Influência da participação de estudantes em ligas acadêmicas na escolha da especialidade para o programa de residência médica da Bahia 2017 / Influence of student participation in academic leagues in the choice of specialty for the Bahia 2017 Medical Residency Program

Introdução: A participação em Ligas Acadêmicas (LAs), hoje, é um importante componente do processo formativo do estudante de Medicina. No entanto, esta participação pode estar propiciando precocemente a escolha da especialidade futura, limitando a atuação e a busca por conhecimento amplo e generalizado. Objetivo: Avaliar a influência da participação em LAs sobre a escolha da especialidade por recém-ingressos no Programa de Residência Médica da Bahia 2017 (PRM/BA/2017). Métodos: Estudo epidemiológico observacional transversal, no qual residentes do PRM/BA/2017, durante matrícula, foram convidados a responder questionário contendo informações sobre a participação em LAs e a escolha da especialização médica. Resultados:Dos 339 entrevistados, 79,8% participaram de LAs. Destes, 45,4% consideraram que a participação em LAs influenciou a escolha da especialidade. A correlação geral entre participação em LAs e escolha de especialidade na mesma área (correlação L-E) atingiu 30,9% e foi encontrada aumentada de maneira significativa no grupo que considerou que a participação em LAs influenciou o processo decisório, que participou da LA durante mais de 3 semestres, que ocupou 3 ou 4 cargos em uma mesma liga, que participou de "Estágios" e que alegou "Afinidade/Curiosidade" como principal motivo para entrada na LA. Das grandes áreas da Medicina, o grupo que optou por Cirurgia Geral apresentou maior correlação L-E (53,1%) e o que optou pela Pediatria menor (12,5%) Conclusões: Apesar de estar presente no processo formativo da maioria dos estudantes, a participação em LAs não pareceu representar a especialização precoce destes. O fator mais associado à correlação L-E foi a percepção de que esta participação influenciou a escolha da especialidade.

Introduction: Participating in Academic Leagues (LAs) nowadays is an important component of the medical student's graduation process. However, this participation may be prematurely promoting specialty choice, limiting the performance and the search for ample and widespread knowledge. Objective: Evaluate the influence of participating in LAs with regards to the choice of specialty by new entrants in the Medical Residency Program of Bahia 2017 (PRM/BA/2017). Methodology: This is an observational cross-sectional epidemiological study in which residents from the PRM/BA/2017, during the enrollment, were invited to respond a questionnaire containing information about the participation in LAs and the choice of medical specialization. Results: 339 individuals were interviewed. 79.8% of interviewed participated in LAs. From those, 45.4% considered that participating in LAs influenced the choice of specialty. The general correlation between participation in LAs and the choice of a specialty at the same area (L-E correlation) reached 30.9%. A higher and significant L-E correlation was found in group that considered participation in LA as a influence in the decision making process, that participated in LA for more than 3 semesters, that occupied 3 or 4 positions at the same league, that participated on "Internship" and that claimed "Affinity/Curiosity" as the main reason for get into LA. Within all the medical specialties, the group that have chosen General Surgery had higher L-E correlation and the one that chose Pediatrics had lower. Conclusions: Despite being present in the training process of most students, participating in LAs did not seem to represent their premature specialization. The most associated factor with the L-E correlation was the perception that this participation influenced the choice of the specialization.

Leishmania infantum lipophosphoglycan induced-Prostaglandin E2 production in association with PPAR-γ expression via activation of Toll like receptors-1 and 2.

Lipophosphoglycan (LPG) is a key virulence factor expressed on the surfaces of Leishmania promastigotes. Although LPG is known to activate macrophages, the underlying mechanisms resulting in the production of prostaglandin E2 (PGE2) via signaling pathways remain unknown. Here, the inflammatory response arising from stimulation by Leishmania infantum LPG and/or its lipid and glycan motifs was evaluated with regard to PGE2 induction. Intact LPG, but not its glycan and lipid moieties, induced a range of proinflammatory responses, including PGE2 and nitric oxide (NO) release, increased lipid droplet formation, and iNOS and COX2 expression. LPG also induced ERK-1/2 and JNK phosphorylation in macrophages, in addition to the release of PGE2, MCP-1, IL-6, TNF-α and IL-12p70, but not IL-10. Pharmacological inhibition of ERK1/2 and PKC affected PGE2 and cytokine production. Moreover, treatment with rosiglitazone, an agonist of peroxisome proliferator-activated receptor gamma (PPAR-γ), also modulated the release of PGE2 and other proinflammatory mediators. Finally, we determined that LPG-induced PPAR-γ signaling occurred via TLR1/2. Taken together, these results reinforce the role played by L. infantum-derived LPG in the proinflammatory response seen in Leishmania infection.