Emprego de tecnologias computacionais (Weblab) como suporte às práticas laboratoriais em curso de Medicina / Using computational technologies (Weblab) in an undergraduate medical course as supporting tools for laboratorial practices

Resumo: Introdução: As escolas de Medicina buscaram maneiras factíveis de introduzir melhorias no processo de ensino-aprendizagem, especificamente no ensino remoto, durante o período de isolamento social ocasionado pela pandemia do novo coronavírus Sars-Cov-2. Um dos maiores desafios encontrados foi a estruturação das aulas práticas laboratoriais, essenciais à formação médica, em face dessa nova realidade. O Weblab, um sistema de automação remota concebido, desenvolvido e instalado para substituir as aulas práticas presenciais, apresentou-se como uma possível alternativa para o cumprimento da carga horária estabelecida pelo MEC. Relato de experiência: A experiência ocorreu nas aulas práticas de Anatomia, nos primeiros semestres de 2020 e 2022. Em 2020, em virtude da necessidade de realizar atividades laboratoriais, respeitando as regras de distanciamento social, desenvolveu-se um sistema composto de hardwares e softwares que objetivava a realização a distância de observação e manipulação de peças anatômicas como alternativa às práticas laboratoriais presenciais. Nessa proposta, além da análise detalhada das peças, o discente conseguia armazenar as imagens e enviá-las para o seu e-mail, contribuindo para executar os exercícios específicos indicados pelo professor. Discussão: O projeto contribuiu para aumentar a motivação dos alunos, em face da dinâmica interação docente-discente estabelecida remotamente. Os resultados das avaliações qualitativas realizadas com dez alunos indicaram que a nova atividade remota era amigável e de fácil realização. Na perspectiva dos alunos, também houve melhoria no processo ensino-aprendizagem. No entanto, seria ainda necessário o emprego de métodos estatísticos de avaliações quantitativas, em uma população maior, utilizando grupos de controle, para comprovar os benefícios no processo ensino-aprendizagem. Conclusão: A plataforma Weblab Anatomia demonstrou que o emprego de tecnologias no ensino pode ajudar como um apoio às aulas práticas laboratoriais presenciais ou mesmo como modelo a ser operado a distância, em atenção às situações de pandemia, de acordo com as orientações sanitárias. Os resultados qualitativos apresentam aspectos importantes e positivos dessa experiência.

Abstract: Introduction: Medical Schools sought feasible ways to introduce improvements in the teaching-learning process, specifically in remote teaching, during the period of social distancing enforced by the new Sars-Cov-2 coronavirus pandemic. One of the biggest challenges encountered was the structuring of practical laboratory classes, essential to medical training, in the face of this new reality. The design, development, and installation of a remote automation system, called Weblab, replacing face-to-face practical classes, was presented as a possible alternative for meeting the workload established by the Brazilian Ministry of Education. Experience report: this experiment took place in practical Anatomy classes, in the first semesters of 2020 and 2022. In 2020, there was a need to carry out laboratory activities respecting the social distancing rules. A system with hardware and software was developed for students to perform the activities proposed by the teacher. In this system, the student can position a certain anatomical piece remotely, save images with different views and send them to their e-mail, completing the proposed exercises. Discussion: the experiment provided indications of increased student motivation to execute laboratory activities remotely, in view of the dynamic teacher-student interaction. The results of the qualitative evaluations carried out by 10 students indicated that students found it easy to use the equipment in the experiment. From the students' perspective, there was also an indication of improvement in the teaching/learning process. However, statistical indications are needed to demonstrate this improvement with the application of quantitative assessments on the course content in control groups, using a larger population and with and without the use of the Weblab. Conclusion: the Weblab Anatomy platform demonstrated that the use of technologies makes it possible to change face-to-face laboratory classes to a remote model, helping to solve the problem of physical distancing, complying with health guidelines to avoid contagion in pandemic periods. Qualitative results show important and positive aspects of this experiment, such as the ease of using the Weblab platform.

Identification of secondary predictive factors for acute hypocalcemia following thyroidectomy in patients with low postoperative parathyroid hormone levels without overt calcium deficiency: A cohort study.

BACKGROUND: The transient acute hypocalcemia (HypoCa) is the most prevalent complication after total thyroidectomy, detected primarily by subnormal intact parathyroid hormone (iPTH) and calcium levels. However, the need for calcium supplementation is ambiguous in patients who exhibit low iPTH with normal calcium levels. The aim of this study was to evaluate complementary predictors of HypoCa in this scenario. METHODS: A retrospective cohort study with of 1597 consecutive patients undergoing total thyroidectomy, with or without neck dissection, from January 2014 to December 2018 at a single institution. Patients with an iPTH <12 pg/mL and a total calcium level ≥8 mg/dL in the first 8 h after surgery were included. RESULTS: 1597 patients identified with low postoperative iPTH without overt calcium deficiency was diagnosed. The transient HypoCa in that specific subgroup was 509 (31.9%). Multivariate analysis indicated that HYPOCA was associated with bilateral level VI neck dissection and pre- to postoperative calcium reduction >38 pg/mL. To better illustrate the model, we plotted a nomogram with the variables selected for the final model. CONCLUSION: Total thyroidectomy patients who exhibit low postoperative iPTH levels without overt calcium deficiency should be considered for calcium replacement therapy when they a marked drop in iPTH postoperatively and underwent bilateral level VI neck dissection.

The hidden curve behind COVID-19 outbreak: the impact of delay in treatment initiation in cancer patients and how to mitigate the additional risk of dying-the head and neck cancer model.

PURPOSE: The rapid spread of the SARS-CoV-2 pandemic around the world caused most healthcare services to turn substantial attention to treatment of these patients and also to alter the structure of healthcare systems to address an infectious disease. As a result, many cancer patients had their treatment deferred during the pandemic, increasing the time-to-treatment initiation, the number of untreated patients (which will alter the dynamics of healthcare delivery in the post-pandemic era) and increasing their risk of death. Hence, we analyzed the impact on global cancer mortality considering the decline in oncology care during the COVID-19 outbreak using head and neck cancer, a known time-dependent disease, as a model. METHODS: An online practical tool capable of predicting the risk of cancer patients dying due to the COVID-19 outbreak and also useful for mitigation strategies after the peak of the pandemic has been developed, based on a mathematical model. The scenarios were estimated by information of 15 oncological services worldwide, given a perspective from the five continents and also some simulations were conducted at world demographic data. RESULTS: The model demonstrates that the more that cancer care was maintained during the outbreak and also the more it is increased during the mitigation period, the shorter will be the recovery, lessening the additional risk of dying due to time-to-treatment initiation. CONCLUSIONS: This impact of COVID-19 pandemic on cancer patients is inevitable, but it is possible to minimize it with an effort measured by the proposed model.