COVID-19: Medical education from the point of view of medical students using the participatory Delphi method.

BACKGROUND: The COVID-19 pandemic has prompted a transformation of medical training. Although there were obvious medical education and social interaction challenges, e-learning presented some advantages, which may have generated medical curricula innovation and adjustments to novel technological methodologies. This study aims to generate consensuses among medical students regarding medical education provided during the pandemic in the resource-limited context of a Global South university. METHODS: The implementation of a participatory Delphi method included a recruitment campaign, training, constitution of Delphi panels and questions, and development of the Delphi exercises. Students from the second to the sixth year of medicine of a university in Quito, Ecuador, constituted two Delphi panels, developed questions about the education received during the pandemic, and answered them over 3.5 rounds. FINDINGS: Twenty-two medical students participated in the Delphi exercises about their perception of medical education during the COVID-19 pandemic. The analysis consisted of a total of 22 Delphi questions divided into five distinct categories: adaptations and innovations, curriculum and assessment changes, virtual clinical practice, time management, and mental health. The authors established high, medium, and low consensuses for analysis. CONCLUSIONS: Consensuses were reached based on students' academic year and focused on the changes in lecture delivery, the usage of new technologies, patient care skills, the impact of the educational routine, and the mental health of the COVID-19 pandemic. The way the pandemic affected medical education in the Global South set the stage for the need for a comprehensive review of tools, skills, and curricula for students from culturally diverse backgrounds. This study offers a highly replicable methodology to generate consensuses and introduce students to academic research.

Risk factors for cerebral palsy in premature infants identified during the pre and perinatal periods: a case-control study.

BACKGROUND: The aim of this paper was to assess the pre and perinatal risk factors for cerebral palsy in premature infants, comparing them with full-term infants. METHODS: This was a prospective cross-sectional cohort study on 48 infants between four and eight months of life, of whom 20 were born prematurely (<37 weeks of gestational age) and 28 at full term (37 to 42 weeks). A questionnaire was used, which investigated maternal reproductive, obstetric and neonatal factors, along with an evaluation scale for neurosensory-motor development of infants at risk of neuromotor alterations. For the statistical analysis, the Student's t, chi-square, Fisher's exact and Cramer's V tests were used. RESULTS: All the newborns that were small for their gestational age (35%) were in the premature group (P=0.001). Hyperbilirubinemia (P=0.000), anemia (P=0.009), respiratory distress syndrome (P=0.000) and periventricular hemorrhage (P=0.025) were more frequent in the premature newborn group. Phototherapy and blood transfusion were more frequent among the premature infants: 70.0% vs. 25.0% (P=0.002) and 20.0% vs. 0.0% (P=0.025), respectively. Among the premature infants, 50.0% presented neuromotor development alterations, against only 14.3% of the full-term infants. CONCLUSIONS: Prematurity is an important risk factor for the development of neurosensory-motor alterations that are suggestive of cerebral palsy.

Genetic and epigenetic studies of FOXP3 in asthma and allergy.

Multiple factors interact to trigger allergic diseases, including individual genetic background and factors related to the environment such as exposure to allergens, air pollution and respiratory infections. The FOXP3 transcription factor is constitutively expressed in CD4+CD25+FOXP3+ regulatory T cells (Tregs) and is critical for the maintenance of immune homeostasis. For example, FOXP3 is responsible for the suppression of the Th2 response following exposure to allergens. Studies have shown that expression of the FOXP3 gene is reduced in patients with asthma and allergies compared to healthy controls. Therefore, the impairment of FOXP3 function caused by genetic polymorphisms and/or epigenetic mechanisms may be involved in the etiology of asthma and other allergic diseases. This review discusses some aspects of the role of FOXP3 in the development of asthma and allergy, with a particular emphasis on genetic and epigenetic factors.