Bipolar disorder and tobacco smoking: Categorical and dimensional clinical correlates in subjects from the Brazilian bipolar research network.

BACKGROUND: People with bipolar disorder (BD) have high rates of smoking. However, the scientific literature examining the association between clinical outcomes in BD and tobacco smoking is still limited and there are conflicting results. The objective of the current study was to comprehensively investigate associations between BD and tobacco smoking in a large Brazilian sample. METHODS: This study evaluated 336 outpatients from the Brazilian Bipolar Research Network, which is a collaboration between three large academic centers in Brazil. MAIN FINDINGS: Regarding the categorical analysis (i.e. current smokers versus non-smokers), tobacco smokers showed: 1) a higher percentage of individuals identifying as Non-Caucasians; 2) a longer duration of illness; 3) a longer duration of untreated illness; 4) more severe manic symptoms; 4) a stronger family history of mood disorder; and 6) a higher current prevalence of alcohol/substance use disorder. The dimensional analysis in smokers (i.e. number of cigarettes per day versus clinical variables) found a positive correlation between number of cigarettes per day and a) age, b) age at onset of BD, c) duration of illness, and d) current diagnosis of panic disorder. CONCLUSION: This study found important clinical correlates of tobacco smoking in BD subjects. We observed that the variables associated with current smoker status (categorical approach) are not necessarily correlated with number of cigarettes per day (dimensional approach). Duration of illness appears to be a particularly relevant clinical variable in the association between BD and tobacco smoking.

Chicago medical response to the 2010 earthquake in Haiti: translating academic collaboration into direct humanitarian response.

On January 12, 2010, a major earthquake in Haiti resulted in approximately 212 000 deaths, 300 000 injuries, and more than 1.2 million internally displaced people, making it the most devastating disaster in Haiti's recorded history. Six academic medical centers from the city of Chicago established an interinstitutional collaborative initiative, the Chicago Medical Response, in partnership with nongovernmental organizations (NGOs) in Haiti that provided a sustainable response, sending medical teams to Haiti on a weekly basis for several months. More than 475 medical volunteers were identified, of whom 158 were deployed to Haiti by April 1, 2010. This article presents the shared experiences, observations, and lessons learned by all of the participating institutions. Specifically, it describes the factors that provided the framework for the collaborative initiative, the communication networks that contributed to the ongoing response, the operational aspects of deploying successive medical teams, and the benefits to the institutions as well as to the NGOs and Haitian medical system, along with the challenges facing those institutions individually and collectively. Academic medical institutions can provide a major reservoir of highly qualified volunteer medical personnel that complement the needs of NGOs in disasters for a sustainable medical response. Support of such collaborative initiatives is required to ensure generalizability and sustainability.

Effects of transfusions in extremely low birth weight infants: a retrospective study.

OBJECTIVES: To determine the risks and benefits associated with the transfusion of packed red blood cells (PRBCs) in extremely low birth weight (ELBW) infants. We hypothesized that when ELBW infants underwent transfusion with the University of Washington Neonatal Intensive Care Unit (NICU) 2006 guidelines, no clinical benefit would be discernible. STUDY DESIGN: We conducted a retrospective chart review of all ELBW infants admitted to the NICU in 2006. Information on weight gain, apnea, heart rate, and respiratory support was collected for 2 days preceding, the day of, and 3 days after PRBC transfusion. The incidence, timing, and severity of complications of prematurity were documented. RESULTS: Of the 60 ELBW infants admitted to the NICU in 2006, 78% received PRBC transfusions. Transfusions were not associated with improved weight gain, apnea, or ventilatory/oxygen needs. However, they were associated with increased risk of bronchopulmonary dysplasia, necrotizing enterocolitis, and diuretic use (P < .05). Transfusions correlated with phlebotomy losses, gestational age, and birth weight. No association was found between transfusions and sepsis, retinopathy of prematurity, or erythropoietin use. CONCLUSIONS: When our 2006 PRBC transfusion guidelines were used, no identifiable clinical benefits were identified, but increased complications of prematurity were noted. New, more restrictive guidelines were developed as a result of this study.

Diseño de un programa académico para la implementación de un aula de apoyo para consolidar competencias esenciales / Design of an academic program for the implementation of a classroom of support to consolidate essential competencies

El propósito del presente trabajo, es de proporcionar una base orientadora para el tratamiento de problemas de aprendizaje, particularmente referidos a la adquisición de competencias esenciales en los recién egresados de la carrera de Nutrición y Dietética, cuya metodología puede ser aplicada en otros ámbitos de la Educación Superior. El trabajo parte de un diagnóstico y análisis de la Evaluación de Competencias Esenciales que debe tener el nutricionista en el área de Salud Pública. Este tipo de evaluación se realiza desde 1999 a la fecha, aplicando un Examen Objetivamente Estructurado. Los resultados de dicho análisis, muestran una deficiencia acentuada en la consolidadción de habilidades lógico intelectuales en casi la mitad de los estudiantes, aunque en diferentes proporciones según los temas evaluados. La propuesta de un programa académico, para la inplementación de un Aula de Apoyo, surge como respuesta a la necesidad de una experiencia de aprendizaje que contribuya a superar este problema en estudiantes que reprueban los Exámenes Objetivamente Estructurados. La misma hace énfasis en la Evaluación Nutricional, que es una competencia fundamental para el nutricionista. En la misma dirección, se hace una propuesta de Evaluación del efecto de aula apoyo, a través de los resultados del programa académico y de las calificaciones de los estudiantes en una segunda aplicación del Examen Objetivamente Estructurado

Las "ideas básicas" como método docente de investigación / The idea basic with method faculty and investigation

Se describe el origen del método de las "ideas básicas" de la Universidad de California. La crisis universitaria se debe al contraste entre la escala de valores de la universidad y la de la ciudad en la cual está inmersa. Estamos en la etapa posindustrial. El conocimiento es acumulativo y continuo. Se esboza la historia de los cambios en los planes de estudios médicos, desde 1959 en la Facultad de Medicina de la Universidad Central de Venezuela. Se señalan dos experiencias docentes en cirugía con las ideas básicas, una pregrado en 1970 y otra de posgrado en 1992. En la experiencia de pregrado los profesores de las cuatro cátedras de Clínica Quirúrgica elaboramos 1260 ideas en el Hospital Universitario de Caracas. En la experiencia de posgrado elaboramos los alumnos y los profesores del Servicio de Cirugía IV del Hospital Miguel Pérez Carreño, 2880 ideas. En la segunda experiencia la evaluación mejoró 12 por ciento. Se propone que las cátedras o las unidades docentes elaboren al comienzo de cada año las metas en las áreas cognoscitiva, de conducta y de las habilidades

Fundación del Centro de Estudiantes de Medicina 8 de mayo de 1906 / Fundation of the Center of Medical Student May 8, 1906

Al atardecer del 8 de mayo de 1906, un grupo de estudiantes de la entonces primera "Facultad de Ciencias Médicas de Bolivia" bajo el lema "La unión hace la fuerza" se congregaron y fundaron el "Centro de estudios Médicos" con gran entuciasmo y de vocación. los tiempos eran difíciles, en la Universidad y la sociedad reinaba un espíritu de rechazo a este tipo de organizaciones, ya que existía la suceptibilidad académica de destruir los pensamientos del "Magister Dei". A un contra las advesidades en Julio del mismo año ya se ven los primeros frutos importantes de este Centro, es asi que el 15 de julio de 1906 circula la "Revista del Centro de Estudios Médicos" en cuyo contenido se ven plasmadas los altos intereses académicos y de servicio para se "un instrumento científico.