ABSTRACT
Medical education migrated from a practice-based to a knowledge-based discipline after the publication of the Flexner Report. The emergence of competence-based medical education led to a greater standardization of teaching, allowing students to integrate knowledge, skills and attitudes for the execution of a given task. A challenge is the evaluation of learning. Complex evaluation systems and a consequent atomization that independently assesses different competence components. However, the evaluation carried out at the clinical practice sites allows assessing the overall level of learning. Supervisors observe students' performance and decide if the apprentice can execute a specific task independently. This decision is based upon the trust that the tutor places on the student. Consequently, Ten Cate (2005) proposed the term Entrustable Professional Activities (EPAs), as a framework for professional practice tasks or responsibilities that can be fully entrusted to students, when they demonstrate the competences that are necessary to execute such activity with an increasing level of autonomy.
Subject(s)
Humans , Clinical Competence/standards , Competency-Based Education/standards , Education, Medical/methods , Educational Measurement/methods , Work Performance/education , Physicians , Students, Medical , Trust , Education, Medical/standardsABSTRACT
Resumen Los hemangiomas son las neoplasias más comunes en la infancia; incluyen diferentes tipos según su histología, expresión proteica y curso clínico. Por lo general, aparecen en piel y tejidos blandos. Son lesiones raras a nivel intestinal, y más aún en un recién nacido; por ello, decidimos publicar un caso que ocurrió en nuestro hospital y el manejo que se le dio; revisamos la literatura.
Abstract The most common neoplastic lesions in the infancy are hemangiomas; they are classified according to their histology, proteic expression, and clinical presentation. They normally appear in the skin and soft tissue. They are very rare in the viscera, in the stomach, and in neonates they are even more unusual; this is the reason why we decided to review the literature and present this case.
ABSTRACT
Background: Quality of Life (QOL) assessment may evaluate the impact of diseases and their treatment on the overall well-being of patients. Aim: To assess QOL in Chilean breast cancer survivors. Patients and Methods: Ninety one female breast cancer patients aged 60 ± 10 years, who finished their oncologic treatment at least a year prior to the assessment, who were disease free and in medical follow-up were included in the study. They completed the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 core questionnaire and the breast cancer module QLQ-BR23. Results: Forty eight percent of respondents were long term survivors (more than five years). Global QOL scores were high (73.6 ± 18.2), emotional scale had the lowest scores in QLQ-C30 functional scales (72.1). Symptoms with the highest scores were: Insomnia (= 21.2), pain (= 20.8), and fatigue (= 19.1). Body image, sexual function, and concern about the future were the most relevant problems. Body image was superior in patients with breast-conserving surgery (p = 0.008), and cognitive function was better in patients in early disease stage (p = 0.03) and in those with more than five years of survival (p = 0.04). Conclusions: Even when global QOL scores were high, some symptoms were prevalent. Awareness about these problems and symptoms should improve their diagnosis and treatment.
Subject(s)
Humans , Female , Middle Aged , Quality of Life/psychology , Body Image/psychology , Breast Neoplasms/psychology , Socioeconomic Factors , Breast Neoplasms/surgery , Mastectomy, Segmental/psychology , Survival Analysis , Chile , Cross-Sectional StudiesABSTRACT
El estudio midió los efectos del entrenamiento a jugadores de rugby con espacios reducidos. Se realizó con 27 jugadores pertenecientes a dos equipos de la Liga Antioqueña de Rugby, con edad de 22,4 (±3,66) años, peso de 78,76 (±11,93) kg. y talla de 176,06 (±5,97) cm. Para medir los efectos de la planificación con espacios reducidos se utilizó una fase de un programa modelador (Agudelo, 2012), lo que constituyó la variable independiente. Para verificar los posibles efectos, como pre pruebas y pos pruebas, se utilizaron los 30 m para velocidad (aceleración), los 3000 m para resistencia, y la adaptación de un test de pase realizado en Australia, lo que permitió verificar, a través de estadísticos no paramétricos seleccionados, qué tan significativo fueron los cambios. Verificados los resultados, se puede afirmar que el juego con espacios reducidos, aparentemente propicia un excelente medio para entrenar de forma integrada, ya que facilita el incremento del componente condicional, especialmente en cuanto a la resistencia, y mantiene la velocidad, a la vez que permite el desarrollo del componente técnico.
The study measured the effects of training on rugby players with reduced spaces. It was made with 27 players belonging to two teams of the Antioquia Rugby League, with age of 22.4 (± 3.66) years, weight of 78.76 (± 11.93) kg. and size of 176.06 (± 5.97) cm. To measure the effects of planning with reduced spaces, a phase of a modeling program was used (Agudelo, 2012), which constituted the independent variable. To verify the possible effects, such as pre-tests and post-tests, were used the 30 m for speed (acceleration), the 3000 m for resistance, and the adaptation of a pass test carried out in Australia, which allowed us to verify, through selected nonparametric statistics, how significant the changes were. Once the results have been verified, it can be affirmed that the game in reduced spaces, apparently propitiates an excellent means to train in an integrated manner, since it facilitates the increase of the conditional component, especially in terms of resistance, and maintains speed, while at the same time allows the development of the technical component.
O estudo mede os efeitos de treinar com espaços reduzidos a jogadores de rugby, realizou-se em 27 jogadores pertencentes a duas equipes, de une-a Antioqueña de Rugby. Tinham uma idade de 22,4 (±3,66) anos, um peso de 78,76 (±11,93) Kg. e uma talha de 176,06 (±5,97) cm. Para medir os efeitos do planejamento com espaços reduzidos utilizou-se uma fase de um programa modelador (Agudelo, 2012) o que constituiu a variável independente, utilizaram-se como pré-teste e pós-testes para verificar "possíveis efeitos" 30 m. Para a velocidade (aceleração), os 3000 m. Para a resistência e uma adaptação de um teste de passe realizado em Austrália, o que permitiu verificar através de estatísticos não paramétricos selecionados que tão significativas são as mudanças. Verificados os resultados pode ser afirmado que o jogo em espaços reduzidos aparentemente propicia uma excelente maneira para treinar de forma integrada já que facilita o incremento da parte condicional, especialmente quanto à resistência e mantém a velocidade, enquanto permite o desenvolvimento do técnico.
Subject(s)
Sexual VulnerabilityABSTRACT
Background: Quality of Life assessment in oncologic patients evaluates the impact ana sequels of the disease ana the adverse effects of available treatments. Aim: To validate in Chile the breast cáncer specific-questionnaire (BR23) developed by the European Organization for Research and Treatment of Cancer (EORTC). Patients and Methods: After performing a linguistic validation of the BR23 according to EORTC instructions, its psychometric properties were tested in 103 patients with breast cancer whose ages ranged from 34 to 83 years. Infernal consistency ofthe scales was assessed using the Cronbach's alpha coefficient. The test-retest correlations of each scale (n = 83) were evaluated. The correlation ofBR23 scales with SF36 version 2 and C30 version 3.0 scales was also assessed. The sensitivity and specificity of the instrument were analyzed using receiver operating characteristic curves (ROC). Results: Alpha values showed acceptable levels of internal consistency, ranging between 0.702 and 0.917 in all scales of BR23. The statistical analysis revealed significant test-retest correlations in most scales ofBR23. The correlations between BR23 and similar domains of C30 and SF36 questionnaires were also significant. The BR23 questionnaire demonstrated satisfactory levels of sensitivity and specificity when compared with the SF-36 scale. Conclusions: The BR23 questionnaire adapted for use in Chile is linguistically appropriate and psychometrically valid.
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Middle Aged , Breast Neoplasms/psychology , Breast Neoplasms/diagnosis , Chile , Quality of Life , Surveys and Questionnaires , ROC Curve , Sensitivity and SpecificityABSTRACT
La intención de este trabajo es mostrar el protocolo que utilizamos en nuestra unidad para la selección de pacientes y elección de la técnica quirúrgica apropiada de reducción mamaria en hombres obesos masculinos, que ofrezca los mejores resultados postoperatorios. Para eso se estudian el Indice de Masa Corporal Total (Body Mass Index-BMI) (1), los grados de Obesidad Mórbida (2), la medición de la ptosis del complejo aréola-pezón (NAC) (3,4) y la revisión de las técnicas clásicas (5), así como de los criterios de inclusión o eclusión de las mismas (6)
The aim of the present report was to show the protocol used in our Unit for the selection of patients suitables for breast reduction and to choice the appropriate surgical technique in obese male patients that offers the best postoperative results. For that, we studied the Total. Corporal Mass Index (Body Mass Index-BMI) (1), the degrees of Morbid Obesity (2), measurement of ptosis, the complex areola-nipple (NAC) (3,4), with a revision of the classical techniques (5), the same as the criteria for inclusion or exclusion (6)
Subject(s)
Middle Aged , Body Mass Index , Lipectomy/methods , Mammaplasty , Obesity/surgery , Obesity/pathology , Obesity/therapy , Postoperative Complications , Surgical FlapsABSTRACT
Existe una multitud de técnicas quirúrgicas para la corrección de orejas micróticas. Sin embargo, uno de los factores que regula la calidad de los mismos son las condiciones iniciales en el área y la habilidad quirúrgica para tallar el marco cartilaginoso. En las técnicas convencionales, las primeras etapas de reconstrucción sólo brindan dos dimensiones lo que siempre implica un tiempo quirúrgico posterior para la proyección del marco, que conlleva mayor cantidad de cicatrices totales, de tiempo quirúrgico y de cirugías, con pérdida de sensibilidad en el área retroauricular. Se presenta la técnica clásica de Tanzer en 1959 posteriormente modificada por Brent en 1980, brinda características únicas, ya que el marco en sí tiene altura, profundidad y anchura determinados, así como cierto grado de movimiento y proyección de la oreja neoformada desde un inicio, dando una apariencia en tres dimensiones y recrea el surco aurículo-cefálico sin necesidad de otro tiempo quirúrgico, con un resultado estético adecuado.
There is a great number of surgical techniques for microtic ear correction. However, one factor that regulates the quality of these is the initial conditions in the area and surgical skill to carve the cartilage frame-work. In conventional techniques, the early stages of reconstruction only provide two dimensional which always involves a posterior surgical time of surgery, with loss of sensation in the retroauricular area. The technique presented is the classic technique of Tanzer in 1959 and subsequently amended by Brent in 1980, offers unique features such as the frame itself has height, depth and width determined and a degree of movement and projection of the newly formed ear from the beginning, giving a three dimensional appearance and recreates the atrium-ventricular groove head once without surgery, with an adequate cosmetic result.
Subject(s)
Female , Guided Tissue Regeneration , Ear Auricle/surgery , Tissue Expansion DevicesABSTRACT
Se presenta un estudio de las irregularidades en la utilizacion de medicamentos en un servicio hospitalario y se recomiendan algunas medidas de control que incluyen el empleo de un formulario especial para realizar pedidos a la farmacia del hospital