Importancia social de la preparación pedagógica del tutor en la formación del médico general integral

Introducción: la figura del tutor es de vital importancia en la formación del especialista en medicina general integral. Objetivo: fundamentar la importancia del desempeño profesional pedagógico del tutor en la formación del especialista en medicina general integral en la sociedad cubana. Materiales y métodos: se realizó un análisis documental a partir de una búsqueda sobre el tema, de enero de 2020 a agosto de 2022, en las bases de datos PubMed y SciELO, y en el motor de búsqueda Google Académico. Se evaluaron artículos de revisión, de investigación y páginas web -en español, portugués e inglés- que hicieran referencia al tema a través del título. Fueron excluidos los artículos que no cumplieron con estas condiciones. Conclusiones: la medicina familiar es eminentemente social, por su objeto y misión en la comunidad, de ahí que garantizar la formación de profesionales integrales que involucren en su desarrollo los contenidos y habilidades de la especialidad, junto a valores y formas de actuación acorde con los principios de la sociedad socialista, supondrá una mayor resolutividad de los problemas de salud de la población y, por ende, una mayor calidad de vida.

Introduction: the figure of the tutor is of vital importance in the training of the specialist in comprehensive general medicine. Objective: to base the importance of the professional pedagogical performance in the training of the specialist in comprehensive general medicine in Cuban society. Materials and methods: a documental analysis was carried out froma search on the subject, from January 2020 to August in PubMed and SciELO databases and in the Google Scholar search engine. Review and research articles and web pages-in Spanish, Portuguese and English-that referred to the subject in the title were evaluated. Articles that did not meet this condition were excluded. Conclusions: family medicine is eminently social, due to its objective and mission in the community, hence guaranteeing the training of comprehensive professionals who involve the contents and skills of the specialty in their development, along with values and forms of action in accordance with the principles of the socialist society, will suppose a better resolution of the health problems of the population, and therefore, a better quality of life.

Prevención de las hepatitis virales crónicas como contenido de la formación del especialista de Medicina General Integral

La superación profesional constituye un proceso permanente de la educación superior que garantiza la actualización y preparación de sus graduados para un ejercicio adecuado de sus desempeños en la práctica: en particular, en el ámbito de las ciencias médicas favorece la atención a las situaciones de salud que se presentan en la comunidad. El objetivo del presente trabajo está encaminado a exponer los fundamentos teóricos que sustentan el estudio del proceso de formación del residente de Medicina General Integral y la concreción del trabajo preventivo desde la comunidad. Se trata de un acercamiento inicial al proceso de formación de los especialistas de la Atención Primaria de Salud y la prevención de las hepatitis virales crónicas y como continuidad de las acciones de un proyecto de investigación, se acomete el abordaje actual en el período comprendido entre septiembre de 2022 a octubre de 2024, bajo el auspicio del Centro de Estudios de Ciencias de la Educación Enrique José Varona, de la Universidad Ignacio Agramonte Loynaz y el Centro de Desarrollo de las Ciencias Sociales y Humanísticas en Salud, de la Universidad de Ciencias Médicas, ambas instituciones pertenecientes a la provincia de Camagüey.

Professional improvement constitutes a permanent process of higher education that guarantees the updating and preparation of its graduates for an adequate exercise of their performances in practice: in particular, in the field of medical sciences, it favors attention to health situations that appear in the community. The objective of this work is aimed at exposing the theoretical foundations that support the study of the training process of the Comprehensive General Medicine resident and the concretion of preventive work from the community. This is an initial approach to the training process of Primary Health Care specialists and the prevention of chronic viral hepatitis and as a continuation of the actions of a research project, the current approach is undertaken in the period between September from 2022 to October 2024, under the auspices of the Enrique José Varona Center for the Study of Education Sciences, of the Ignacio Agramonte Loynaz University and the Center for the Development of Social and Humanistic Sciences in Health, of the University of Medical Sciences, both institutions belonging to the province of Camagüey.

Preliminary Exploration of Integrating Narrative Medicine into General Practice Education / 中国医学伦理学

In the context of a healthy China, strengthening humanistic literacy education for general medical students reflects the demands of the times, promotes the transformation of medical models, and has important practical significance in reducing the work burnout of general practitioners in practice. Integrating narrative medicine into general practice student education is conducive to implement the patient-centered concept of general practice, provide continuous and systematic medical services, and further improve the humanistic literacy of general practitioners. Based on these, this paper proposed the relevant paths of integrating narrative medicine into student education in general medicine, including changing educational concepts and integrating educational resources, boldly carrying out curriculum reforms and innovating educational methods, fully utilizing parallel medical records and reflective writing, as well as cultivating the habit of lifelong learning.

A study on prescription pattern and safety profile of antimicrobial agents in medicine department of tertiary care hospital

Background: Antimicrobial agents (AMAs) are an integral part of management of diseases in the department of general medicine, and a wide range of antimicrobials are used for prevention, prophylaxis, or treatment of various infectious diseases. Systematic studies regarding the pattern of AMAs use may help in improving the quality of patient care by evidence-based practices and also in formulating effective antimicrobial usage guidelines. Aim and Objectives: The objectives of this study were as follows: (i) To analyze the prescribing trends of Antimicrobials in Medicine wards of a Tertiary Care Hospital; (ii) to assess safety profile of AMAs; and (iii) to analyze extraneous factors influencing AMAs prescription. Materials and Methods: The prospective analysis of Antimicrobial prescriptions of Medicine wards for the period of July 2018–August 2019. The class of AMAs, formulation, dose, route of administration, frequency, and duration of administration and their safety was assessed using the WHO indicators. Results: The most frequently used AMAs were third generation cephalosporin (Ceftriaxone) and it was frequently combined with metronidazole. The choice of initial AMAs was empirical, which was later changed depending on the clinical response. The AMAs were effective in preventing or controlling infections and well tolerated without any serious adverse reactions or drug interactions. Conclusions: The rational use of AMAs is necessary to control worldwide emergence of antibacterial resistance, side effects, and to reduce the cost of treatment.

La competencia estadística en la dimensión investigativa del Médico GeneralIntegral

Introducción: Los estudios orientados al desarrollo y perfeccionamiento del sistema de competencias del modelo de profesional del médico general integral (MGI), no identifican la competencia estadística como tal, ni los modos de actuación que, con respecto a la utilización de esta herramienta auxiliar, debe reflejar su actividad científica. Objetivo: Fundamentar y definir la competencia estadística para la formación de la dimensión investigativa del especialista en MGI. Método: Se realizó una investigación documental orientada a sistematizar los fundamentos que acreditan la utilización de la Estadística como herramienta auxiliar en la actividad científica del MGI y los elementos que determinan la articulación de la competencia estadística al sistema de competencias específicas de la profesión. De una amplia revisión bibliográfica en bases de datos académicas se identificaron 47 referencias bibliográficas, de las cuales 30 se adherían a la temática abordada. Resultados: La asimilación de los modos de actuación estadística garantiza que el MGI domine el tratamiento adecuado de los conjuntos de datos y el análisis crítico de resultados durante el desarrollo de la actividad científica de su profesión. Se propone una definición de competencia estadística y en correspondencia los modos de actuación que deben ser aprehendidos por los especialistas de MGI. La inclusión de la competencia estadística al sistema de competencias profesionales específicas del médico general integral constituye una alternativa para mejorar la calidad de la formación para la dimensión investigativa. Conclusiones: La integración de la competencia estadística al sistema de competencias profesionales específicas del MGI constituye una alternativa para mejorar la calidad del proceso de formación de la dimensión investigativa en esta especialidad.

Introduction: The studies that are oriented to the development and improvement of the system of competencies of the professional model of the comprehensive general practitioner, do not identify the statistical competence as such, nor the modes of action that, with respect to the use of this auxiliary tool, should reflect their scientific activity. Objective: To base and define the statistical competence for the training in the investigative dimension of the specialist in Comprehensive General Medicine. Method: A documentary research was carried out aimed at systematizing the foundations that prove the use of Statistics as an auxiliary tool in the scientific activity of the comprehensive general practitioner and the elements that determine the articulation of statistical competence to the system of specific competences of the profession. From an extensive bibliographic review in academic databases, 47 bibliographic references were identified, of which 30 adhered to the topic addressed. Results: The assimilation of the modes of statistical action guarantees that the comprehensive general practitioner masters the proper treatment of data sets and the critical analysis of results during the development of the scientific activity of his profession. A definition of statistical competence is proposed and correspondingly the modes of action that must be apprehended by MGI specialists. The inclusion of statistical competence to the system of specific professional competences of the comprehensive general practitioner constitutes an alternative to improve the quality of training for the investigative dimension. Conclusions: The integration of the statistical competence to the system of specific professional competences of the MGI constitutes an alternative to improve the quality of the training process of the investigative dimension in this specialty.

A STUDY ON POLYPHARMACY AMONG ELDERLY PATIENTS IN MEDICINE WARD OF A TERTIARY CARE TEACHING HOSPITAL OF EASTERN INDIA

Background: In the modern era, with the increase in the lifespan of individuals with increasing access to health-care facilities, the population of elderly is also increasing with an equal pace. However, on the other hand, with the increasing population of the elderly another important issue of polypharmacy has also emerged. Elderly people usually have more disease conditions for which more of medications are prescribed in older individuals as compared to younger population. Hence, optimizing drug therapy in this aging population is a challenging task for physician. Polypharmacy can also lead to increase in drug interactions, adverse drug reactions, and medication errors. It was an observational, cross-sectional, prospective study. The Materials and Methods: study was conducted in patients admitted in general medicine wards at College of Medicine& JNM Hospital, Kalyani, West Bengal. The study involved 320 elderly patients (above 65 years of age) of either sex for 3 months from January to March 2020. The information recorded included the demographic details of the patients, diagnosis, comorbid illnesses, details about medications being, the total number of drugs being used, and the factors associated with polypharmacy. A total of 320 geriatric patients were included in the study. Pol Results: ypharmacy was found (>5 medications/day) in 79.71% of geriatrics. Pantoprazole , antimnicrobials and NSAIDS were most commonly prescribed drugs. To counteract the problems Conclusion: associated with polypharmacy, regular follow- ups and proper monitoring of drug regimens of older individuals are the need of the hour

Hemorragia del tracto digestivo superior, enfoque para el médico general / Upper digestive tract bleeding, approach for the general Practitioner / Hemorragia do trato digestivo superior, enfoque para o médico geral

La hemorragia del tracto digestivo superior (HTDS) es el sangrado originado por encima del ángulo de Treitz. A pesar del aumento en las estrategias de prevención, del incremento en los tratamientos con Inhibidor de bomba de protones (IBP) y de la intervención endoscópica temprana, esta patología sigue siendo una causa frecuente de consulta a urgencias, con una morbimortalidad no despreciable y alta carga para el sistema de salud. Esta revisión se enfoca en la HTDS de causa diferente a las varices. La principal causante de esta entidad es la enfermedad ácido-péptica, que es consecuencia del gran consumo de antiinflamatorios no esteroideos (AINES) y de la infección por Helicobacter Pylori. Otras causas son el síndrome de Mallory Weiss, la esofagitis erosiva, las malformaciones arteriovenosas y la malignidad.

Upper gastrointestinal bleeding (UGIB) refers to any bleeding originating above the angle of Treitz. Despite an increase in prevention strategies, proton pump inhibitor (PPI) therapy and early endoscopic intervention, this pathology continues to be an important cause of admission to the emergency department for gastrointestinal causes, having a pretty high morbidity and mortality in addition to a high burden on the health system. This review focuses on non-variceal UGIB. The main cause of this entity being peptic acid disease, due to great consumption of NSAIDs and Helicobacter Pylori infection. Other causes are Mallory Weiss syndrome, erosive esophagitis, arteriovenous malformations, and malignancy.

A hemorragia do trato digestivo superior (HTDS) é o sangrado originado acima do ângulo de Treitz. Apesar do aumento nas estratégias de prevenção, do incremento nos tratamentos com Inibidor da bomba de prótons (IBP) e da intervenção endoscópica precoce, esta patologia segue sendo uma causa frequente de consulta a urgências, com uma morbimortalidade não depreciável e alta carga para o sistema de saúde. Esta revisão se enfoca na HTDS de causa diferente às varizes. A principal causante desta entidade é a doença ácido-péptica, que é consequência do grande consumo de anti-inflamatórios não esteróideos (AINES) e da infecção por HelicobacterPylori. Outras causas são a síndrome de Mallory Weiss, a esofagites erosiva, as malformações arteriovenosas e a malignidade. Palavras-chave: hemorragia gastrointestinal; úlcera péptica; endoscopia gastrointestinal; inibidores da bomba de prótons; medicina geral.

Sociological interpretation in general practice clinical thinking / 中华全科医师杂志

There are a large number of atypical symptoms and undifferentiated diseases in general practice, in which sociological factors are deeply involved. So to incorporate social factors into clinical thinking and to interpret disease from the perspective of the patient′s social life will enrich the multidisciplinary medical model and holistic care in general practice. This article shares author′s clinical experience through introducing typical cases, in which the patient′s social life and behavior characteristics played certain roles in disease development. The article also explores a new way from the sociological perspectives to interpret the complex symptoms that are difficult to be explained clinically by biomedicine or psychology.

El ejercicio médico en el siglo XXI. Retos y rescate del método clínico / Medical practice in the twenty-first century. Challenges and rescue of the clinical method

Resumen El método clínico, desde su creación en la Grecia antigua, no ha tenido mayores cambios en sus componentes y aplicación. Sin embargo, desde hace un tiempo se ha venido vulnerando debido al gran impacto que ha tenido la tecnología en las ciencias de la salud, y los nuevos paradigmas impuestos a la práctica clínica y la educación médica. El presente artículo describe los datos históricos más relevantes del método clínico, sus componentes científicos y su aplicación en la medicina, se resalta su importancia en todos los aspectos médicos, y se plasma una reflexión acerca de las causas de esta crisis y cómo involucra al profesional de medicina general en Colombia. (Acta Med Colomb 2021; 46. DOI: https://doi.org/10.36104/amc.2021.1997).

Abstract Since its inception in ancient Greece, the clinical method has experienced no major changes in its components and application. However, for some time now, it has been infringed upon by the high impact of technology on the healthcare sciences, and the new paradigms imposed on clinical practice and medical education. This article describes the most relevant historical data on the clinical method, its scientific components and its application in medicine, highlighting its importance in all medical aspects; and provides some thoughts on the reasons for this crisis and how it involves general medical practitioners in Colombia. (Acta Med Colomb 2021; 46. DOI: https://doi.org/10.36104/amc.2021.1997).

Uso de la biblioteca médica por residentes de Medicina General Integral del municipio de Niquero / Use of the medical library by residents of Comprehensive General Medicine specialty in Niquero municipality

RESUMEN Fundamento: Las bibliotecas constituyen una fuente indispensable de recursos instructivos para la sociedad en general. En el campo de las Ciencias Médicas contribuyen a la formación de especialistas en Medicina General Integral. Objetivo: Determinar el uso que hacen de la Biblioteca Médica los residentes de la especialidad de Medicina General Integral del Policlínico "Ernesto Guevara" de Niquero. Metodología: Se realizó un estudio observacional descriptivo, de corte transversal. El universo de estudio estuvo conformado por los 51 residentes de esta especialidad. Se utilizaron métodos teóricos, empíricos y estadísticos-matemáticos (frecuencia absoluta y porcentaje). Las variables estudiadas fueron: frecuencia de visita, uso de los servicios prestados y las fuentes de información consultadas. Resultados: Predominaron los residentes que visitaban la biblioteca ocasionalmente (56.9 %). El servicio más demandado fue la búsqueda de información (92.2 %). La fuente de información que más se usó fue la consulta de revistas, el 96.1 % de los encuestados. Conclusiones: Teniendo en cuenta los resultados, existen fisuras en la interacción de los usuarios (médicos-residentes) con las oportunidades opciones que ofrece la Biblioteca Médica del municipio de Niquero, lo cual se evidencia en el limitado aprovechamiento que realizan de este servicio los futuros especialistas en Medicina General Integral.

ABSTRACT Background: Libraries are an indispensable source of instructional resources for society in general. In the field of Medical Sciences, they contribute to the training of specialists in Comprehensive General Medicine. Objective: To determine the use that residents of the Comprehensive General Medicine specialty of the `` Ernesto Guevara '' Polyclinic in Niquero make of the Medical Library. Methodology: A cross-sectional, descriptive observational study was carried out. The study universe was made up of the 51 residents of this specialty. Theoretical, empirical and statistical-mathematical methods (absolute frequency and percentage) were used. The variables studied were: frequency of visits, use of the services provided and the sources of information consulted. Results: Residents who visited the library occasionally predominated, 56.9%. The information search was the service mostly known by them, 92.2%. The most requested source of information was the consultation of magazines, 96.1% of those surveyed. Conclusions: According to the results of the study, it is necessary to take full advantage of the strengths offered by the Medical Library in the municipality of Niquero to increase the informational competencies in residents of the Comprehensive General Medicine specialty, for their training with great scientificity.

Resultados del Examen Estatal Práctico de Medicina General Integral en el municipio Niquero. 2019 / Results of Practical State Exam of Comprehensive General Medicine in Niquero municipality, 2019 / Resultados do Exame Prático de Estado de Medicina Geral Integral no Município de Niquero. 2019

RESUMEN Introducción: el examen estatal permite apreciar el desempeño del residente de Medicina General Integral en la Atención Primaria de Salud. Objetivo: describir los resultados del examen práctico estatal de los residentes evaluados en el municipio de Niquero, presentados a la primera convocatoria, curso académico 2018-2019, de la Universidad de Ciencias Médicas de Granma. Métodos: se realizó un estudio observacional descriptivo, de corte transversal, sobre los resultados del examen referido en el objetivo. El universo lo constituyeron 21 residentes. Se emplearon métodos teóricos (revisión documental de las actas de exámenes) y estadísticos (frecuencia absoluta y porcientos). Resultados: se obtuvo un 100% de promoción. Por rublos, pocos residentes obtuvieron la nota máxima, siendo la Actividad Grupal la de más alta cuantía, 42,9%. La nota entre 18-19 puntos fue la predominante en todos los acápites del examen. El mayor porciento de errores estuvo en: Discusión del Problema de Salud en 20 residentes (95,2%), Consulta en 19 residentes (90,5%), Visita a la Familia en 17 médicos (80,9%) y Análisis de la Situación de Salud en 16 residentes (76,1%). Conclusiones: el examen estatal práctico para la especialidad de Medicina General Integral tuvo una buena promoción, aunque se evidenciaron deficiencias cognoscitivas sobre Discusión del Problema de Salud, Consulta, Visita a la Familia y Análisis de la Situación de Salud, por lo que se hace necesario para las próximas convocatorias elevar la preparación de los residentes.

ABSTRACT Introduction: State Exam allow the evaluation of teaching-learning results and its quality in residents of Comprehensive General Medicine in Primary Health Care. Objective: to describe the results of the State Practical Exam of residents in the Family Medicine in Niquero municipality in the Academic Course 2018-2019, first call, at the University of Medical Sciences of Granma. Methods: a cross-sectional, observational descriptive study was carried out with the teaching-learning results of the State Exam declared in the objective. The universe was formed by 21residents. Empirical methods and statistical processing were used along with documentary analysis of exam records. All variables were given an absolute frequency distribution and percentage. Results: 100% of the residents were approved in the first calls from 2018 to 2019. A few residents got the highest marks. The highest results obtained in all the exam questions ranged between 18-19 points. Group Activity was the most outstanding mark (42,9%).Nevertheless, the answers with the lowest results belonged to the topics on Discussion of Problem of Health (20 residents, 95,2%), Doctor's Consulting (19 residents, 90,5%), Family Home Visiting (17 doctor, 80,9%) and Analysis of the Health Situation (16 residents, 76,1%). Conclusions: the total of the residents passed the State Practical Exam to obtain the degree of specialists in Family Medicine though some cognitive deficiencies were found on Discussion of Problem of Health, Doctor's Consulting, Family Home Visiting and Analysis of the Health Situation. Therefore, it is necessary to improve the preparation of residents and their professional competences.

RESUMO Introdução: o exame estadual permite avaliar a atuação do residente de Medicina Geral Integral na Atenção Primária à Saúde. Objetivo: descrever os resultados do exame prático estadual dos residentes avaliados no município de Niquero, apresentado na primeira convocação, ano letivo 2018-2019, da Universidade de Ciências Médicas do Granma. Métodos: foi realizado um estudo observacional descritivo, transversal, dos resultados do exame referido no objetivo. O universo foi formado por 21 residentes. Foram utilizados métodos teóricos (revisão documental de fichas de exames) e estatísticos (frequência absoluta e percentual). Resultados: obteve 100% de promoção. Para rublos, poucos residentes obtiveram a pontuação máxima, sendo a Atividade de Grupo a mais alta, 42,9%. A nota entre 18-19 pontos foi a predominante em todas as seções do exame. O maior percentual de erros foiem: Discussão do Problema de Saúde em 20 residentes (95,2%), Consulta em 19 residentes (90,5%), Visita à Família em 17 médicos (80,9%) e Análise da Situação de Saúde em 16 residentes (76,1%) %). Conclusões: o exame prático estadual para a especialidade de Medicina Geral Integral teve boa divulgação, embora tenham sido evidenciadas deficiências cognitivas na Discussão do Problema de Saúde, Consulta, Visita à Família e Análise da Situação de Saúde, por isso é necessário para a próximas ligações para elevar a preparação dos residentes.

Exploration of assessment model for general practice faculty based on general practitioner post competence / 中华医院管理杂志

The study is designed to explore new methods of evaluation for teachers′ comprehensive ability in general medicine. In the whole education process of resident aiming at general practitioner (GP) residency post competency, the authors made comprehensive evaluation of GP faculty, and created a comprehensive GP faculty evaluation model of result orientation. The efforts aim at exploring and introducing faculty evaluation methods and promoting education quality, in order to develop outstanding GP residents of strong post competency.

Conocimientos sobre el rol del tutor en Medicina General Integral. Policlínico Jimmy Hirzel. 2019 / Knowledge about the role of the tutor in Integral General Medicine. Jimmy Hirzel Polyclinic. 2019 / Conhecimento sobre o papel do tutor em Medicina Geral Integral. Policlínica Jimmy Hirzel. 2019

RESUMEN Introducción: la formación en el trabajo garantiza la competencia y desempeño adecuado del futuro especialista en la atención no solo del individuo, sino también de la familia y la comunidad. Objetivo: identificar el nivel de conocimientos que poseen los especialistas de Medicina General Integral sobre su rol de tutor en la formación de futuros especialistas del Policlínico Jimmy Hirzel. Bayamo. 2019. Método: se utilizaron métodos teóricos, empíricos y estadísticos. Fueron estudiadas las variables: edad, sexo, años de graduados en función de la tutoría, categoría docente en relación a los años como tutor, nivel de conocimientos sobre el rol del tutor. Se aplicó el coeficiente alfa de Cronbach para medir la confiabilidad del cuestionario aplicado. El universo quedó constituido por todos los especialistas pertenecientes al policlínico Jimmy Hirzel y la muestra por 38 que estaban ejerciendo como tutores en el año 2019. Resultados: predominaron las féminas sobre los masculinos con un 63,2%. El grupo etario más representativo fue de 35 a 39 años con un 31,6%, los especialistas carecen de experiencia y no se han enfrentado a la tutoría, obteniéndose un 52,6%. El 89.5% fueron especialistas sin categoría docente. El nivel de conocimientos de los tutores sobre su rol en la formación de especialistas de Medicina General Integral fue bajo con un 50%. Conclusiones: se demuestra que existen insuficiencias en el conocimiento del rol del tutor en la formación de especialistas en Medicina General Integral y marca un reto para la preparación del claustro en cada institución.

ABSTRACT Introduction: on-the-job training guarantees the competence and adequate performance of the future specialist in the care not only of the individual, but also of the family and the community. Objective: to identify the level of knowledge that the specialists in Comprehensive General Medicine possess about their role as tutor in the training of future specialists of the Jimmy Hirzel Polyclinic. Bayamo. 2019. Method: theoretical, empirical and statistical methods were used. The variables were studied: age, sex, years of graduates depending on the tutoring, teaching category in relation to the years as tutor, level of knowledge about the role of the tutor. Cronbach's alpha coefficient was applied to measure the reliability of the applied questionnaire. The universe was made up of all the specialists belonging to the Jimmy Hirzel polyclinic and the sample of 38 who were working as tutors in 2019. Results: females predominated over males with 63.2%. The most representative age group was 35 to 39 years old with 31.6%, specialists lack experience and have not faced tutoring, obtaining 52.6%. 89.5% were specialists without a teaching category. The level of knowledge of the tutors about their role in the training of specialists in Comprehensive General Medicine was low with 50%. Conclusions: it is shown that there are insufficiencies in the knowledge of the role of the tutor in the training of specialists in Comprehensive General Medicine and marks a challenge for the preparation of the faculty in each institution.

RESUMO Introdução: o treinamento no local de trabalho garante a competência e o desempenho adequado do futuro especialista no cuidado não apenas ao indivíduo, mas também à família e à comunidade. Objetivo: identificar o nível de conhecimento que os especialistas em Medicina Geral Compreensiva possuem sobre seu papel de tutor na formação de futuros especialistas da Policlínica Jimmy Hirzel. Bayamo. 2019. Método: foram utilizados métodos teóricos, empíricos e estatísticos. As variáveis ​​estudadas foram: idade, sexo, anos de egressos, dependendo da tutoria, categoria de ensino em relação aos anos de tutor, nível de conhecimento sobre o papel do tutor. O coeficiente alfa de Cronbach foi aplicado para medir a confiabilidade do questionário aplicado. O universo foi composto por todos os especialistas pertencentes à policlínica Jimmy Hirzel e a amostra de 38 que estavam trabalhando como tutores em 2019. Resultados: o sexo feminino predominou sobre o masculino, com 63,2%. A faixa etária mais representativa foi de 35 a 39 anos, com 31,6%, os especialistas não têm experiência e não enfrentaram aulas particulares, obtendo 52,6%. 89,5% eram especialistas sem categoria de ensino. O nível de conhecimento dos tutores sobre o seu papel na formação de especialistas em Medicina Geral Integral foi baixo, com 50%. Conclusões: mostra-se insuficiente o conhecimento do papel do tutor na formação de especialistas em Medicina Geral Compreensiva e marca um desafio para a preparação do corpo docente em cada instituição.

Application of "three-in-one" tutorial system in standardized residency training of general practice / 中华全科医师杂志

The mentor system has been applied in the standardized residency training, currently the "one to one" ortwo mentors′ system are more common applied. However, the clinical training of general practitioners needs joint effort of mentors from the general practice department and specialists in hospital, as well as of mentors from primary health institutes. Thus, we proposed a "three-in-one" tutorial system, which consisted of one GP mentor, one specialists in the hospital and one primary physician for residency training of general practice. The implementation of the "three-in-one" system has motivated the enthusiasm of specialists and community instructors, and enhanced their responsibility. The mentors from different department can learn from each other and complement each other, so the overall teaching level can be raised and the quality of standardized training of general practitioners can be improved.

Desempeño social del especialista en Medicina General Integral en el enfrentamiento a la COVID-19 / Social performance of the specialist in Comprehensive General Medicine in the confrontation with COVID-19

RESUMEN El enfrentamiento a la COVID-19 constituye un desafío para los profesionales de la salud en Cuba esencialmente con los cuidados a la población. El trabajo tiene como objetivo describir el desempeño social del especialista en Medicina General Integral en el enfrentamiento a la COVID-19. Se realizó un estudio que evidenció el desempeño social de este especialista en el enfrentamiento epidemiológico a la COVID-19.

ABSTRACT The confrontation with COVID-19 constitutes a challenge for health professionals in Cuba, essentially with care for the population. The objective of the work is to describe the social performance of the specialist in Comprehensive General Medicine in the confrontation with COVID-19. A study was carried out that showed the social performance of this specialist in the epidemiological confrontation with COVID-19.

A Prospective Study On Usage Pattern Of Corticosteroids In A Tertiary Care Hospital

Rational use of corticosteroids is very essential for improving patient safety on long term use. The present study aimed to study the prescribing usage pattern of corticosteroids in a tertiary care hospital. A prospective observational study was conducted in the department of dermatology, gynecology and general medicine in a tertiary care teaching hospital for the period of 6 months (August-February). All patients receiving any category of Steroid therapy were included and the prescribing and tapering pattern of steroids were reviewed. Prescribing pattern was observed and analysed in 132 participants during the study period. Cases were collected from the departments of Dermatology, General Medicine, Pediatrics and Gynecology in Gandhi Hospital, Secunderabad. All the prescriptions containing steroids were included in this study and the parameters evaluated were gender distribution, age of the patients, types of steroids according to the route of administration, number of prescribed daily dose (PDD) where compared with defined daily dose (DDD). In the collected 132 cases, 162 times corticosteroids were prescribed. The steroid utilization was found to be more in female patients, the maximum number of cases with corticosteroids was found in Dermatology department (39.4%). Particularly Injection Dexamethasone (24.7%) and Tablet Prednisolone (24.7%) are mostly prescribed. Most drugs were prescribed rationally although some factors like improper history, drug administration time and tapering were deviating away from rationality. Although most of the drugs were prescribed rationally, involvement of a Clinical pharmacist in patient care can help in more rational prescribing along with prevention and early detection of ADRs which can directly promote drug safety and better patient outcomes.

El especialista en Medicina General Integral en el perfeccionamiento medioambiental para un desarrollo sostenible / The specialist in Comprehensive General Medicine in the environmental improvement for a sustainable development

RESUMEN Es importante el desarrollo de la educación ambiental desde la simple atención a los aspectos físicos y biológicos locales, como también mantener un enfoque integral de las realidades ambientales. Existe una estrecha vinculación entre desarrollo económico y conservación o degradación del medio ambiente, así como la necesidad de una integración mundial. Es cardinal la conservación del medio ambiente y la necesidad de garantizar la sostenibilidad ambiental. En esta tarea se asume al hombre como el primordial recurso natural existente, que igualmente corre el riesgo de desaparecer ante la presente crisis ambiental. En el funcionamiento y desarrollo de las comunidades se perfila el rescate de la iniciativa y la búsqueda de solución a las dificultades ambientales más diversas, en las localidades y barrios, donde se involucren a todos sus miembros. Los autores de este trabajo se plantearon valorar la importancia de la participación del especialista en Medicina General Integral en el perfeccionamiento medioambiental para el logro de un desarrollo sostenible.

ABSTRACT Environmental education is very important, ranging from the simple attention to local biological and physical aspects to keeping an integral approach to the environmental realities. There is a tight relation between economical development and environmental conservation or degradation, and also the necessity of a worldwide integration. It is cardinal the environmental conservation and the necessity of guaranteeing the environmental sustainability. The man is the main natural resource and he is also at risk of disappearing as the result of the current environmental crisis. The functioning and development of the communities, villages and towns, should be based in rescuing the initiative and searching solutions to the most different environmental difficulties with the participation of all their members. The authors of this work aimed their work at assessing the importance of the participation of the specialist in Comprehensive General Medicine in the environmental improvement to achieve a sustainable development.

Construction of an appropriate technology catalogue for general practice based on Delphi method / 预防医学

Objective @#To construct an appropriate technology catalogue for general practice based on Delphi method,and to provide reference for promoting appropriate techniques and training general practitioners.@*Methods @#The catalogue was briefly constructed based on literature reviews and the data of the top twenty diseases diagnosed in out-patient department of Sir Run Run Shaw Hospital and two community health service centers in Hangzhou. Two-round Delphi consultation was conducted by fourteen general practitioners coming from upper first-class hospitals and community hospitals. The final catalogue was established according to evaluation of the degree of involvement,authority coefficient and Kendall's W values of the fourteen specialists.@*consultations @#Results Of the fourteen specialists,nine had bachelor's degrees and five had master's degrees or above;twelve were deputy chief physicians or chief physicians and two were physicians. They were engaged in general practice for 17.21 years in average. The positive coefficients of the two rounds of were both 100.00%. The authority coefficient of the specialists was 0.891. After the first round of consultation,the W values for importance and feasibility of 6 first-class indicators were 0.170 and 0.244,and the ones of 56 second-class indicators were 0.236 and 0.250（all P<0.05）. Six of second-class indicators were excluded because their coefficent of variation（CV）for importance and feasibility were more than 0.25. After the second round of consultation,the W values for importance and feasibility of 6 first-class indicators were 0.245 and 0.247,and the ones of 50 second-class indicators were 0.355 and 0.370（all P<0.05）. The CV for each indicator was less than 0.25. Finally,an instructional catalogue was defined,consisting of 6 first-class indicators（basic diagnosis and treatment skills,first aid skills,symptomatic diagnosis and treatment skills,chronic disease management skills,common disease diagnosis and treatment skills,and common manipulative skills）and 50 second-class indicators.@*Conclusion @#The degrees of involvement,authority and consistency of the specialists were relatively high. The catalogue of appropriate technology for general practitice had good reliability and feasibility,which was worthy of promotion and application.

Análisis del método clínico a través de la disciplina Medicina General Integral / Analysis of the clinical method through the discipline Comprehensive General Medicine

El método clínico está presente de una forma u otra en todas las actividades de la disciplina Medicina General Integral como fenómeno insoslayable de la relación médico-paciente, así como en el desarrollo de actividades dentro de la Atención Primaria de Salud. Es por ello que el objetivo de la presente investigación es analizar el método clínico a través de la disciplina Medicina General Integral. Para ello se realizó un estudio de corte pedagógico, rectorado por el método materialista dialéctico, el cual permitió el empleo de métodos teóricos y empíricos. Dentro de los primeros, el análisis-síntesis, inducción-deducción e histórico-lógico, y en el segundo grupo análisis documental, la revisión bibliográfica y el grupo nominal. Como principales resultados hubo correspondencia, pertinencia y profundidad de los contenidos pertenecientes a la disciplina Medicina General Integral con el método clínico, así como importantes bibliografías que reafirman dicho nexo. Resultó necesaria la intención de fortalecer el trabajo metodológico en función de desarrollar el método clínico a través de la disciplina Medicina General Integral, coincidiendo en su análisis oportuno y sistemático. Dicho método desde la disciplina Medicina General Integral constituye una vía para la formación general integral de sus profesionales, así como un sólido argumento de las relaciones a desarrollar en la prestación de servicios de salud(AU)

The clinical method is present in one form or another in all the activities of the Comprehensive General Medicine discipline as an unavoidable phenomenon of the doctor-patient relationship, as well as in the development of activities within the Primary Health Care. That is why the objective of this research is to analyze the clinical method through the Comprehensive General Medicine discipline. To this end, a pedagogical study was carried out, guided by the dialectical materialist method, which allowed the use of theoretical and empirical methods. Among the first, the analysis-synthesis, induction-deduction and historical-logical, and in the second group, documentary analysis, the bibliographic review and the nominal group. The main results were correspondence, relevance and depth of the contents belonging to the Comprehensive General Medicine discipline with the clinical method, as well as important bibliographies that reaffirm this connection. It was necessary to strengthen the methodological work in order to develop the clinical method through the Integral General Medicine discipline, coinciding in its timely and systematic analysis. This method from the Comprehensive General Medicine discipline constitutes a way for the general comprehensive training of its professionals, as well as a solid argument of the relationships to be developed in the provision of health services(AU)

Assessment of Depression among Hypertensive Patients Visited in Hospital: A Prospective Study

Background: Hypertension is the leading risk factor for morbidity and mortality worldwide. Depression is a significant contributor to the global burden of disease. More and more psychologist have recognized addressing patients’ mental needs as their priority research fields. Hence; we planned the present study to assess the prevalence of depression among hypertensive patients.  Materials & Methods: A total of 60 hypertensive patients were included in the present study. We included only those patients in the present study which were diagnosed as suffering from hypertension. A questionnaire was prepared which comprised of questions pertaining to the demographic details, factors associated with hypertension and back depression inventory scale. All the results were recorded on the Microsoft excel sheet and were analyzed by SPSS software. Results: Depression was found to be present in 58.3 percent of the hypertensive patients in the present study. We obtained while significant results while comparing the prevalence of depression among hypertensive patients divided on the basis of marital status, gender and educational qualification.  Conclusion: Depression is a common problem encountered among hypertensive patients.