ABSTRACT
Introduction: In recent years, the relationship between the systematic practice of physical exercise, cardiovascular dynamics and the functioning of the autonomic nervous system has been recognized. Objective: To determine the modifications that non-linear parameters undergo in the autonomic cardiovascular regulation of the heart rate variability with the systematic practice of physical exercise. Methods: A retrospective cohort analytical study was conducted from February 2016 to August 2018. Population and sample: 36 individuals (Group 1: 18 high- performance baseball athletes; Group 2: 18 medical students). The data were collected in the Biomedical Basic Sciences Laboratory at Medical school 1, University of Santiago de Cuba, through the 8-channel PowerLab polygraph, and stored using the Kubios Software version 3.0.4 Premium. Results: Statistically significant differences between means were found in heart rate values (p = 0.000); SD1 (p = 0.025); SD2/SD1 ratio (p = 0.007); sample entropy (p = 0.011); short-term fluctuations α 1 (p = 0.019); mean line length (p = 0.016); max line length (p = 0.001); recurrence rate (p = 0.034); determinism (p = 0.010) and Shannon entropy (p = 0.015). The parameters of SD1 (C = 0.906) and sample entropy (C = 0.712) were significantly associated with a heart rate ≤ 70 beats per minute. Conclusions: With the systematic practice of physical exercise, the non-linear parameters of the autonomic cardiovascular regulation of the heart rate variability undergoes modifications that respond to a better adaptability of the autonomic nervous system, and to a greater capacity to regulate cardiovascular function(AU)
Subject(s)
Humans , Exercise/physiology , Cardiorespiratory Fitness , Retrospective Studies , Cohort StudiesABSTRACT
Introducción: la crisis del método clínico es una preocupación constante para los profesionales de la salud porque esta comprende aspectos muy sensibles de la práctica médica y la preparación para su empleo se produce tempranamente en la formación de los estudiantes. Objetivo: determinar el desempeño en la aplicación del método clínico de los estudiantes de tercer año de la carrera de Medicina en la provincia Holguín. Métodos: se realizó un estudio descriptivo con los estudiantes del tercer año de la carrera de Medicina de la Universidad de Ciencias Médicas de Holguín en el curso escolar 2009-2010. La muestra estuvo integrada por 439 estudiantes, el 66,6% de la población estudiada. Se consideraron los resultados obtenidos por los estudiantes en los exámenes prácticos de la asignatura de Medicina Interna. Resultados: el 95% de los alumnos presentaron dificultades en el interrogatorio del paciente, el 92% en el examen físico y el 93,6% no pudieron realizar el diagnóstico correcto. En cuanto a los criterios de los profesores sobre la interrelación interrogatorio-examen físico, análisis complementarios, diagnóstico y conducta, el 46,7% lo consideró regular y el 23,3%, malo. Conclusiones: Los estudiantes del tercer año de la carrera de Medicina carecieron del dominio y aplicaron de manera deficiente el método clínico durante los exámenes prácticos de Medicina Interna.
Introduction: the crisis of the clinical method is a constant concern for all the health professionals as it turns around many sensitive aspects of the medical practice and takes place at an early stage in their formation as doctors. Objective: to determine the role of clinical method application by third-year students of Medicine Career of Holguín province. Methods: A descriptive study in the third-year medical students from the University of Medical Sciences in Holguín was conducted during the school year 2009-2010. The sample comprised 439 students representing 66.6% of the studied population. The results obtained in the practical examinations of Internal Medicine Subject were considered. Results: Ninety-five percent of the students had difficulties in interviewing the patients; 92% had problems in the physical examination and 93.6% had troubles in making the accurate diagnosis. As for the professors' assessment of the interrelation between interview-physical examinations, routine tests, diagnosis and treatment: 46.7% considered it fair and 23.3%, bad. Conclusions: the mastery and the application of the clinical method during the practical examinations of Internal Medicine are deficient, since the students were unable, through the interview and the physical exam, to make a correct diagnosis or develop a logical reasoning of diagnosis-treatment.