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7.
FEM (Ed. impr.) ; 17(2): 93-97, jun. 2014. tab
Artigo em Espanhol | IBECS | ID: ibc-124966

RESUMO

Introducción. Hemos desarrollado un cortometraje educativo para la formación en exploración física de estudiantes de medicina de tercer año, sin experiencia previa en habilidades clínicas. Materiales y métodos. El estudio se ha realizado en el Servicio de Medicina Interna del Hospital Universitari Sagrat Cor de Barcelona durante dos años consecutivos. Se efectuaron evaluaciones sobre exploración física de los estudiantes antes y después de ver la película. La primera evaluación se llevó a cabo el primer día de estancia de los estudiantes en el hospital. A continuación, visualizaron la filmación y se les informó de que al cabo de 48 horas se efectuaría una segunda evaluación en la que deberían realizar una exploración física de acuerdo con lo que habían visto y oído en el cortometraje. Al final del período de seis semanas de estancia en el hospital se realizó una tercera evaluación. Todas las evaluaciones se llevaron a cabo por el mismo profesor, a partir de un listado de contenidos evaluativos elaborado previamente. Resultados. Después de ver la película, 48 horas después de su llegada al hospital, los estudiantes habían mejorado en las diferentes pruebas de exploración física, en una tasa media del 43,4%. Al cabo de seis semanas, se apreció un 14,3% de mejora en relación con la segunda evaluación del tercer día del curso. Conclusión. Un cortometraje es un buen medio para la formación en la exploración física normal, más rápido que otros sistemas de enseñanza y favorece la adopción de competencias estables (AU)


Introduction. We created a short educational film to teach third-year medical students on physical examination, without previous experience in clinical skills. Designed to be understood without other explanations than those which appear in the film, the students are shown the film on their first day in the hospital. Materials and methods. The study has been made in the Department of Internal Medicine at the University Hospital Sagrat Cor of Barcelona during two consecutives course years. We assess the educational possibilities of this resource testing student skills before and after watching the film. The first evaluation was held on the students' first day in the hospital and they were informed that 48 hours later they would be given a second evaluation where they had to do a physical exploration according to the film. At the end of the 6-week period in the internal medicine department the third evaluation was given. All of these explorations were performed by the same professor with a same check list. Results. After watching the film, 48 hours after their arrival, the students had improved in the different tests on physical exploration, at an average rate of 43.4%. At the end of the stage their progression was of 14.3% improvement in relation to the third day of the course. Conclusion. A short film is a good element for training in normal physical exploration, faster than other teaching systems, and also gives permanent skills (AU)


Assuntos
Humanos , Aprendizagem Baseada em Problemas/métodos , Exame Físico/métodos , Competência Clínica , Educação Médica/métodos , Simulação/métodos , Simulação de Paciente , Filmes Cinematográficos , Mídia Audiovisual , Materiais de Ensino , Avaliação Educacional
8.
Educ. méd. (Ed. impr.) ; 15(3): 167-170, sept. 2012. tab
Artigo em Espanhol | IBECS | ID: ibc-106425

RESUMO

Introducción. Desde el curso 2003-2004 impartimos en la Facultad de Medicina de la Universitat de Barcelona la asignatura optativa semipresencial 'Elementos diagnósticos en medicina interna', en la que se aborda el diagnóstico a través de análisis de laboratorio, pruebas funcionales, de imagen y electrocardiografía. Materiales y métodos. Tras las sesiones presenciales, el material docente se deposita en la página web o campus virtual de la asignatura, a partir del cual los estudiantes responden a seis cuestionarios. Resultados. En el curso 2008-2009 se matricularon 61 alumnos de cuarto a sexto curso. Veintisiete alumnos (44,26%) respondieron correctamente a más de la mitad de las preguntas, el 31,15% no alcanzó esta cifra y el 24,59% no completó el programa de evaluaciones. Las puntuaciones más altas se han dado de las pruebas funcionales respiratorias, y las más bajas, en la evaluación de la radiografía de tórax. Conclusiones. No es fácil la evaluación de competencias clínicas. El coste de realización de las pruebas y la resistencia de los estudiantes a ser evaluados quedan soslayados en esta experiencia, donde los estudiantes se matriculan voluntariamente. La sencillez del proyecto permitiría evaluar en competencias clínicas a todos los estudiantes de la facultad en los cursos clínicos cuando aún es posible la formación. Una vez comprobado que los estudiantes tienen una buena aceptación del sistema propuesto, se podría diseñar un sistema de acceso a créditos docentes y un plan de formación específica en las materias no superadas (AU)


Introduction. From the course 2003-2004, we give in the Faculty of Medicine of the University of Barcelona a matter called Diagnostics Elements in Internal Medicine, for the diagnostic through analysis of laboratory, functional proofs, of image and electrocardiogram. Materials and methods. All the educational material is deposited in the page web of the topic and through it the students answer the 6 questionnaires. Results. In the course 2008-2009, 61 students have choose the topic. 27 students (44,26%) answered correctly more than 50% of the questions. 31,15% did not achieve this figure and 24,59% did not complete the program of evaluations. The highest punctuations have given in respiratory functional proofs and the lowest in the evaluation of the thoracic X-ray. Conclusions. It's not easy the evaluation of clinical skills. The cost of realization of the proofs and the resistance of the students to be evaluated remain skewed in this experience where the students participate voluntarily. The simplicity of the project would allow evaluating in clinical skills all the students of the faculty in the clinical courses period when it still is possible the training. The students have a good acceptance of the system proposed, and it could design a system of access to educational credits and a plan of specific training in the no surpassed matters (AU)


Assuntos
Humanos , Cuidados Médicos/métodos , Técnicas e Procedimentos Diagnósticos , Competência Clínica , Técnicas de Laboratório Clínico , Diagnóstico por Imagem , Estudantes de Medicina/estatística & dados numéricos , Aptidão
11.
Int J Gynecol Cancer ; 21(8): 1486-90, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21892092

RESUMO

BACKGROUND: Women infected with human immunodeficiency virus (HIV) are at increased risk of developing precancerous and cancerous lesions in cervix because of persistence of oncogenic human papillomavirus (HPV) infection. Scarce information about the HPV genotypes attributed to cervical cancer in the HIV-infected population is available, especially in countries with a low prevalence of this pathology. OBJECTIVE: The objective of the study was to assess the prevalence and distribution of HPV types, and the viral integration of HPV-16 and HPV-18 in cervical squamous cell carcinoma of HIV-infected and HIV-negative women. METHODS: A total of 140 formaldehyde-fixed paraffin-embedded specimens from 31 HIV-infected and 109 matched HIV-negative women, with a diagnosis of in situ or invasive cervical carcinoma, were identified between 1987 and 2010 from different hospitals of the Barcelona area, Spain. Human papillomavirus genotyping and integration were analyzed by standardized polymerase chain reaction. RESULTS: Similar prevalence and distribution of HPV genotypes were detected in cervical cancers (in situ and invasive) regardless of HIV condition. The most common types were as follows: HPV-16 (58% in HIV-positive vs 72% in HIV-negative) and HPV-33 (16% vs 8%). In invasive cervical carcinoma, HPV-18 was significantly more prevalent in HIV-positive women (14% vs 1%; P = 0.014). The proportion of samples with integrated forms of HPV-16 (39% vs 45%) and HPV-18 (50% vs 50%) was similar in both groups. CONCLUSIONS: The prevalence and distribution of principal HPV types involved in the carcinogenesis process of the cervix were similar in HIV-infected and noninfected women, although a tendency toward a lower HPV-16 and a higher HPV-18 prevalence in invasive cervical carcinoma was detected in HIV-positive women. Similar percentage of HPV-16 and HPV-18 viral integration was found in formaldehyde-fixed paraffin-embedded specimens of cervical cancer regardless of the HIV infection status.


Assuntos
Carcinoma in Situ/virologia , Infecções por HIV/complicações , Papillomavirus Humano 16/genética , Papillomavirus Humano 18/genética , Infecções por Papillomavirus/complicações , Neoplasias do Colo do Útero/virologia , Adulto , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos
12.
Coron Artery Dis ; 22(1): 73-80, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21150777

RESUMO

OBJECTIVES: Multislice computerized tomographic scan can identify coronary artery disease (CAD) with quantification of coronary artery calcium (CAC) and computed tomographic coronary angiography (CTA). The utility of CAC in comparison with CTA in asymptomatic patients has not been assessed. METHODS: Patients with risk factors for CAD, who were referred for screening, were studied using CAC and CTA, using a Phillips Mx8000 IDT 16 multislice computed tomographic scanner. RESULTS: Three hundred and forty-seven patients with a mean age of 55 years, 89.9% male, were included. CAC showed calcium deposits in 171 patients (49.3%) whereas CTA found lesions in 157 patients (45%). CAC correctly identified 309 patients with respect to CTA (presence of any disease) implying a test accuracy of 89%, sensitivity of 85%, specificity of 86%, and negative predictive value of 93%. Obstructive lesions were shown by 7.7% of the patients (stenosis >50%), 22% of the patients with CAC greater than 400, and 2.8% of the patients with CAC of 0. To undergo a CTA scan after CAC permits to re-classify 11% of the patients on the basis of CTA. CONCLUSION: CAC, in detecting silent CAD, seems to be a good alternative to CTA, in these asymptomatic patients, but CAC is inappropriate to predict the presence or absence of a coronary artery obstruction.


Assuntos
Calcinose/diagnóstico por imagem , Angiografia Coronária/métodos , Doença da Artéria Coronariana/diagnóstico por imagem , Estenose Coronária/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Doenças Assintomáticas , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Valor Preditivo dos Testes , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Espanha
13.
Harm Reduct J ; 7: 27, 2010 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-21059272

RESUMO

BACKGROUND: The main objectives of this study are to describe the smoked cocaine user's profile in socially-depressed areas and their needs from a harm-reduction perspective, to investigate their use of smoking crack and compare the acute effects between injecting and smoking consumption. METHODS: The study took place in SAPS, Barcelona, Spain. Two focus group sessions were undertaken with a total of 8 drug users. Secondly, the 8 participants answered a structured questionnaire and in the course of the sessions, as a snowball activity, were trained to survey 6 other crack smokers. RESULTS: We obtained 56 questionnaires. The majority of participants were from non-European Community countries (62.69%), 70.2% of participants referred to sharing the smoking equipment. The most frequent symptoms reported during smoked cocaine were mydriasis (83.33%)), perspiration (72.92%) and compulsive object search (70.83%) During the group sessions, participants said that smoked cocaine is much more addictive than injected cocaine and causes more anxiety. Participants also reported the difficulty of changing from injected use to smoked use, due to the larger amount of cocaine needed to reach the same effects as when having injected. CONCLUSIONS: We can conclude that the research, focused on achieving greater knowledge of the smoked cocaine user's profile, their usage of smoking crack, consumption patterns and acute effects, should be incorporated into substance misuse interventions.

14.
Heart Lung ; 39(6 Suppl): S14-22, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20598745

RESUMO

OBJECTIVE: The objective of the study was to evaluate the effectiveness of a single home-based educational intervention for patients admitted with heart failure. METHODS: There were 106 patients: 42 in the intervention group and 64 in the control group. Patients were randomly assigned to receive an intervention by nursing staff 1 week after discharge. Primary end points were readmissions, emergency department visits, deaths, costs, and quality of life. RESULTS: During the 24-month follow-up, there were fewer mean emergency department visits in the intervention group than in the control group (.68 vs 2.00; P = .000), fewer unplanned readmissions (.68 vs 1.71; P = .000), and lower costs (€ 671.56 = $974.63 = GBP598.42 per person vs € 2,154.24 = $3,126.01 = GBP1,919.64; P = .001). There was a trend toward fewer out-of-hospital deaths (14 [46.6%] vs 31 [55.3%]; P = .45) and improvement in quality of life. CONCLUSION: Patients with heart failure who receive a home-based educational intervention experience fewer emergency department visits and unplanned readmissions with lower healthcare costs.


Assuntos
Redução de Custos , Insuficiência Cardíaca , Serviços de Assistência Domiciliar/organização & administração , Educação de Pacientes como Assunto/organização & administração , Prevenção Secundária/organização & administração , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Autoavaliação Diagnóstica , Eficiência Organizacional/economia , Cuidado Periódico , Feminino , Insuficiência Cardíaca/economia , Insuficiência Cardíaca/fisiopatologia , Insuficiência Cardíaca/terapia , Humanos , Assistência de Longa Duração/economia , Masculino , Alta do Paciente/economia , Participação do Paciente , Qualidade de Vida , Apoio Social , Fatores Socioeconômicos
17.
Rev Esp Cardiol ; 60(10): 1093-6, 2007 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-17953932

RESUMO

The Minnesota Living With Heart Failure Questionnaire (MLWHFQ) was used to evaluate the quality of life of patients with heart failure, both before and 6 months after an educational intervention. The study included 99 patients (70 male) with a mean age of 78 years. Significant correlations were found between the MLWHFQ score and the SF-36 score (r=0.41, P=.01), the Barthel Index score (r=-0.23, P=.02), New York Heart Association functional class (r=0.37, P=.01), and the number of readmissions within 6 months (r=0.47, P< .002). Following the intervention, the MLWHFQ score decreased by 34 points (P=.0001). The MLWHFQ score appears to be a useful measure: there were good correlations with functional class and the SF-36 score, and the measure was sensitive to changes in health since there was also a correlation with the patients' prognosis.


Assuntos
Insuficiência Cardíaca , Qualidade de Vida , Inquéritos e Questionários , Atividades Cotidianas , Idoso , Cognição , Feminino , Nível de Saúde , Insuficiência Cardíaca/fisiopatologia , Insuficiência Cardíaca/psicologia , Humanos , Masculino , Reprodutibilidade dos Testes , Perfil de Impacto da Doença , Espanha , Estatísticas não Paramétricas
18.
Rev. esp. cardiol. (Ed. impr.) ; 60(10): 1093-1096, oct. 2007. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-058118

RESUMO

Hemos estudiado la utilidad del Minnesota Living With Heart Failure Questionnaire (MLWHFQ) en la calidad de vida de los pacientes con insuficiencia cardiaca, aplicándolo antes y a los 6 meses de una intervención educativa. De los 99 pacientes (70 varones; media de edad, 78 años) hemos encontrado una correlación entre la puntuación del MLWHFQ y las del SF-36 (p = 0,01; r = 0,41), el índice de Barthel (p = 0,02; r = ­0,23), la clase funcional (p = 0,01; r = 0,37) y el número de ingresos en 6 meses (p < 0,002; r = 0,47). La intervención disminuye la puntuación del MLWHFQ 34 puntos (p = 0,0001). El MLWHFQ es un instrumento válido, pues se correlaciona con la clase funcional y con el SF-36, y es sensible a los cambios de salud, ya que se correlaciona con el pronóstico de los pacientes (AU)


The Minnesota Living With Heart Failure Questionnaire (MLWHFQ) was used to evaluate the quality of life of patients with heart failure, both before and 6 months after an educational intervention. The study included 99 patients (70 male) with a mean age of 78 years. Significant correlations were found between the MLWHFQ score and the SF-36 score (r=0.41, P=.01), the Barthel Index score (r=­0.23, P=.02), New York Heart Association functional class (r=0.37, P=.01), and the number of readmissions within 6 months (r=0.47, P<.002). Following the intervention, the MLWHFQ score decreased by 34 points (P=.0001). The MLWHFQ score appears to be a useful measure: there were good correlations with functional class and the SF-36 score, and the measure was sensitive to changes in health since there was also a correlation with the patients' prognosis (AU)


Assuntos
Humanos , Perfil de Impacto da Doença , Insuficiência Cardíaca/epidemiologia , Qualidade de Vida , Inquéritos e Questionários
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