and non-HDL-c are associated with insulin resistance, dyslipidemia, atherogenic indices, and obesity. There is therefore a need for randomized clinical intervention trials examining the potential role of non-HDL-c as a possible primary therapeutic target.

CONTEXTO: A dislipidemia está associada à aterosclerose e às doenças cardiovasculares. Recentemente, a lipoproteína de não alta-densidade de colesterol (não HDL-c) emergiu como um novo alvo para avaliação da predição de risco de doença cardiovascular, intimamente associada à progressão da placa de ateroma. OBJETIVOS: Avaliar as associações de níveis de HDL-c e não HDL-c com parâmetros antropométricos e bioquímicos, bem como com índices de Castelli I e II (CI-I e CI-II). MÉTODOS: Trezentas pessoas selecionadas aleatoriamente foram divididas em dois grupos: pacientes com valores normais de não HDL-c e pacientes com valores alterados de não HDL-c. Esses parâmetros foram associados a glicemia, colesterol total (CT), triglicerídeos (TG), lipoproteína de baixa densidade (LDL-c), CI-I, CI-II, circunferência de cintura (CC), índice de massa corporal (IMC) e presença de síndrome metabólica (SM). RESULTADOS: Glicemia, CT, TG, LDL-c, CI-I, CI-II, CC e IMC exibiram valores significativamente maiores para o não HDL-c quando comparado ao HDL-c. Uma diferença significativa na ocorrência de SM foi encontrada em pacientes com valores alterados de HDL-c e não HDL-c. CONCLUSÕES: Nossos resultados mostram que tanto o HDL-c quanto o não HDL-c estão associados a resistência à insulina, dislipidemia, índices de aterogênese e obesidade. Assim, há uma necessidade de futuros ensaios randomizados de intervenção clínica examinando o papel potencial do não HDL-c como possível alvo terapêutico primário.

HDL-C and non-HDL-C levels are associated with anthropometric and biochemical parameters / Associação de níveis de HDL-c e não HDL-c com parâmetros antropométricos e bioquímicos

Dyslipidemias are associated with atherosclerosis and cardiovascular diseases. Recently, non-high-density lipoprotein cholesterol (non-HDL-c) has emerged as a new target for assessment and prediction of risk of cardiovascular disease (CVD) and is closely associated with atheroma plaque progression. Objectives To evaluate associations between HDL-c and non-HDL-c levels and anthropometric and biochemical parameters and with the Castelli risk indexes I and II. Methods 300 randomly selected people were subdivided into two groups: patients with normal values for non-HDL-c and patients with altered values for non-HDL-c. These parameters were analyzed for associations with glycemia, total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL-c), Castelli Index I (CI-I), Castelli Index II (CI-II), waist circumference (WC), body mass index (BMI) and presence of metabolic syndrome (MS). Results Glycemia,TC, TG, LDL-c, CI-I, CI-II, WC and BMI were all significantly different between subjects with normal and altered values of HDL-c and non-HDL-c. TC and WC both exhibited significantly higher values among patients with abnormal non-HDL-c when compared to patients with abnormal HDL-c. A significant difference was observed in occurrence of MS among patients with altered values of HDL-c and non-HDL-c. Conclusions Our results show that both HDL-c and non-HDL-c are associated with insulin resistance, dyslipidemia, atherogenic indices, and obesity. There is therefore a need for randomized clinical intervention trials examining the potential role of non-HDL-c as a possible primary therapeutic target

A dislipidemia está associada à aterosclerose e às doenças cardiovasculares. Recentemente, a lipoproteína de não alta-densidade de colesterol (não HDL-c) emergiu como um novo alvo para avaliação da predição de risco de doença cardiovascular, intimamente associada à progressão da placa de ateroma. Objetivos Avaliar as associações de níveis de HDL-c e não HDL-c com parâmetros antropométricos e bioquímicos, bem como com índices de Castelli I e II (CI-I e CI-II). Métodos Trezentas pessoas selecionadas aleatoriamente foram divididas em dois grupos: pacientes com valores normais de não HDL-c e pacientes com valores alterados de não HDL-c. Esses parâmetros foram associados a glicemia, colesterol total (CT), triglicerídeos (TG), lipoproteína de baixa densidade (LDL-c), CI-I, CI-II, circunferência de cintura (CC), índice de massa corporal (IMC) e presença de síndrome metabólica (SM). Resultados Glicemia, CT, TG, LDL-c, CI-I, CI-II, CC e IMC exibiram valores significativamente maiores para o não HDL-c quando comparado ao HDL-c. Uma diferença significativa na ocorrência de SM foi encontrada em pacientes com valores alterados de HDL-c e não HDL-c. Conclusões Nossos resultados mostram que tanto o HDL-c quanto o não HDL-c estão associados a resistência à insulina, dislipidemia, índices de aterogênese e obesidade. Assim, há uma necessidade de futuros ensaios randomizados de intervenção clínica examinando o papel potencial do não HDL-c como possível alvo terapêutico primário

Edible coating with probiotic as a quality factor for minimally processed carrots.

The objectives of this study were to elaborate an edible coating based on sodium alginate with probiotic potential and to evaluate the coating's performance with respect to microbial viability and the characteristics of safety and freshness of minimally processed carrots stored at 8 ± 2 °C. Carrot slices were submerged in a sodium alginate solution with and without the addition of Lactobacillus acidophilus La-14 (7.36 log CFU/g), and gelling was activated by subsequent immersion in a calcium chloride solution. Physical, chemical and microbiological analyses of coated and non-coated samples were performed over a period of 19 days. At the end of this period, the viable cell count of the probiotic remained at 7.11 log CFU/g. Thus, the alginate coating was an efficient support for L. acidophilus. In addition, comparing the acidity increase between the treatments, samples with probiotic coating presented the lowest statistically significant variation, suggesting that the probiotics had reduced the metabolism of the minimally processed carrot slices. The barrier created by the coatings also contributed to the quality of the minimally processed carrots by conserving their moisture and minimizing color changes during storage. These factors are important determinants of the successful commercialization of these products.

Association between vitamin D status and metabolic syndrome risk factors.

BACKGROUND: The concern with the incidence of chronic-degenerative diseases is increasing worldwide, and many studies have shown that insufficiency of vitamin D (VD) can be linked to several metabolic disorders. AIMS: Thus, the objective of this study was to evaluate the association of the metabolic syndrome risk factors, atherogenic indices and VD in a group of patients attended at a Cardiology Center. METHODS: For this study, we invited 200 patients of both sexes attended in a Cardiology Center (Medical School of Marilia - São Paulo - Brazil). Most were female (n = 111) and aged between 41 and 70 years (from march to august, 2017). RESULTS: Our results showed that only 20.0% of the patients presented normal levels of VD. Patients with altered values for this vitamin presented significantly higher values for glycemia, HbA1c, Total cholesterol, LDL-c, triglycerides, Castelli Index I, Castelli Index II, Body Mass Index, waist circumference, non-HDL-c and the estimative of the size of the LDL-c particle. Vitamin D correlated negatively with glycemia, HbA1C, triglycerides, atherogenic indices, Body Mass Index, and blood pressure. Multiple Regression Model showed that for an individual to maintain metabolic parameters, at least at borderline values, the levels of VD should be 37.64 that is not in accordance with the reference values. CONCLUSIONS: These results showed a remarkable prevalence of low concentrations of Vitamin D in patients with cardiovascular risk factors.

Hypertension, C Reactive Protein and Metabolic Profile: What is the Scenario in Patients Undergoing Arteriography?

INTRODUCTION: High Blood Pressure (HBP), Diabetes Mellitus (DM), Metabolic Syndrome (MS) and Cardiovascular Diseases (CVD) are among the main causes of death worldwide and HBP is one of the most common chronic health problem representing an important and modifiable risk factor for vascular events and mortality. AIM: To study the association among high sensitivity CRP levels, and the biochemical, and anthropometric profile in hypertensive and non-hypertensive patients who underwent arteriography. MATERIALS AND METHODS: This research was performed at the Haemodynamic Laboratory of the University Hospital in the city of Marilia - state of São Paulo, Brazil. Ninety-five subjects who underwent arteriography were included. Anthropometric (body mass index and waist circumference) and biochemical parameters (glycaemia, total cholesterol, HDL-c, LDL-c, triglycerides, and high sensitivity C reactive protein), were evaluated. Variables pertaining to blood pressure, atherogenic indices, diagnosis of metabolic syndrome and catheterization details were collected. Statistical analysis was performed with Chi-square test, Fisher, Student t-test and ANOVA complemented by Tukey test. RESULTS: Our results showed that 78.95% of the patients who underwent arteriography were suffering from HBP. Hypertensive individuals had significantly higher glycaemia (124.14±45.33 mg/dL) or DM, higher values of triglycerides (195.27±74.52 mg/dL), waist circumference (98.52±12.52 cm), body mass index (29.99±1.41 kg/m2) and hs-CRP (0.53±0.44 mg/dL). Most of the hypertensive patients (93.33%) presented with MS and were related to the presence of more severe lesions in the arteries and had passed through more invasive procedures like angioplasty and surgery. CONCLUSION: Our findings indicate that blood pressure control is of paramount importance to ensure better quality of life and life expectancy as it is associated with several risk factors that increase the morbidity and mortality.

Dipteryx alata Vogel May Improve Lipid Profile and Atherogenic Indices in Wistar Rats Dipteryx alata and Atherogenic Indices.

Worldwide prevalence of noncommunicable chronic degenerative diseases is among the main causes of death worldwide. The consumption of some foods such as nuts and seeds may be beneficial in preventing these diseases. Dipteryx alata Vogel (DA), known popularly as Baru, belongs to the family Fabaceae and is a native fruit tree from the Brazilian savanna. The purpose of this study was to evaluate the use of seeds of DA on the metabolic and oxidative profile of Wistar rats. Animals were divided randomly into four groups (n = 10): G1 (control group), and G2 (treated with DA 20%), G3 (treated with DA 30%), and G4 (treated with DA 40%). After 40 days, animals were euthanized and metabolic and oxidative profiles were analyzed (glycemia, cholesterol, triglycerides [TGs], high-density lipoprotein-cholesterol [HDL-c], very low-density lipoprotein-cholesterol [VLDL-c], low-density lipoprotein-cholesterol [LDL-c], C reactive protein, aspartate aminotransferase, alanine aminotransferase, Lee index, weight, visceral fat, ferric reducing ability of plasma, and ferric-xylenol orange method. The use of the seeds was effective in reducing TGs, VLDL-c, LDL-c, and increasing HDL-c but did not interfere in the percentage of weight gain, visceral fat, levels of total cholesterol, and oxidative stress. Based on our results, it is possible to say that the use of DA may improve the lipid profile of Wistar rats and we may suggest that the consumption of DA almonds or products prepared with them may be an effective option for the intake of healthy products.

Metabolic syndrome and atherogenic indices in school children: A worrying panorama in Brazil.

BACKGROUND: Metabolic Syndrome (MS) is defined as the combination of a cluster of cardiovascular risk factors. The use of cardiovascular indices such as the ratios TC/HDL-c, LDL-c/HDL-c and TG/HDL-c may help in the assessment of cardiovascular risk. Investigation of cardio-metabolic risks in the pre-adolescent stage is essential to characterize possible patterns for MS in the earliest stages of the life avoiding further irreversible consequences. AIMS: This work aimed to investigate the presence of MS and cardiovascular indices in a group of children aged 6-10 years. METHODS: We included 150 children from a city in Brazil. Anthropometric (Body Mass Index and Waist Circumference) and biochemical parameters (glycaemia, total cholesterol, LDL-c, HDL-c, and triglycerides) were evaluated in order to identify the presence of MS. Atherogenic Indices were also calculated (TC/HDL-c, LDL-c/HDL-c and TG/HDL-c). RESULTS: Our results showed that there are high percentages of children with altered values for biochemical and anthropometric parameters and in the atherogenic indices. MS was identified in 17.8% of the children. The main parameters related to alterations in the atherogenic indices were waist circumference, body mass index and the presence of MS. CONCLUSION: The high prevalence of MS and alterations in the atherogenic indices in schoolchildren is a worrying panorama. We suggest the performance of more studies focusing on identification, intervention and prevention programs in order to reduce the risk factors of this syndrome in childhood and to reduce future cardiovascular deaths.

Determinação do teor de água em carcaças de três diferentes marcas de frangos, comercializados no município de Marília-SP / Determination of water content in carcasses of three different brands of chickens marketed in Marilia-SP

Com o crescimento no consumo da carne de frango a preocupação em manter a qualidade do produto para que o consumidor possa adquirir produtos íntegros é cada vez maior, desta forma este trabalho teve por objetivo realizar análises em três marcas de carcaças de frangos congeladas, inspecionadas pelo Serviço de Inspeção de São Paulo (SISP), para a avaliação da prevalência de qualquer irregularidade, sendo a mais comum a presença de água no interior da carcaça em quantidade superior ao permitido pela Portaria nº 210 de novembro de 1998, que determina que a porcentagem não pode ultrapassar 6%. Os resultados obtidos nas análises demonstraram que as três marcas apresentavam teor de água superior ao permitido, sendo a marca B a que obteve resultados mais insatisfatórios apresentando 21,73 de porcentagem de água na carcaça. Desta forma, faz-se necessária uma fiscalização mais efetiva nos estabelecimentos que seguem o SISP, para garantir que o consumidor não seja lesado no momento da compra.

Metabolic syndrome and C reactive protein in patients undergoing angiography: Inevitable association?

BACKGROUND: The Metabolic Syndrome (MS) is characterized by a set of risk factors, which causes metabolic and inflammatory changes that increase vascular risk and may promote the development of atherosclerosis. Changes in lifestyle are related to obesity and associated diseases such as hypertension, type 2 diabetes mellitus, MS and cardiovascular disease (CVD). AIMS: This study aimed to evaluate the relationship of MS components and high sensitivity C Reactive Protein (hsCRP) in patients undergoing arteriography. METHODS: A group of patients undergoing arteriography was recruited in order we could evaluate the metabolic profile, levels of hsCRP and number of obstructions in the arteries. RESULTS: Most of our patients underwent arteriography are more likely to have hypertension, glucose intolerance, dyslipidemia, and central obesity, thus, MS is prevalent in this group. They also tend to exhibit higher values of hsCRP, lower values ​​for the estimative of the size of the LDL-c particle and higher number of obstruction in the arteries. CONCLUSION: We may say that the improvement of the above parameters could reduce inflammation and oxidative stress and vascular damages what would extend life expectancy and quality of life of this group of patients.

Pereskia aculeata Miller Flour: Metabolic Effects and Composition.

Pereskia aculeata Miller is known in Brazil as ora-pro-nobis (OPN) and has been used commonly in the folklore medicine. The purpose of our study was to evaluate the composition and the effects of OPN flour on the metabolic profile and intestinal motility of Wistar rats. Animals were divided randomly into five groups (n = 10): G1 (control group) and G2 (treated with OPN flour). For the intestinal motility: G3 (control group), G4 (treated with senne), and G5 (treated with OPN flour). After 40 days, G1 and G2 were euthanized and metabolic profiles were analyzed (glycemia, cholesterol, triglycerides, high density lipoprotein [HDL-c], C reactive protein, AST, ALT, Lee Index, weight, and visceral fat). The flour of OPN was effective in reducing percentage of weight gain, visceral fat, levels of total cholesterol, triglycerides, low density lipoprotein, very low density lipoprotein, and increased HDL-c. Significance was also found in the distance covered by the activated charcoal from the pylorus to the beginning of the cecum, which was higher in animals treated with OPN. Our results indicate that OPN flour may bring health benefits, as the improvement of the intestinal motility, and it is associated with reduction of visceral fat and lipid profile, as well as the increase of HDL-c levels. With these results, we may suggest that the incorporation of this flour in different industrial products may be a convenient and effective way for the intake of healthier products.

Eating habits and presence of cardiovascular risks in children.

INTRODUCTION: The changes in the eating habits associated with physical inactivity are directly related to the increase in the prevalence of obesity and associated diseases such as diabetes mellitus (DM), metabolic syndrome and cardiovascular diseases. OBJECTIVE: The aim of this study was to investigate the relationship between the frequency of consumption of some food groups (snacks, fruits, vegetables and candies), physical exercise, nutritional classification and biochemical profile in children. METHODS: After the approval of the Ethics Committee, we studied 882 schoolchildren ranging between 6 and 10 years of age. Biochemical and anthropometric evaluations were performed and questionnaires were used in order to check the eating habits and physical activity. RESULTS: Our results showed that we may relate the consumption of snacks, fruits, vegetables or candies with modifications in the glycemia, triglycerides, total cholesterol, HDL-c, and LDL-c but we did not observe association with the nutritional classification. It is noteworthy to say that almost 50% of the studied children were overweight or obese and many presented alterations in the lipid and glucose levels. CONCLUSION: Our results also show that many children have abnormal levels of lipids and glycemia and a great number of them are classified as overweight or obese. In this context, we can say that urgent approaches are needed to be carried out by a multidisciplinary team in order to improve the diet and reduces the risk factors in this population of children and prevent secondary diseases in adolescence and adulthood.

Teaching elliptical excision skills to novice medical students: a randomized controlled study comparing low- and high-fidelity bench models.

BACKGROUND: The search for alternative and effective forms of training simulation is needed due to ethical and medico-legal aspects involved in training surgical skills on living patients, human cadavers and living animals. AIMS: To evaluate if the bench model fidelity interferes in the acquisition of elliptical excision skills by novice medical students. MATERIALS AND METHODS: Forty novice medical students were randomly assigned to 5 practice conditions with instructor-directed elliptical excision skills' training (n = 8): didactic materials (control); organic bench model (low-fidelity); ethylene-vinyl acetate bench model (low-fidelity); chicken legs' skin bench model (high-fidelity); or pig foot skin bench model (high-fidelity). Pre- and post-tests were applied. Global rating scale, effect size, and self-perceived confidence based on Likert scale were used to evaluate all elliptical excision performances. RESULTS: The analysis showed that after training, the students practicing on bench models had better performance based on Global rating scale (all P < 0.0000) and felt more confident to perform elliptical excision skills (all P < 0.0000) when compared to the control. There was no significant difference (all P > 0.05) between the groups that trained on bench models. The magnitude of the effect (basic cutaneous surgery skills' training) was considered large (>0.80) in all measurements. CONCLUSION: The acquisition of elliptical excision skills after instructor-directed training on low-fidelity bench models was similar to the training on high-fidelity bench models; and there was a more substantial increase in elliptical excision performances of students that trained on all simulators compared to the learning on didactic materials.

Acquisition of suture skills during medical graduation by instructor-directed training: a randomized controlled study comparing senior medical students and faculty surgeons.

Due to shortage of time and limited availability of faculty surgeons to teach basic surgical skills during medical graduation, the search for alternative ways of simulated training with feedback is needed. The purpose of this study was to compare the simulated teaching of suture skills to novice medical students by senior medical students and by experienced faculty surgeons. Forty-eight novice medical students were randomly assigned to three practice conditions on bench model (n = 16): self-directed suture training (control), senior medical student-directed suture skills' training, or experienced faculty surgeon-directed suture skills' training. Pre- and post-tests were applied. Global Rating Scale with blinded evaluation and self-perceived confidence based on Likert scale were used to assess all suture performances in pre- and post-training. Effect size was also calculated. The analysis made after training showed that the students who received feedback from the instructors had better performance based on the Global Rating Scale (all p < 0.0000) and felt more confident to carry out sutures (all p < 0.0000) when compared to the control. There was no significant difference (all p > 0.05) between the student-directed teaching and faculty-directed teaching groups. The magnitude of the effect (instructor-directed training suture) was considered large (>0.80) in all measurements. The acquisition of suture skills after student-directed training was similar to the training supervised by faculty surgeon, and the increase in suture performances of trainees that received instructor administered training was superior to self-directed learning.

Iron supplementation in pregnancy and breastfeeding and iron, copper and zinc status of lactating women from a human milk bank.

This study evaluated the influence of iron supplementation in pregnancy and breastfeeding on iron status of lactating women from a Brazilian Human Milk Bank. Blood and mature breast milk samples were collected from 145 women for assessment of iron status, as well as copper and zinc status. Haemoglobin, serum iron and ferritin were determined, respectively, by electronic counting, colorimetry and chemiluminescence. Transferrin and ceruloplasmin were analysed by nephelometry. Serum copper and zinc were measured by atomic absorption spectrophotometry, and serum alkaline phosphatase was measured by a colorimetric method. Iron, zinc and copper in breast milk were determined by spectrometry. Mean values of iron, copper and zinc (blood and breast milk) were compared by ANOVA, followed by Tukey's test. Iron supplementation was beneficial to prevent anaemia in pregnancy but not effective to treat anaemia. During breastfeeding, iron supplementation had a negative effect on maternal copper status, confirming an interaction between these micronutrients.

Does bench model fidelity interfere in the acquisition of suture skills by novice medical students?

OBJECTIVE: Although several inanimate bench models have been described for training of suture skills, so far, there is no ideal method for teaching and learning this skill during medical education. The aim was to evaluate whether bench model fidelity interferes in the acquisition of suture skills by novice medical students. METHODS: 36 medical students with no surgical skills' background (novices) were randomized to three groups (n = 12): theoretical suture training alone (control); low-fidelity suture training model (synthetic ethylene-vinyl acetate bench model); or high-fidelity suture training model (pig feet skin bench model). Pre- and post-tests were applied (performance of simple interrupted sutures and subdermal interrupted sutures on ox tongue). Three tools (Global Rating Scale with blinded assessment, effect size, and self-perceived confidence based on Likert scale) were used to measure all suture performances. RESULTS: The post-training analysis showed that the students that practiced on bench models (hands-on training) presented better (all p < 0.0000) performance in the Global Rating Scale evaluation, compared with the control, regardless of the model fidelity. The magnitude of the effect (training) was considered large (> 0.80) in all measurements. Students felt more confident (all p < 0.0000) to perform both types of sutures after training. CONCLUSION: The acquisition of suture skills on the low-fidelity bench model was similar to that of the high-fidelity bench model, and the increase in the performance of participants that received bench model training was superior to those who received training based on theoretical teaching materials.

Does bench model fidelity interfere in the acquisition of suture skills by novice medical students? / Será que a fidelidade do modelo de bancada interfere na aquisição das habilidades de sutura por estudantes de medicina iniciantes na prática cirúrgica?

OBJECTIVE: Although several inanimate bench models have been described for training of suture skills, so far, there is no ideal method for teaching and learning this skill during medical education. The aim was to evaluate whether bench model fidelity interferes in the acquisition of suture skills by novice medical students. METHODS: 36 medical students with no surgical skills' background (novices) were randomized to three groups (n = 12): theoretical suture training alone (control); low-fidelity suture training model (synthetic ethylene-vinyl acetate bench model); or high-fidelity suture training model (pig feet skin bench model). Pre- and post-tests were applied (performance of simple interrupted sutures and subdermal interrupted sutures on ox tongue). Three tools (Global Rating Scale with blinded assessment, effect size, and self-perceived confidence based on Likert scale) were used to measure all suture performances. RESULTS: The post-training analysis showed that the students that practiced on bench models (hands-on training) presented better (all p < 0.0000) performance in the Global Rating Scale evaluation, compared with the control, regardless of the model fidelity. The magnitude of the effect (training) was considered large (> 0.80) in all measurements. Students felt more confident (all p < 0.0000) to perform both types of sutures after training. CONCLUSION: The acquisition of suture skills on the low-fidelity bench model was similar to that of the high-fidelity bench model, and the increase in the performance of participants that received bench model training was superior to those who received training based on theoretical teaching materials.

OBJETIVO: Embora vários modelos de bancada inanimados tenham sido descritos para o treinamento de habilidades de sutura, até o momento, não existe um método ideal para esse ensino e aprendizagem durante a formação médica. O objetivo foi avaliar se a fidelidade dos modelos de bancada interfere na aquisição de habilidades de sutura em estudantes de medicina iniciantes na prática cirúrgica. MÉTODOS: 36 estudantes de medicina sem exposição prévia a habilidades cirúrgicas foram randomizados em três grupos (n = 12): treinamento de suturas baseado em materiais didáticos (controle); treinamento de suturas em modelo de baixa-fidelidade (modelo de bancada de etileno vinil acetato); ou treinamento de suturas em modelo de alta-fidelidade (modelo de bancada de pele de pata de porco). Foram aplicados pré e pós-testes (realização de pontos simples e pontos subdérmicos invertidos em língua de boi). Três ferramentas (Global Rating Scale com avaliação cega, tamanho do efeito e autopercepção da confiança baseada em uma escala de Likert) foram utilizadas para mensurar todas as performances de sutura. RESULTADOS: A análise após o treinamento demonstrou que os estudantes que treinaram nos modelos tiveram um melhor (p < 0.0000) desempenho na avaliação pela Global Rating Scale, quando comparados com o controle, independente da fidelidade do modelo. A magnitude do efeito (treinamento) foi considerada grande (> 0.80) em todas as mensurações. Após o treinamento os alunos sentiram-se mais confiantes (p < 0.0000) para executarem os dois tipos de suturas. CONCLUSÃO: A aquisição de habilidades de suturas no modelo de baixa fidelidade foi semelhante à prática no modelo de alta fidelidade, sendo que a melhora no desempenho dos participantes que treinaram nesses dois modelos foi superior à aprendizagem baseada em materiais didáticos.

Training on synthetic ethylene-vinyl acetate bench model allows novice medical students to acquire suture skills.

PURPOSE: To assess the acquisition of suture skills by training on ethylene-vinyl acetate bench model in novice medical students. METHODS: Sixteen medical students without previous surgery experience (novices) were randomly divided into two groups. During one hour group A trained sutures on ethylene-vinyl acetate (EVA) bench model with feedback of instructors, while group B (control) received a faculty-directed training based on books and instructional videos. All students underwent a both pre-and post-tests to perform two-and three-dimensional sutures on ox tongue. All recorded performances were evaluated by two blinded evaluators, using the Global Rating Scale. RESULTS: Although both groups have had a better performance (p<0.05) in the post-test when compared with the pre-test, the analysis of post-test showed that group A (EVA) had a better performance (p<0.05) when compared with group B (control). CONCLUSION: The ethylene vinyl acetate bench model allowed the novice students to acquire suture skills faster when compared to the traditional model of teaching.

Training on synthetic ethylene-vinyl acetate bench model allows novice medical students to acquire suture skills / Treinamento no modelo de bancada sintético de etileno vinil acetato permite que estudantes de medicina iniciantes na prática cirúrgica adquiram habilidades de sutura

PURPOSE: To assess the acquisition of suture skills by training on ethylene-vinyl acetate bench model in novice medical students. METHODS: Sixteen medical students without previous surgery experience (novices) were randomly divided into two groups. During one hour group A trained sutures on ethylene-vinyl acetate (EVA) bench model with feedback of instructors, while group B (control) received a faculty-directed training based on books and instructional videos. All students underwent a both pre-and post-tests to perform two-and three-dimensional sutures on ox tongue. All recorded performances were evaluated by two blinded evaluators, using the Global Rating Scale. RESULTS: Although both groups have had a better performance (p<0.05) in the post-test when compared with the pre-test, the analysis of post-test showed that group A (EVA) had a better performance (p<0.05) when compared with group B (control). CONCLUSION: The ethylene vinyl acetate bench model allowed the novice students to acquire suture skills faster when compared to the traditional model of teaching.

OBJETIVO: Avaliar a aquisição das habilidades de sutura com o treinamento no modelo de bancada de etileno vinil acetato em acadêmicos de medicina. MÉTODOS: Dezesseis estudantes de medicina iniciantes na prática cirúrgica foram divididos aleatoriamente em dois grupos. Durante uma hora o grupo A treinou diferentes suturas no modelo de bancada de etileno vinil acetato (EVA) com feedback dos instrutores, enquanto os do grupo B (controle) receberam um treinamento dirigido por instrutor baseado em livros e vídeos didáticos. Todos foram submetidos à pré e pós-testes para realização de suturas bi e tridimensionais em língua de boi. As performances gravadas foram avaliadas por dois avaliadores cegos, utilizando a Global Rating Scale. RESULTADOS: Embora os dois grupos tenham apresentado um melhor desempenho (p<0.05) no pós-teste quando comparado com o pré-teste, a análise do pós-teste mostrou que os alunos do grupo A (EVA) tiveram um melhor desempenho (p<0.05) quando comparados com os do grupo B (controle). CONCLUSÃO: O modelo de etileno vinil acetato permitiu que os alunos adquirissem habilidades de sutura mais rapidamente quando comparado ao modelo tradicional de ensino.