Myocardial infarction and alcohol consumption: a population-based case-control study.

BACKGROUND AND AIM: Coronary heart disease (CHD) is the leading cause of death in industrialized societies. Identifying and characterizing modifiable variables associated with CHD is an important issue for health policy. The aim of the present study was to analyze the association of non-fatal myocardial infarction with total alcohol consumption and type of alcoholic beverage consumed. Preference of the subjects' consumption for beer, wine, or spirits was set at 80% or more of total alcoholic beverage consumption. METHODS AND RESULTS: A population-based case-control study (244 subjects and 1270 controls) was conducted. Male patients aged 25 to 74 years with first myocardial infarction (MI) were recruited in the same region as the healthy male controls, who were taken from a random sample representative of the Gerona population. Alcoholic beverage consumption during the preceding week was recorded. Multiple logistic regression analysis was performed to determine the association of alcohol consumption and non-fatal MI. Total alcohol consumption up to 30 g per day, adjusted for lifestyle and cardiovascular risk factors, was inversely associated (Odds ratio 0.14; 95% confidence interval 0.06-0.36) with the risk of non-fatal MI. Drinking up to 20 g of alcohol through wine, beer and spirits significantly decreased the adjusted risk of MI. Higher alcohol intake did not substantially reduce the risk. A preference for spirits was correlated with a significantly increased risk of non-fatal MI (P<0.05). CONCLUSION: Moderate alcohol consumption, independent of the type of alcoholic beverage, was associated with non-fatal MI risk reduction.

Evaluación de la empatía en estudiantes de Medicina / Empathy assessment in medical students

INTRODUCCIÓN Y OBJETIVOS: La empatía es la capacidad de transmitir comprensión hacia las emociones de otros individuos. La empatía de los profesionales sanitarios se ha asociado a mejores resultados clínicos y de relación con el paciente. El objetivo del estudio era conocer el nivel de empatía de los estudiantes de Medicina, y su evolución después de recibir un curso sobre Entrevista Clínica y Comunicación. MÉTODOS: Estudio longitudinal prospectivo con intervención (módulo de Comunicación y Entrevista Clínica de un mes de duración) y sin grupo control. La empatía se midió con el cuestionario Índice de Reactividad Interpersonal (IRI) que tiene 2 dimensiones cognitivas (toma de perspectiva y fantasía) y 2 emocionales (preocupación empática y distrés personal). La empatía percibida se obtuvo mediante autoevaluación del 0 al 10. RESULTADOS: Participaron 136 alumnos, un 72% eran mujeres, con una edad media de 20,3 años. La empatía percibida correlacionó con las dimensiones del IRI, excepto con distrés personal. Después de la intervención educativa se observaron incrementos en los hombres en toma de perspectiva (de 16,5 a 17,8; p = 0,005) y en las mujeres en fantasía (de 15,5 a 16,7; p = 0,001), con aumento en ambos sexos de la empatía percibida autoevaluada (de 6,9 a 7,4 en hombres; p = 0,009 y de 7,4 a 7,8 en mujeres; p < 0,001). No se modificaron las dimensiones emocionales de empatía. CONCLUSIONES: Los estudiantes de Medicina no perciben dentro de la empatía el componente de distrés personal, y después de la formación se incrementaron los niveles de empatía cognitiva y percibida

INTRODUCTION AND OBJECTIVES: Empathy is the capacity to place oneself in another's position and understand his/her emotions. Empathy of health professionals has been associated with better clinical outcomes and relationship with the patients. The aim of the study is to define the level of empathy of Medical students and how does it evolve after following a one-month Clinical Interview and Communication training module. METHODS: The study is a non-control prospective longitudinal study. Second year Medical students have followed Clinical interview and Communication training module during one month. Empathy has been measured through the Interpersonal Reactivity Index (IRI) questionnaire that has 2 cognitive (perspective taking and fantasy) and 2 emotional (empathic concern and personal distress) dimensions. The perceived empathy was self-assessed using a 1-10 points scale. RESULTS: A sample of 136 students participated on this study (72% women, mean age 20.3 years). The perceived empathy correlates with the size of IRI, except personal distress. Post training intervention scores showed a significant increase in perspective taking dimension among men (from 16.5 to 17.8; P=.005) and fantasy among women (from15.5 to 16.7; P=.001), while self-assessed empathy increased in both sexes (from 6.9 to 7.4 in men; P=.009 and from 7.4 to 7.8 in women; P<.001). CONCLUSIONS: Medical students don't perceive personal distress as an empathy component. After receiving clinical interview and training module, cognitive and perceived empathy were significantly increased