Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 10 de 10
Filtrar
Mais filtros










Intervalo de ano de publicação
1.
Rev. Fund. Educ. Méd. (Ed. impr.) ; 22(4): 191-196, jul.-ago. 2019. graf, tab
Artigo em Espanhol | IBECS-Express | ID: ibc-ET2-4723

RESUMO

Introducción: No hay muchos estudios que valoren la docencia clínica de una asignatura determinada. Este estudio pretende ser la continuidad de uno que se publicó en esta misma revista en 2015. Sujetos y métodos: Se han analizado las encuestas a alumnos de los cursos desde 2011-2012 hasta diciembre de 2018, lo que representa 7,5 cursos. Los objetivos de la estancia clínica no cambiaron a lo largo del período analizado, ni tampoco varió el número de alumnos por unidad ni las siete unidades/centros docentes. Resultados: Se han recogido 1.180 encuestas (92% del total). Se constató una muy buena valoración global del período de docencia clínica (mediana: 5; primer cuartil: 4, en escala de 1 a 5), sin variaciones significativas en los cursos analizados. Tampoco hubo variaciones significativas en ninguna de las siete unidades docentes. Conclusión: La docencia clínica está muy bien valorada de forma global en esta asignatura en las distintas unidades docentes, sin variaciones a lo largo del tiempo


Introduction: There are few studies regarding the clinical skills training of a particular matter. The present study reflect the continuation of a previous work published in 2015 in the same journal. Subjects and methods: The period of study represents 7,5 cycles (2011-2018). The main objectives of the clinical practice as well as the number of students and the number of facilities did not change over time. Results: A total number of 1,180 (92%) of the requested surveys were collected. A very good global qualification was assessed (median: 5; first quartile: 4, in 1-5 scale) without significant differences either through the time or among the different seven units. Conclusions: Clinical skills training in this matter is considered near excellent without significant variations through the time

2.
FEM (Ed. impr.) ; 18(5): 331-335, sept.-oct. 2015. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-144625

RESUMO

INTRODUCCIÓN: Existen pocos estudios que de forma selectiva valoren la docencia clínica de una determinada asignatura. En este artículo se presenta la experiencia en docencia clínica de la asignatura 'Semiología General y Propedéutica Clínica' en tercer curso del Grado de Medicina en la Facultad de Medicina de la Universitat de Barcelona. MATERIALES Y MÉTODOS: Se han analizado los cursos 2011-2012, 2012-2013 y 2013-2014, representando un total de cinco 'cursos', ya que la asignatura es semestral y se imparte dos veces en cada curso académico. El período de docencia clínica de la asignatura es de siete semanas (28 días) y el número de alumnos oscila entre cuatro y ocho por cada una de las siete unidades/centros distintos. A su llegada se les informa de los objetivos de la estancia clínica y al final del período se les invita a cumplimentar una encuesta anónima y voluntaria en la que valoran distintos ítems. RESULTADOS: Se han recogido 477 encuestas (95%). Se constató una muy buena valoración global del período de docencia clínica (mediana: 5; primer cuartil: 4, en escala de 1 a 5), sin variaciones significativas entre los distintos períodos evaluados (p = 0,658). CONCLUSIONES. La docencia clínica en esta asignatura está muy bien valorada de forma global, sin detectar variaciones relevantes en los cinco cursos analizados


INTRODUCTION: There are very few studies regarding the clinical skills training of a particular matter. In the present study the experience in clinical training in the matter ‘Semiology and Clinical Propedeutics’ from the Faculty of Medicine in the University of Barcelona is presented. The results of surveys from five consecutive cycles are compared. MATERIALS AND METHODS: The period of study represents five cycles (2011-2014) since the matter is developed twice a year. The clinical period training in the matter spent seven weeks (28 days) and the number of students for each of the seven different facilities ranged from 4-8. When arriving, the students are informed about the objectives to be achieved through their training period, and at the end they are asked about the voluntary and anonymous survey complementation. RESULTS: A total of 95% (n = 477) of the requested surveys were collected. A very good global qualification was assessed (median: 5; first quartile: 4, in 1-5 scale), without significant differences among the different evaluated periods of time (p = 0.658). CONCLUSIONS: Clinical skills training in this matter is considered near excellent without significant variations through the five consecutive periods analyzed


Assuntos
Humanos , Ensino/organização & administração , Educação Médica/organização & administração , Docentes/organização & administração , Avaliação Educacional , Faculdades de Medicina/estatística & dados numéricos , Estudantes de Medicina/estatística & dados numéricos
3.
J Hypertens ; 33(4): 851-8; discussion 859, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25915890

RESUMO

OBJECTIVE: The physiopathological mechanisms implicated in hypertensive heart disease are multi-factorial, including myocyte hypertrophy, apoptosis and myocardial remodelling. In this process, some hormonal and local growth factors have a regulatory influence. The aim of this study was to evaluate the potential role of myostatin and insulin-like growth factor-1 (IGF-1) myocardial expression in the development of hypertensive-induced cardiac damage. METHODS: Samples of human myocardium tissue from organ donors were prospectively collected and classified according to the presence of hypertension, alcohol consumption, other causes of myocardial damage and the presence of structural cardiomyopathy (CMP). Myocardial samples were studied by immunohistochemistry and myostatin, and IGF-1 myocardial expression was evaluated in all the different groups of donors. Hypertensive donors were compared to other groups. RESULTS: A total of 66 heart samples from human donors were collected: 33 donors had no previous or present history of hypertension and 33 donors presented defined hypertension. Donors with hypertension presented higher myocyte cell and nuclear hypertrophy and showed similar myostatin myocardial expression as controls, but lower IGF-1 myocardial expression. Myostatin expression was significantly higher in hypertensive donors with CMP compared to non-hypertensive healthy donors. The presence of CMP of diverse origin (alcoholic, valve and coronary) also significantly increased myostatin myocardial expression. CONCLUSION: The presence of hypertension significantly decreases IGF-1 myocardial expression. Myostatin myocardial expression increases in the presence of structural CMP either of hypertensive or other origin. These effects open the possibility of modulating hypertensive-induced cardiac damage.


Assuntos
Cardiopatias/metabolismo , Hipertensão/metabolismo , Fator de Crescimento Insulin-Like I/metabolismo , Miocárdio/metabolismo , Miostatina/metabolismo , Adulto , Idoso , Alcoolismo/metabolismo , Apoptose , Estudos de Casos e Controles , Feminino , Expressão Gênica , Cardiopatias/etiologia , Humanos , Hipertensão/complicações , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Doadores de Tecidos
4.
Regen Med Res ; 1(1): 3, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25984322

RESUMO

BACKGROUND: Alcoholic cardiomyopathy (CMP) is one of the major complications of chronic excessive alcohol consumption. The pathogenic mechanisms implicated are diverse, inducing functional and structural changes in the myocardium. Insulin-like Growth Factor 1 (IGF-1) plays an important role in modulating the cell cycle, and helps the differentiation and proliferation of cardiac tissue inhibiting apoptosis. Experimental studies have suggested the role of IGF-1 in alcohol-induced cardiac damage. The aim of the present study was to determine the effect of chronic alcohol consumption on IGF-1 myocardial expression and to compare this expression in cases of hypertension and other cardiac diseases. METHODS: We studied heart samples from human organ donors: 10 healthy donors, 16 with hypertension, 23 with chronic alcohol consumption and 7 with other causes of cardiac disease. IGF-1 myocardial expression was evaluated with a specific immunohistochemistry assay using a semi-quantitative method. RESULTS: A significant decrease in IGF-1 myocardial expression was observed comparing all the cases included with control donors. This decrease in IGF-1 myocardial expression was significantly lower in the group of donors with chronic alcohol consumption compared to controls. On group evaluation according to the presence of CMP, donors with chronic alcohol consumption without CMP presented significantly lower IGF-1 expression than controls, whereas donors with chronic alcohol consumption with CMP showed a downward trend without achieving significance. CONCLUSIONS: Chronic alcohol consumption significantly reduces IGF-1 myocardial expression. This decrease induced by alcohol is partially compensated in the presence of structural myocardial damage.

5.
Alcohol Clin Exp Res ; 35(7): 1220-9, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21463333

RESUMO

BACKGROUND: Apoptosis mediates in alcohol-induced heart damage leading to cardiomyopathy (CMP). Myocyte proliferation may compensate for myocyte loss. Myostatin is upregulated after cardiac damage and by alcohol consumption thereby decreasing myocyte renewal. We assess the potential role of alcohol in inducing myocyte apoptosis as well as in inhibiting myocyte proliferation. METHODS: Heart samples were obtained from organ donors, including 22 high alcohol consumers, 22 with hypertension, 8 with other causes of CMP, and 10 healthy donors. Evaluation included medical record with data on daily, recent and lifetime ethanol consumption, chest X-ray, left ventricular (LV) function assessed by two-dimensional echocardiography, and LV histology and immunohistochemistry. Apoptosis was evaluated by TUNEL, BAX, and BCL-2 assays. Myocyte proliferation was evaluated with Ki-67 assay. Myostatin activity was measured with a specific immunohistochemical assay. CMP was assessed by functional and histological criteria. RESULTS: Alcoholic and hypertensive donors with CMP showed higher apoptotic indices than did their partners without CMP. Myostatin activity was higher in alcoholics than in controls, mainly in those with CMP. The increase in myostatin expression in alcoholic CMP was higher than in other groups. The Ki-67 proliferation index increased in all groups with CMP compared to those without CMP, with alcoholics showing a lower increase in this proliferation response. CONCLUSIONS: Alcohol produces cardiac myocyte loss through apoptosis but also partially inhibits myocyte proliferation through myostatin up-regulation. The final result may suppose an imbalance in myocyte homeostasis, with a net loss in total ventricular myocyte mass and progressive ventricular dysfunction.


Assuntos
Cardiomiopatia Alcoólica/metabolismo , Cardiomiopatia Alcoólica/patologia , Proliferação de Células , Miócitos Cardíacos/metabolismo , Miostatina/metabolismo , Adulto , Idoso , Alcoolismo/metabolismo , Alcoolismo/patologia , Doença Crônica , Feminino , Humanos , Hipertensão/metabolismo , Hipertensão/patologia , Masculino , Pessoa de Meia-Idade , Miocárdio/metabolismo , Miocárdio/patologia , Miócitos Cardíacos/patologia , Miostatina/biossíntese , Regulação para Cima/fisiologia
6.
Am J Clin Nutr ; 86(5): 1463-9, 2007 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-17991660

RESUMO

BACKGROUND: Moderate alcohol consumption is cardioprotective. The mechanism for this beneficial effect might be reduced inflammatory responses, as suggested by prospective studies and small clinical trials in men. No studies have evaluated the antiinflammatory effects of wine in women. OBJECTIVE: We investigated whether low-dose intake of white and red wines has differential effects on inflammatory markers in women. DESIGN: In a crossover study, we randomly assigned 35 healthy women to two 4-wk periods of 20 g ethanol/d as white or red wine, preceded by two 4-wk washout periods. Before and after interventions, we measured serum lipids, circulating inflammatory biomarkers, cellular adhesion molecules (CAMs), and adhesion of monocytes to stimulated endothelial cells. RESULTS: HDL cholesterol increased, and the serum concentrations of high-sensitivity C-reactive protein, intercellular adhesion molecule-1, CD40L, and interleukin-6 decreased after either wine (P < 0.01, all). Vascular CAM-1 and E-selectin decreased (P < 0.01) only after red wine. CAM expression by mononuclear cells was blunted after either wine, with a greater suppressant effect of red wine. Enhanced adhesion of monocytes to stimulated endothelial cells was reduced by 51% (95% CI: -57%, -45%) after white wine and by 89% (95% CI: -96%, -82%) after red wine (P = 0.01 for between-wine differences). CONCLUSIONS: Moderate wine consumption is associated with beneficial effects on various inflammatory pathways related to endothelial activation in women. Probably because of its higher polyphenol content, red wine shows superior antiinflammatory effects than does white wine. Reducing low-grade inflammation and endothelial activation may be another potential mechanism by which alcoholic beverages exert their cardioprotective effect.


Assuntos
Consumo de Bebidas Alcoólicas , Proteína C-Reativa/análise , Moléculas de Adesão Celular/sangue , Inflamação/prevenção & controle , Vinho , Adulto , Estudos Cross-Over , Regulação para Baixo , Selectina E/sangue , Feminino , Homocisteína/sangue , Humanos , Integrina alfa4beta1/sangue , Molécula 1 de Adesão Intercelular/sangue , Interleucina-6/sangue , Lipídeos/sangue , Pessoa de Meia-Idade , Fator de Necrose Tumoral alfa/farmacologia , Molécula 1 de Adesão de Célula Vascular/sangue
7.
J Nutr ; 137(10): 2279-84, 2007 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17885011

RESUMO

Atherosclerosis is considered a low-grade inflammatory disease. Polyphenol-rich alcoholic beverages (red wine) have shown a more pronounced antiinflammatory effect than polyphenol-free alcoholic beverages (gin). However, no studies to our knowledge have evaluated the antiinflammatory effects of alcoholic beverages with medium-level polyphenol content such as cava (sparkling wine). We enrolled 20 healthy men (aged 34 +/- 9 y) in a randomized crossover study to receive 30 g ethanol/d as cava or gin for 28 d. Before both interventions, subjects abstained from alcohol for 2 wk. Inflammatory biomarkers of atherosclerosis and expression of adhesion molecules on peripheral leukocytes were measured before and after each intervention. Likewise, dietary intake and exercise were also evaluated. Expression of lymphocyte function-associated antigen-1 (LFA-1), very late activation antigen-4 (VLA-4), Sialyl-Lewis(x) (SLe(x)), and CD40 on monocytes decreased after cava intake (all P < 0.05), whereas only SLe(x) was reduced after gin intake (P = 0.036). Circulating markers of atherosclerosis including vascular cell adhesion molecule-1, E-selectin, and P-selectin decreased after both interventions (all P < 0.05). High-sensitivity C-reactive protein, intercellular adhesion molecule-1 (ICAM-1), IL-6, monocyte chemoattractant protein-1 (MCP-1), and CD40L were diminished only after cava intake (all P < 0.05). The effects of cava on circulating CD40L, ICAM-1, and MCP-1, and monocyte surface expression of CD40, LFA-1, and VLA-4 were greater than those of gin (all P < 0.05). In conclusion, both cava and gin showed antiinflammatory properties; however, cava had a greater protective effect, probably due its polyphenol content.


Assuntos
Aterosclerose/metabolismo , Aterosclerose/patologia , Vinho , Adulto , Biomarcadores/metabolismo , Moléculas de Adesão Celular/genética , Moléculas de Adesão Celular/metabolismo , Dieta , Regulação para Baixo , Exercício , Homocisteína/metabolismo , Humanos , Inflamação/metabolismo , Inflamação/patologia , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente , Fatores de Risco
8.
Atherosclerosis ; 175(1): 117-23, 2004 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-15186955

RESUMO

BACKGROUND: No intervention studies have explored the anti-inflammatory effects of different alcoholic beverages on markers of atherosclerosis. We embarked on a randomized, crossover, single-blinded trial to evaluate the effects of wine and gin on inflammatory biomarkers of atherosclerosis. METHODS AND RESULTS: Forty healthy men (mean age, 37.6 years) consumed 30 g ethanol per day as either wine or gin for 28 days. Before and after each intervention, we measured the expression of lymphocyte function-associated antigen 1 (LFA-1), Mac-1, very late activation antigen 4 (VLA-4), and monocyte chemoattractant protein (MCP-1) in monocytes, as well as the soluble vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1), interleukin-1alpha (IL-1alpha), C-reactive protein (hs-CRP) and fibrinogen. After either gin or wine consumption, plasma fibrinogen decreased by 5 and 9%, respectively, and cytokine IL-1alpha by 23 and 21%. The expression of LFA-1 (-27%), Mac-1 (-27%), VLA-4 (-32%) and MCP-1 (-46%) decreased significantly after wine, but not after gin. Wine reduced the serum concentrations of hs-CRP (-21%), VCAM-1 (-17%) and ICAM-1 (-9%). CONCLUSIONS: Both wine and gin showed anti-inflammatory effects by reducing plasma fibrinogen and IL-1alpha levels. However, wine had the additional effect of decreasing hs-CRP, as well as monocyte and endothelial adhesion molecules.


Assuntos
Bebidas Alcoólicas , Arteriosclerose/sangue , Mediadores da Inflamação/sangue , Adulto , Proteína C-Reativa/análise , Moléculas de Adesão Celular/sangue , Quimiocinas/sangue , Estudos Cross-Over , Fibrinogênio/análise , Humanos , Masculino , Pessoa de Meia-Idade , Método Simples-Cego , Vinho
9.
Am J Clin Nutr ; 80(1): 225-30, 2004 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-15213052

RESUMO

BACKGROUND: Moderate alcohol consumption protects against ischemic heart disease, possibly through an antiinflammatory effect. However, little is known about the mechanisms by which alcohol may interfere in the development of atherosclerosis. OBJECTIVE: We analyzed the effects of 2 alcoholic beverages with high (red wine) or low (gin) polyphenolic content on human monocyte adhesion to an endothelial cell line (Ea.hy926). DESIGN: This was a randomized, crossover trial with 8 healthy men. After a washout period, the subjects received 30 g ethanol/d as red wine or gin for 28 d. Before and after each intervention, a dietary survey and laboratory analysis were performed. Adhesion of human monocytes to endothelial cells was measured in basal and stimulated [by tumor necrosis factor alpha (TNF-alpha)] conditions. Adhesion molecules involved in monocyte-endothelium interactions were determined on the cell surface. RESULTS: The mean expression of very late activation antigen 4 on monocytes significantly decreased after red wine intake [by 18% (95% CI: 33%, 3%); P = 0.022]. Monocyte adhesion significantly increased after TNF-alpha stimulation of endothelial cells. This increase, however, was 39% less (95% CI: 48%, 35%; P = 0.049) after gin intake than after the respective washout period and was nearly abolished by red wine intake [96% less than after the respective washout period (95% CI: 142%, 76%); P < 0.001]. The reduction after red wine intake was significantly different from that after gin intake (P = 0.014). CONCLUSIONS: TNF-alpha-induced adhesion of monocytes to endothelial cells was virtually abolished after red wine consumption but was only partially reduced after gin consumption. This effect may be due to the down-regulation of adhesion molecules on the monocyte surface.


Assuntos
Arteriosclerose/prevenção & controle , Células Endoteliais/fisiologia , Etanol/farmacologia , Flavonoides/farmacologia , Monócitos/fisiologia , Fenóis/farmacologia , Vinho , Adulto , Consumo de Bebidas Alcoólicas , Arteriosclerose/sangue , Adesão Celular , Linhagem Celular , Estudos Cross-Over , Células Endoteliais/citologia , Humanos , Masculino , Pessoa de Meia-Idade , Polifenóis , Estudos Prospectivos , Fator de Necrose Tumoral alfa/farmacologia
10.
Alcohol Clin Exp Res ; 27(12): 2002-8, 2003 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-14691389

RESUMO

BACKGROUND: Although epidemiologic studies have reported an association between alcohol intake and high blood pressure (BP), the results of intervention studies have shown inconsistent results. We embarked on a study to determine whether different subgroups of alcohol-dependent patients may be identified in relation to the effect of alcohol on BP. METHODS: Fifty alcohol-dependent men (mean age, 41.4 years) received 0.4 g of ethanol per kilogram of body weight every 4 hr in 200 ml of orange juice during 24 hr and the same amount of orange juice without ethanol during another 24 hr. Twenty-four hour ambulatory BP monitoring was performed during ethanol and orange juice intakes, as was hormonal and biochemical analysis. RESULTS: Thirty-five (75%) alcohol-dependent men were normotensive and 15 (30%) hypertensive. Eighteen (51%) normotensive and 12 (80%) hypertensive subjects showed a significant decrease in 24 hr mean BP after ethanol withdrawal (mean decrease of 8.4 mm Hg [95% confidence interval, -11.2 to -5.7] and 12.5 mm Hg [confidence interval, -16.2 to -8.8], respectively) and were considered as sensitive to alcohol. The remaining alcohol-dependent subjects were considered as resistant to alcohol. Normotensive subjects sensitive to ethanol showed a significantly greater left ventricular mass and a significantly lower ejection fraction than those normotensive patients whose BP did not change after ethanol withdrawal (both p < 0.01). CONCLUSIONS: More than three fourths of the hypertensive and more than half of the normotensive alcohol-dependent patients showed sensitivity to the pressor effects of ethanol. Impairment also was observed in heart function in normotensive patients sensitive to the pressor effects of ethanol.


Assuntos
Alcoolismo/fisiopatologia , Monitorização Ambulatorial da Pressão Arterial/estatística & dados numéricos , Pressão Sanguínea/fisiologia , Hipertensão/fisiopatologia , Síndrome de Abstinência a Substâncias/fisiopatologia , Adulto , Análise de Variância , Pressão Sanguínea/efeitos dos fármacos , Monitorização Ambulatorial da Pressão Arterial/métodos , Distribuição de Qui-Quadrado , Intervalos de Confiança , Estudos Transversais , Etanol/farmacologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Estatísticas não Paramétricas
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA