ABSTRACT
Background: Confidence in the results reported by randomized clinical trials (RCTs) depends mainly on the internal validity of the trial and its conduct, but also on other aspects related to health research such as the complete reporting of conflicts of interest (COI), funding sources and approval by ethics committees. Bias in the study results may arise from any one of these elements. Prior studies have explored the reporting of these items in the medical literature, but there are no reports on RCTs published in Spanish and Latin American journals. This study aimed to evaluate the reporting of COIs, funding sources, and approval by ethics committees of RCTs published in Spanish and Latin American journals in dentistry, geriatrics and neurology. Methods: We did a systematic retrospective survey of all RCTs published from 1990 to 2018 in dentistry, neurology, and geriatrics journals published in Spain and Latin America and included in the BADERI database (Iberoamerican journals and trials database by its initials in Spanish). We completed with hand searching. We included RCTs with a recoverable full text published between 1990 and 2018. We extracted data on sources of funding, COI statements, and ethics reviews. The extraction of these items in the RCTs included was done independently by two pairs of reviewers and in parallel for each article, with a third independent reviewer resolving discrepancies. We analysed compliance for each item. Results: We identified RCTs in 69 journals from Spain and Latin American countries. Dentistry accounted for 75% (n = 52) of the journals, neurology 20.6% (n = 14), and geriatrics 4.4% (n = 3). Of the total number of RCTs included in this study (n = 392), only 102 (26%) reported the presence or absence of a COI, 103 (26%) studies reported funding, and 43 (36%) included the ethics committee approval. Conclusions: RCTs published in the Spanish language in dentistry, neurology, and geriatrics had poor compliance with the reporting of a COI, source of funding, and ethics committee approval. Future research should evaluate the accuracy and completeness of COI statements and their relationship to the funding source and direction of the results.
ABSTRACT
The transition to and through college can affect the mental health of college students. The situation in medical students is particularly worrisome, considering that they have high rates of psychopathology. These mental health problems can be associated with worse academic and professional outcomes and worse patient care. In this scenario, it is relevant to look at how this problem can be addressed considering variables of both mental health and educational systems in medicine. Therefore, initiatives to promote well-being during the career are proposed. The importance of well-being at an institutional level should be defined. Also, the foundations of learning neurosciences from the point of view of well-being should be incorporated. Considering that well-being goes beyond the absence of discomfort, the role of educational environment both in learning and in mental health should be recognized. Proven effective interventions should be incorporated. It must be considered that not every initiative linked to well-being is necessarily positive and that discomfort to a certain extent can be exploited educatively as well. The well-being of medical students is a complex, dynamic and multidimensional issue. These principles are orientations for different actors of the educational process, to define how they will approach this problem in their contexts.
Subject(s)
Humans , Students, Medical , Neurosciences/education , Education, Medical , LearningABSTRACT
Background: The role of staging studies in patients with prostate cancer (PCa) is a topic of discussion. Aim: To evaluate the usefulness of imaging studies in patients with prostate cancer. Material and Methods: We reviewed the pathology service records to identify patients with prostate cancer diagnosed between 2003 and 2013. We reviewed the electronic medical records of those patients identified as having a prostate cancer. Patients were grouped according Damicos classification of cancer dissemination risk. We analized the frequency of imaging studies requested and their efficacy to detect metastases in each risk group. Results: We identified 241 patients with a mean age of 67 years. Fifty two percent of patients were classified as low-risk, 32% as intermediate-risk and 16% as high risk. At least one imaging study was requested to 64% of patients (49, 78 and 87% of patients with low, intermediate and high risk respectively). Among the 155 patients in whom an imaging study was requested, no metastases were found in the low risk group. On the other hand, dissemination was found in 7% of the intermediate-risk group and 62% of the high-risk group. Conclusions: Half of patients with prostate cancer were classified as low risk. In half of this group of low risk patients, staging studies were requested and the probability of detecting metastases was low or nil. The odds of detecting metastases increased in higher risk groups.
Subject(s)
Humans , Male , Middle Aged , Prostatic Neoplasms/diagnostic imaging , Prostatic Neoplasms/pathology , Retrospective Studies , Risk Assessment , Neoplasm Staging/methodsABSTRACT
We report the case of a 60 year old woman with multiple pancreatic nodules found on abdominal computed tomography. Thirteen years earlier she had undergone a left nephrectomy for renal cell carcinoma. The patient underwent surgery with a preoperative diagnosis of multifocal metastatic or neuroendocrine tumor. At surgery, two metastatic nodules of renal cell carcinoma were found and excised. After four years of follow up there is no evidence of recurrence.
Subject(s)
Female , Humans , Middle Aged , Carcinoma, Renal Cell/secondary , Kidney Neoplasms/pathology , Pancreatic Neoplasms/secondary , Magnetic Resonance ImagingABSTRACT
Se presentan 30 casos de tumores primarios retroperitoneales de origen mesenquimático, en un período de 11 años, correspondiendo 17 al sexo femenino y 13 al masculino. Los síntomas y signos tuvieron un promedio de 10,8 meses desde su inicio hasta el momento del diagnóstico. Fueron 21 tumores malignos y 9 benignos, siendo los liposarcomas y neurilemomas los más frecuentes respectivamente. Todos fueron intervenidos quirúrgicamente realizándose extirpación completa en 21, parcial en 4 y sólo biopsia en 5. Se analizan las intervenciones agregadas y sus resultados en cuanto a mortalidad intraoperatoria y global. Se presentan los tratamientos coadyudantes como quimioterapia y radioterapia, mostrando los esquemas usados en cada uno de ellos
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Mesoderm , Retroperitoneal Neoplasms/etiology , Chemotherapy, Adjuvant , Histological Techniques , Intraoperative Complications/mortality , Liposarcoma/surgery , Neurilemmoma/surgery , Radiotherapy, Adjuvant , Retroperitoneal Neoplasms/classification , Retroperitoneal Neoplasms/diagnosis , Retroperitoneal Neoplasms/surgery , Surgical Procedures, Operative/classificationABSTRACT
A male patient complaining of abdominal pain developed rectal bleeding and a painful mass located in the left side of the abdomen. Barium enema revealed a giant diverticulum of the colon. Surgical ressection was performed successfully. A brief review of the literature follows
Subject(s)
Middle Aged , Humans , Male , Diverticulosis, Colonic/pathology , Diverticulosis, Colonic/surgeryABSTRACT
En enero de 1988 comenzamos un programa piloto de screening en cáncer de mama para mujeres asintomáticas. Una mamografía con dos proyecciones se planificó cada 2 años para las mujeres entre 40 y 50 años y anualmente para aquéllas con 50 años o más. Si en esta mamografía se encontraban hallazgos anormales, las mujeres fueron evaluadas con estudios localizados y examen físico realizado por un comité constituído por un radiólogo, un cirujano y un oncólogo. Si luego de esta evaluación la anormalidad del estudio persiste, a juicio del comité, la paciente se planifica para biopsia excisional. Si el resultado de la biopsia es positivo y la enfermedad es localizada, la paciente es tratada conservadoramente con radioterapia. Hasta el 31 de enero de 1990 en 1.742 mujeres se ha realizado este screening y 2.573 mamografías han sido tomadas (en 831 se ha realizado 2 exámenes), 42% de las mujeres tienen 50 años o menos. Después del primer examen 32 mujeres fueron seleccionados para biopsia (24 tenían una lesión no-palpable). Después de la biopsia 4 cánceres fueron diagnosticadas (sólo una palpable) y en otra mujer, una hiperplasia epitelial atípica con lesión no palpable. Después del segundo examen 20 mujeres fueron a biopsia (12 con lesiones no palpables) y 5 cánceres se diagnosticaron (tres no-palpables). De estos 5 cánceres, 2 podrían haber sido vistos en el examen previo, ambos no palpables y tres eran nuevas lesiones. El screening de cáncer de mama es posible de realizar, detecta lesiones pequeñas, permitiendo un tratamiento conservador de las mismas y mejora la sobrevida del cáncer de mama