Realidade Aumentada e Realidade Virtual como inovação no curso médico / Augmented Reality and Virtual Reality as innovation in the medical course / Realidad Aumentada y Realidad Virtual como innovación en el curso médico

Apesar do ensino da medicina ser um dos mais tradicionais, o conceito de educação médica tem se desenvolvido nos últimos séculos em paralelo à evolução da medicina. Uma reflexão sobre este processo é extremamente benéfica e esclarecedora, justamente nesta fase caracterizada pelo aumento de escolas médicas e de um profundo questionamento do paradigma curricular vigente na maior parte destas instituições

Espiritualidade aplicada à medicina / Spirituality applied to medicine / Espiritualidad aplicada a la medicina

Resumo Espiritualidade é a força que une os diferentes aspectos componentes do ser e, quando trabalhada, proporciona uma vivência harmônica e promove equilíbrio entre bem-estar físico, social e mental. Nesse sentido, objetivou-se abordar, secularmente, como a espiritualidade é vista na medicina, sua influência na saúde e a percepção de profissionais e pacientes acerca desse assunto. Para tanto, realizou-se revisão narrativa que priorizou buscas na plataforma PubMed por meio dos seguintes descritores: "medicine and spirituality and secularismo" e "placebo effect and spirituality and medicine". Em seguida foram analisadas fontes referenciadas pela leitura dos artigos primordiais. Percebeu-se que há confusão quanto ao uso do termo espiritualidade e que a capacidade e efetividade do cuidado espiritual prestado por profissionais da saúde são débeis, contrastando com inúmeros benefícios oferecidos por essa atenção, que é uma ferramenta para um trabalho mais ético e humano.

Abstract Spirituality is a uniting force between different constituents of the human being and, when exercised, provides a harmonious experience and promotes balance between physical, social, and mental well-being. As such, this narrative review proposes a secular approach to how spirituality is understood by medicine, its influence on health, and how it is perceived by professionals and patients. Bibliographic search was conducted on the PubMed database, using the following descriptors: "medicine and spirituality and secularism" and "placebo effect and spirituality and medicine." After reading the primary articles, the referenced sources were analyzed. Results show a confusion on how the term spirituality is used and a weak capacity and effectiveness with respect to the spiritual care provided by health personnel, thus ignoring the several benefits offered by such care, which is a tool for a more ethical and humane work.

Resumen La espiritualidad es la fuerza que une los diferentes componentes del ser y al estimularse proporciona una experiencia armoniosa, además de promover el equilibrio de bienestar físico, social y mental. Ante lo anterior, este texto tuvo por objetivo abordar cómo se ve secularmente la espiritualidad en la medicina, su influencia en la salud y la percepción de profesionales y pacientes sobre este tema. Para ello, se realizó una revisión narrativa en la base de datos PubMed utilizando los siguientes descriptores: "medicine and spirituality and secularismo" y "placebo effect and spirituality and medicine". Después, se analizaron las fuentes mediante la lectura de los artículos principales. Se encontró una confusión con relación al uso del término espiritualidad, y es deficiente la habilidad y eficacia del cuidado espiritual que brindan los profesionales de la salud, contrastando con los numerosos beneficios de este cuidado, una herramienta para un trabajo más ético y humanizado.

Anton Chejov / Anton Chejov

Nuestro colega Antón Chéjov decía: "la medicina es mi legítima esposa; la literatura es mi amante". Médico de profesión, Chéjov vio lo mejor y lo peor del ser humano en los hospitales en que trabajó. Conoció sus debilidades y sus fortalezas, lo que había de divino y humano; todo ello le permitió concluir que como especie hemos cambiado poco. Es considerado como el más destacado representante de la escuela realista de su país en su corriente más psicológica. Reconocido mundialmente como un maestro del relato corto y uno de los escritores más importantes de este género en la historia de la literatura.

Our colleague Anton Chekhov said: "Medicine is my lawful wife; Literature is my lover. A doctor by profession, Chekhov saw the best and worst of the human being in the hospitals where he worked. He knew his weaknesses and his strengths, what was divine and human; all this allowed him to conclude that as a species we have changed little. He is considered the most outstanding representative of the realist school of his country in its most psychological current. He is recognized worldwide as a master of short stories and one of the most important writers of this genre in the history of literature.

Fundación Neumológica Colombiana 30 años de una institución con espíritu / Fundación Neumológica Colombiana 30 years of an institution with spirit

Hablar de la Neumología moderna en Colombia y de la Fundación Neumológica Colombiana es hablar de Darío Maldonado Gómez. Nacido en Pamplona, Norte de Santander, llegó a Bogotá siendo un adolescente, cuando sus padres se vieron obligados a salir de su ciudad natal hacia la capital, con todos sus hijos, producto de la violencia encendida a finales de la década de los 40´s. Con el ejemplo de su padre, Darío Maldonado Romero, médico que se especializó en la lepra y consagró sus esfuerzos al desarrollo de políticas de salud pública. Así, con la ambición de aprender y apropiar la ciencia, el arte y el humanismo que sustentan la medicina, ingresó a la Universidad Nacional en Bogotá y obtuvo su título de médico en 1959. Su ánimo de aprender y de poder ofrecer siempre las mejores opciones a sus pacientes, lo llevaron pronto a Chicago y Milwaukee, Estados Unidos, donde, en la década de los 60´s, se entrenó en Medicina Interna y Neumología con el profesor Gordon Snider, pionero y figura de la Neumología moderna en el mundo.

Talking about modern Pulmonology in Colombia and the Colombian Pulmonary Foundation is talking about Darío Maldonado Gómez. Born in Pamplona, Norte de Santander, he came to Bogotá as a teenager, when his parents were forced to leave their hometown for the capital, with all their children, as a result of the violence inflamed at the end of the 1940s. With the example of his father, Darío Maldonado Romero, a doctor who specialized in leprosy and devoted his efforts to the development of public health policies. Thus, with the ambition of learning and appropriating the science, art and humanism that sustain medicine, he entered the National University in Bogotá and obtained his medical degree in 1959. His desire to learn and to always be able to offer the best options to his patients, they soon took him to Chicago and Milwaukee, United States, where, in the 1960s, he trained in Internal Medicine and Pulmonology with Professor Gordon Snider, pioneer and figure of modern Pulmonology in the world.

Expectativas y realización profesional en Cirugía General y subespecialidades quirúrgicas: situación actual de los cirujanos jóvenes en Córdoba / Expectations and professional fulfillment in general surgery and surgical sub-specialties: current situation of young surgeons in Cordoba

RESUMEN Antecedentes: en la Argentina, la especialidad Cirugía General se encuentra en crisis y esta situación alarmante se halla vinculada a las malas condiciones laborales del cirujano general. Objetivo: describir la percepción que el cirujano joven tiene al terminar su programa de formación, en relación con su perspectiva laboral, actividad quirúrgica y académica. Material y métodos: estudio transversal basado en una encuesta dirigida a cirujanos jóvenes en Córdoba, Argentina. Resultados: participaron 53 encuestados. El 58% eran hombres y la mediana de edad fue 32 años. El 72% ejercía Cirugía General y el 55% trabajaba en el sector privado. El 34% pertenecía a la Asociación de Cirugía de Córdoba y el 23% a la Asociación Argentina de Cirugía. En cuanto a la experiencia profesional, el 53,1% eran cirujanos junior y el 64% eran competentes para realizar procedimientos de baja o mediana complejidad. En relación con la perspectiva laboral, el 89% consideró que el cirujano joven no consigue salida laboral rápida y el 96,2% refirió que sus prácticas no eran bien remuneradas. Respecto de la calidad de vida personal y laboral, el 57% manifestó frustración e incertidumbre económica. En cuanto a las cirujanas, la tasa de inequidades de género y hostigamiento sexual en el ámbito laboral fue del 73% y 50%, respectivamente. Conclusión: encontramos la percepción de un bajo nivel de competencia para las cirugías de mayor complejidad y una baja tasa de adherencia a sociedades quirúrgicas. Debido a la escasa oferta laboral existe gran frustración e incertidumbre económica. Actualmente, predomina y persiste el maltrato y hostigamiento hacia las cirujanas.

ABSTRACT Background: In Argentina, the specialty of general surgery is in crisis, and this alarming situation is associated with the poor working conditions of general surgeons. Objective: The aim of this study is to describe the perception of young surgeons at the end of their training program, in relation to their job prospects, surgical and academic activity. Material and methods: We conducted a cross-sectional study based on a survey responded by young surgeons in Cordoba, Argentina. Results: The survey was responded by 53 young surgeons; 58% were men and median age was 32 years. Seventy-two percent practiced general surgery and 55% worked in the private setting. Thirtyfour percent were members of Asociación de Cirugía de Córdoba and 23% belonged to Asociación Argentina de Cirugía. As for professional experience, 53.1% were junior surgeons and 64% were capable of performing low or medium complexity procedures. Eighty-nine percent considered that young surgeons do not get a job quickly and 96.2% reported that they were not well paid for their practice. When asked about their personal and professional quality of life, 57% expressed frustration and economic uncertainty. Among women surgeons, 73% reported gender inequities and 50% reported sexual harassment in the workplace. Conclusion: Young surgeons perceived they had low level of competencies for high complexity surgical procedures and reported low rate of membership in surgical societies. Most of them feel frustrated due to scarce job opportunities and expressed economic uncertainty. Nowadays, abuse and harassment of women surgeons still prevails and persists.

Ensino do exame respiratório: o que é história e o que é necessidade? / Teaching the respiratory physical examination: what is history and what is needed?

A semiologia é uma das técnicas mais utilizadas na prática médica há séculos. Ensinada por meio de roteiros sistematizados, estudantes de inúmeras escolas da área de saúde por todo o mundo aprendem as manobras semiológicas como fundamento na avaliação dos pacientes. No entanto, apesar de extremamente difundida, discute-se pouco sobre sua acurácia como manobra diagnóstica. Tendo este ponto em vista, este artigo aborda a precisão das diversas manobras semiológicas do exame físico do aparelho respiratório e a descrição comparativa do seu ensino em diferentes escolas médicas no mundo. Como resultados, tem-se valores de acurácia discordantes, o que pode ser justificado pela qualidade dos estudos ou pelas variáveis analisadas que diferem entre os estudos e propostas de padronização. Em conclusão, a semiologia é a base da avaliação médica, independentemente dos avanços e disponibilidade dos exames de imagens, e cada manobra deve ser ensinada com seu devido valor científico. Conhecer a aplicabilidade e individualizar a prática das etapas do exame respiratório pode ser um caminho possível de adequação aos tempos atuais, sem impor perdas de informações relevantes para o desenvolvimento do raciocínio clínico (AU)

Medical semiology has been one of the most common techniques used in medical practice for centuries. Health science students around the globe learn these techniques through a systematized model as a fundamental skill for patient evaluation. However, though being widespread, little is known about semiology's true accuracy as a diagnostic maneuver. Knowing that, through a literature review, this paper evaluated the precision of the preconized procedures that are used as part of the exam of the respiratory system and the comparative description of its teaching in different medical schools around the world. As a result, disagreement between several papers was found, which can be justified by the poor quality of the studies and the different variables that were studied in each one. However, one thing is still clear: respiratory physical examination continues to be essential in medical practice, independently of the recent advances and availability of imaging exams. Teaching each step should consider available scientific evidence. The knowledge of the applicability and practical individualization of the respiratory examination can be a possible way for the current times without missing relevant information for developing clinical reasoning (AU)

Honrar el juramento hipocrático / Honor the Hippocratic Oath

"No llevar otro propósito que el bien y la salud a los enfermos" fue la base del juramento que Hipócrates trasmitió a sus discípulos. Recordarlo nos hace necesariamente reflexionar sobre el rol de los médicos para mantener este principio ético que, a más de dos milenios de vigencia, continúa siendo el motor que impulsa nuestra práctica cotidiana. Asistimos a una era extraordinaria con el desarrollo exponencial de nuevos conocimientos. Se estima que la humanidad cada 2 años duplica la información y probablemente estos lapsos se reduzcan a solo 11 horas en las próximas décadas, de acuerdo a algunos pronósticos.

Dificultad y discriminación del examen de Ontogenia Humana y SOMA en la carrera de medicina / Difficulty and discrimination of the Human Ontogeny and Osteomioarticular System Exam in the medical major

Introducción: La evaluación es la categoría reguladora del proceso de enseñanza-aprendizaje. Los instrumentos evaluativos utilizados para tal propósito deben reunir los criterios mínimos de calidad. Objetivo: Evaluar la dificultad y discriminación del examen de la asignatura Ontogenia Humana y SOMA de la carrera de medicina en la Facultad de Ciencias Médicas de Matanzas en tres cursos académicos. Métodos: Se realizó un estudio de investigación descriptivo transversal en el marco de la educación médica, para describir la estructura del examen de la asignatura Ontogenia Humana y SOMA, en la Facultad de Ciencias Médicas de Matanzas, en los cursos 2016-2017, 2017-2018 y 2018-2019; y determinar la frecuencia de errores, y el nivel de dificultad y el poder de discriminación de estos. Resultados: En el examen aplicado en los tres cursos predominaron las preguntas tipo ensayo. La frecuencia de errores fue media, baja y alta, respectivamente. Los exámenes presentaron dificultad media y excelente poder de discriminación. Conclusiones: Los indicadores de calidad estudiados alcanzaron valores satisfactorios para el examen de la asignatura Ontogenia Humana y SOMA en la Facultad de Ciencias Médicas de Matanzas en los cursos académicos estudiados(AU)

Introduction: Evaluation is the regulatory category of the teaching-learning process. The evaluative instruments must meet the minimum quality criteria. Objective: To assess the difficulty and discrimination of the exam of the Human Ontogeny and Osteomioarticular System subject of the medical major in the School of Medical Sciences of Matanzas during three academic years. Methods: A descriptive and cross-sectional research was carried out in the framework of medical education, in order to describe the structure of the exam of the Human Ontogeny and Osteomioarticular System subject, in the School of Medical Sciences of Matanzas, in the academic years 2016-2017, 2017-2018 and 2018-2019; as well as to determine the frequency of errors, together with their level of difficulty and power of discrimination. Results: In the exam applied during the three academic years, essay-type questions predominated. The frequency of errors per year was medium, low and high, respectively. The exams presented medium difficulty and excellent power of discrimination. Conclusions: The studied quality indicators obtained satisfactory values for the exam of the Human Ontogeny and Osteomioarticular System subject in the School of Medical Sciences of Matanzas during the studied academic courses(AU)

Conocimientos, actitudes y percepción sobre el rol de los medios de comunicación respecto a la COVID-19 en estudiantes de Medicina de una universidad peruana / Knowledge, attitudes, and perception of the role of the media regarding COVID-19 in medical students from a peruvian university

RESUMEN Se realizó un estudio transversal en estudiantes de Medicina de una universidad privada de Lima. El objetivo fue describir el nivel de conocimientos y las actitudes sobre la COVID-19, además de su percepción sobre el rol de los medios de comunicación y de las redes sociales. El 32% no sabía que en los primeros cinco días de la enfermedad, las pruebas serológicas son preferibles para diagnosticar la COVID-19, comparadas con las pruebas moleculares; el 73% reportó estar dispuesto a trabajar como voluntario durante la pandemia y el 94% recibió información falsa sobre la COVID-19 en las redes sociales. Este estudio demuestra que la información sobre el uso de pruebas diagnósticas debe ser reforzada y que se debe tomar en cuenta el alto porcentaje de estudiantes dispuestos a ser voluntarios durante la pandemia de la COVID-19.

ABSTRACT A cross-sectional study was carried out on medical students from a private Peruvian university. The aim was to describe knowledge and attitudes towards COVID-19 as well as the student's perception of the role of media outlets and social media. Of the students, 32% did not know that during the first five days of illness, serological tests are preferred for diagnosing COVID-19 over molecular tests; 73% reported being willing to work as a volunteer during the pandemic, and 94% received false information regarding COVID-19 on social media. This study demonstrated that information regarding diagnostic tests should be reinforced and that the high percentage of students willing to volunteer during the COVID-19 pandemic should not be overlooked.

As implicações da pandemia de COVID-19 na saúde mental e física dos estudantes do Curso de Medicina de uma Universidade da Região Metropolitana do Espírito Santo / As implicações da pandemia de COVID-19 na saúde mental e física dos estudantes do Curso de Medicina de uma Universidade da Região Metropolitana do Espírito Santo / Las implicaciones de la pandemia de COVID-19 en la salud mental y física de los estudiantes del Curso de Medicina de una Universidad de la Región Metropolitana de Espírito Santo

Introdução: O primeiro caso reportado da infecção pelo novo coronavírus ocorreu na China, em dezembro de 2019. Dado o alastramento da doença, ocorreram modificações no estilo de vida, que associadas ao período de incertezas geraram impactos na saúde da população. Objetivo: Compreender as implicações da pandemia de COVID-19 na saúde mental e física dos estudantes do Curso de Medicina de uma universidade do Espírito Santo. Métodos: Estudo transversal de agosto de 2020 a janeiro de 2021, com abordagem quantitativa e qualitativa, com estudantes de Medicina de todos os períodos. Coleta de dados feita com questionário eletrônico, englobando dados sociodemográficos, econômicos, características individuais e familiares sobre o período prévio e concorrente à pandemia. Os programas Excel 2020 e OPENEPI foram utilizados para as análises. O estudo foi aprovado pelo Comitê de Ética em Pesquisa com Seres Humanos, sob o número 4.224.502. Resultados: Foram avaliados 779 acadêmicos, a maioria do sexo feminino (61,6%), entre 20 e 24 anos (64,0%), nos dois primeiros anos do curso (46,5%), residentes em área urbana (98,1%), com uma a três pessoas em seu domicílio (65,0%) e sem vínculo empregatício (93,2%). Características da amostra durante a pandemia: necessidade de trancar matrícula (3,9%), preocupação constante com a família (73,9%), dificuldade de adaptação à educação a distância (76,0%), convívio familiar contínuo (84,5%), alterações do sono (54,9%), da prática de atividade física (60,3%) e do peso (71,0%), participação nos afazeres domésticos (77,9%), pressão psicológica (47,6%), alimentação (69,6%). As variáveis que sofreram modificações significativas entre os períodos prévio e concorrente à pandemia foram diminuição de renda (p=0,005), aumento do uso de medicamentos (p=0,0009) e do nível de estresse autopercebido (p≤0,0000001). Com relação ao desenvolvimento de dores no período da pandemia, apresentaram impacto: sexo feminino (p≤0,0000001), segundo ano do curso (p=0,001), preocupação constante com a família (p=0,000002), dificuldade de adaptação ao ensino a distância (p=0,002), alterações no sono (p=0,000003), atividade física (p=0,001), mudanças no peso (p=0,00007) e na alimentação (p=0,01). Para o desenvolvimento de distúrbios psíquicos durante a pandemia, as com maior significância foram sexo (p=0,004), preocupação constante com a família (p=0,005), sono (p=0,006) e alimentação (p=0,003). Conclusões: Modificações dos padrões de vida decorrentes da pandemia impactaram negativamente a saúde física e mental, tornando essencial que as instituições de ensino proporcionem ações de cuidado à saúde de estudantes.

Introduction: The first reported case of infection by the new coronavirus occurred in China, in December 2019. Due to the spread of the disease, changes in lifestyle occurred, which, associated with the period of uncertainty, generated impacts on the health of the population. Objective: To understand the implications of the COVID-19 pandemic on the mental and physical health of medical students at a university in Espírito Santo. Methods: Cross-sectional study from August 2020 to January 2021, with a quantitative and qualitative approach, with medical students enrolled in all periods. Data collection was carried out with an electronic questionnaire, encompassing sociodemographic, economic, individual, and family characteristics about the period prior to and during the pandemic. Excel 2020 and OPENEPI programs were used for analyses. The study was approved by the Human Research Ethics Committee, under number 4.224.502. Results: 779 students were evaluated, mostly females (61.6%), between 20 and 24 years old (64.0%), in the first two years of the course (46.5%), residing in urban areas (98.1%) with 1 to 3 people in their household (65.0%), and unemployed (93.2%). Sample characteristics during the pandemic: need to pause enrollment (3.9%), constant concern with the family (73.9%), difficulty in adapting to distance education (76.0%), continuous family life (84.5%), changes in sleep (54.9%), physical activity (60.3%), and weight (71.0%), participation in household chores (77.9%), psychological pressure (47.6%), food (69.6 %). The variables that underwent significant changes between the previous period and during the pandemic were lower income (p=0.005), increased use of medication (p=0.0009), and self-perceived stress level (p≤0.0000001). Regarding the development of pain during the pandemic period, the following had an impact: female (p≤0.0000001), second year of the course (p=0.001), constant concern for the family (p=0.000002), difficulty in adapting to distance education (p=0.002), changes in sleep (p=0.000003), physical activity (p=0.001), weight (p=0.00007), and diet (p=0.01). For the development of mental disorders during the pandemic, the most significant were gender (p=0.004), constant concern for the family (p=0.005), sleep (p=0.006), and diet (p=0.003). Conclusions: Changes in living standards resulting from the pandemic had a negative impact on physical and mental health, making it essential for educational institutions to provide student with health care actions.

Introducción: El primer caso reportado de contagio por el nuevo coronavirus ocurrió en China, em diciembre de 2019. Debido a la propagación de la enfermedad, se produjeron cambios en el estilo de vida, que, asociados al periodo de incertidumbre, generaron impactos en la salud de la población. Objetivo: Comprender las implicaciones de la pandemia COVID-19 en la salud física y mental de los estudiantes de medicina de una universidad de Espírito Santo. Métodos: Estudio transversal de agosto de 2020 a enero de 2021, cuantitativo y cualitativo, con estudiantes de medicina matriculados en todos los períodos. La recopilación de datos se realizó con un cuestionario electrónico, que abarcó características sociodemográficas, económicas, individuales y familiares sobre el período previo y durante la pandemia. Para los análisis se utilizaron los programas Excel 2020 y OPENEPI. El estudio fue aprobado por el Comité de Ética en Investigación con Seres Humanos, bajo el número 4.224.502. Resultados: Fueran evaluados 779 estudiantes, mayoría mujeres (61,6%), entre 20 y 24 años (64,0%), en los dos primeros años del curso (46,5%), residentes en áreas urbanas (98,1%), con 1 a 3 personas em su hogar (65,0%) y sin empleo (93,2%). Características de la muestra durante la pandemia: necesidad de cerrar matrícula (3,9%), preocupación constante por la familia (73,9%), dificultad de adaptación a la educación a distancia (76,0%), convivencia familiar continua (84,5%), trastornos del sueño (54,9%), actividad física (60,3%) y peso (71,0%), participación en las tareas del hogar (77,9%), presión psicológica (47,6%), alimentación (69,6%). Las variables que sufrieron cambios significativos entre el período anterior y durante la pandemia fueron la disminución de ingresos (p=0,005), el aumento del uso de medicamentos (p=0,0009) y el nivel de estrés autopercibido (p≤0,0000001). En cuanto al desarrollo del dolor durante el período de la pandemia, incidieron: sexo femenino (p≤0,0000001), segundo año de carrera (p=0,001), preocupación constante por la familia (p=0,000002), dificultad de adaptación a la educación a distancia (p=0,002), cambios en el sueño (p=0,000003), actividad física (p=0,001), cambios en el peso (p=0,00007) y dieta (p=0,01). Para el desarrollo de los trastornos mentales durante la pandemia, los más significativos fueron el sexo (p=0,004), la preocupación constante por la familia (p=0,005), el sueño (p=0,006) y la alimentación (p=0,003). Conclusiones: Los cambios en los niveles de vida derivados de la pandemia impactaron negativamente en la salud física y mental, por lo que es fundamental que las instituciones educativas brinden acciones de atención a la salud de los estudiantes.

Patients' preferences regarding physicians' gender: a clinical center cross-sectional study

ABSTRACT BACKGROUND: Even with the significant growth of female representation within medicine, inequality and prejudice against this group persist. OBJECTIVE: To analyze patients' preferences regarding the gender of physicians in general and according to different specialties, and the possible reasons behind their choice. DESIGN AND SETTING: Cross-sectional study at the Clinical Center of the University of Caxias do Sul, Brazil. METHODS: Over a three-month period in 2020, 1,016 patients were asked to complete a paper-based 11-item questionnaire. RESULTS: The majority (81.7%; n = 830) of the patients did not have a preference regarding the gender of physicians in general. The preference rate for same-gender physicians was 14.0% (n = 142/1,016), and this preference was more common among female than among male patients (17.6% versus 7.0%; odds ratio, OR = 2.85; 95% confidence interval, CI = 1.80-4.52; P < 0.001). When asked about their preference for the gender of the specialist who they were waiting to see, the overall preference rate for a same-gender professional was 17.2% (n = 175). Preference for same-gender specialists was higher for specialties essentially based on pelvic or breast examination (i.e. gynecology, urology, proctology and mastology), compared with others (33.4% versus 9.7%; OR = 4.69; 95% CI = 3.33-6.61; P < 0.001). CONCLUSIONS: The patients' model for choice of their physician does not seem to involve physicians' gender in general or in the majority of medical specialties. The data presented in this study may make it easier to understand patients' preferences and concerns.

El doctor Juan Noé y el nacimiento de la biología celular en Chile / Dr. Juan Noé and the birth of cell biology in Chile

Dr. Vicente Izquierdo San Fuentes was the first professor of Histology at the Faculty of Medicine of the University of Chile. In that Chair, cell theory strongly radiated to new generations of health students. However, the conditions for the creation of the discipline of General or Cell Biology were not yet ripe. Almost three decades later, Dr. Juan Noé Crevani was hired in Italy to lead Medical Zoology in 1912. From the heterogeneous discipline of Medical Zoology, Dr. Noé managed to create in 1926 the new chairs of General Biology, Embryology-Comparative Anatomy and Parasitology. His vision of biology as an essentially dynamic and experimental science, contributed to modernize and encourage the development of different areas of biology in Chile. Retaining their full independence, these chairs met in 1931, in a new organization called the Juan Noé Institute of Biology, which lasted until the university reform of 1968. Afterwards, the departments of Biology and Genetics, Parasitology, Human Anatomy and Histology were created. In 1998, a new reorganization of the Faculty of Medicine of the University of Chile began, creating the so-called Institute of Biomedical Sciences (ICBM) that houses several disciplinary programs that replaced the old departments.

Índice de temas y autores volumen 44. Número 1-4 (136-139) año 2022 / Index of the National Academy of Medicine

Índice de temas y autores correspondientes al volumen 44 de la Revista Médica de la Academia Nacional de Medicina de Colombia. Año 2022

Índice de la revista de la Academia Nacional de Medicina de Colombia / Index of the National Academy of Medicine

La revista MEDICINA, desde sus inicios en 1873 hasta nuestros días, permite el acceso a su contenido en texto completo, por ello se percibió la necesidad de elaborar un índice con el contenido total de sus números, para permitir a sus usuarios contar con una herramienta tanto virtual como impresa de lo publicado en esta. Para su versión online podrá acceder a través del siguiente enlace: https://indice.revistamedicina.net/

Building the foundation for universal healthcare: Academic family medicine's ability to train family medicine practitioners to meet the needs of their community across the globe

Background: The Declaration of Astana marked a revived global interest in investing in primary care as a means to achieve universal healthcare. Family medicine clinicians are uniquely trained to provide high-quality, comprehensive primary care throughout the lifespan. Yet little focus has been placed on understanding the needs of family medicine training programs. Aim: This study aims to assess broad patterns of strengths and resource challenges faced by academic programs that train family medicine clinicians. Methods: An anonymous online survey was sent to family medicine faculty using World Organization of Family Doctors (WONCA) listservs. Results: Twenty-nine representatives of academic family medicine programs from around the globe answered the survey. Respondents cited funding for the program and/or individual trainees as one of either their greatest resources or greatest limitations. Frequently available resources included quality and quantity of faculty and reliable clinical training sites. Frequently noted limitations included recruitment capacity and social capital. Over half of respondents reported their program had at some point faced a disruption or gap in its ability to recruit or train, most often because of loss of government recognition. Reflecting on these patterns, respondents expressed strong interest in partnerships focusing on faculty development and research collaboration. Lessons learnt: This study provides a better understanding of the challenges family medicine training programs face and how to contribute to their sustainability and growth, particularly in terms of areas for investment, opportunities for government policy and action and areas of collaboration.

Mastering Your Fellowship: Part 4, 2022

The 'Mastering Your Fellowship' series provides examples of the question format encountered in the written and clinical examinations, Part A of the Fellowship of the College of Family Physicians of South Africa examination. The series is aimed at helping family medicine registrars prepare for this examination.

The effect of CAM comprehensive nursing interventions on the improvement of quality of life to patients with breast cancer and gynaecological tumours

Breastcancerin females, which is consideredthe most dreadfuldisease in India andthe worldas compared toother gynaecological cancers,demands extensive care and proper medicationin order to control itsprogressive growth. In addition to the conventional care ofthe patients, Complementary andAlternative Medicine(CAM)is administeredin a controlled way through proper guidance and counselling in orderto attainimprovedphysical andmental health forthe patients.Objective: The aim of the study wasto assess the effectiveness of CAMcomprehensive nursing interventionsand their benefit forpatients who havebreast cancer and gynaecological tumours.Methods: Statistical data was used to map the adult womendiagnosed with breast and gynaecological cancer and who were set to start new chemotherapy treatments. A total of 450 patients from different states of East India were enrolled in the studyover a period of four years. The patients wereselectedbased on their preference for undergoing CAM.The research was conducted usingacross-sectionalanonymous self-administered questionnaireto examine women's perspectivestowards the use of CAM and itseffect on their mental andphysical health.Results:42%of the women preferred theuseofCAM astheir alternative treatment. Breast cancer patients disclosed that 48.1% of them had used CAM and 39% of women with gynaecological cancersstated that they had usedCAM. The results further indicated a less frequent deteriorationin the health of CAM users(38.4%) thantonon-users(55%). In terms of those who utilizedvitamins and nutritional diets,60% of the participants reported using a proper diet, including antioxidants, minerals, vitamins and herbs etc. 37% opted for spiritual healing through yoga, 26% utilized energy healing, 42.4% utilized acupuncture,72% preferred massagesand 23% of patients utilized chiropractic methods.The use of CAM was foundmainlyin the patients with proper education and awareness and those with a family history of cancer who were not receiving the necessary care from their previous primary physician.Conclusion:CAM still requiresextensive research in terms of its applications in dealing with patients and in orderto successfully launch programmes aimed at promoting its useworldwide andto eradicate all the other false notions about it.[Ethiop. J. Health Dev. 2022; 36(2):000-000]Keywords: Breast Cancerand gynaecological tumours,Complementary And Alternative Medicine (CAM), Complementary Oncology,Quality Of Life, Nutritional Diet and Spiritual Healing, HRQL (Health-Related Quality Of Life).IntroductionCancer has been the primaryconcern in Indiafrom the onset,resulting in thousands of deaths due to the lack of adequatemedication and therapy.Breast cancer is considered to bea common invasive form of cancer which is responsible for the second highest mortality rate among the primaryfatal conditions of cancer-causing deaths in women. Under the National Cancer Registry Program,the breast, cervix, uteri,and oral cavity(7)are the most common cancer sitesin women. According to statistics, 50-60% of all cancers amongIndian women are commonly found inthe cervix uteri, breast, corpus uteri and ovaries,which are the main organs forcancer invasion. The percentage of women who experience these types of cancer is increases, with more women becoming susceptible to breast cancer, in women up to 3-8% suffer fromovarian cancer,0.5-4.8%have cancer of the corpus uteri, 1-3% have vulva and/or gestational trophoblastic tumours and a staggering75,000 or more women have breast cancer. With the advancements of the disease through time,research programs were also improved in order to enable the improvement of existing measures and/or the development of new measures aimed at combating the diseas and decreasing mortality rates. Apart from the conventional chemotherapy technique,various other programs have been introduced andencorporated into treatment regimes in order to improve the lives of those who are affected by cancer.Complementary andAlternative Medicine (CAM) emphasizesthe methods and practices that are therapeutic and which help diagnose or curethe disease,these methods are intended tocomplement the conventional methods and can be used in place of mainstream medicine. Women with breast cancer and other gynaecological tumoursare increasingly inclined towards the use of CAM. With the increasing number of cancer reports in Indiaand the world,and with the principal amount leading to mortality, women with proper education and awareness are inclined to choosealternative methods rather than the old conventional ones. The side-effects resulting from the chemotherapy are immense and toxic,which is one of the reasons women are inclined to choose.Various research projects and cumulative studies have been conducted in order to review and discoverthe

Factors affecting family medicine programmes in Sub-Saharan Africa: a narrative review of recent literature

Objectives: This study sought to assess the level of anti-glycaemic medication-taking and its predictors among adults living with diabetes receiving treatment at Cape Coast Teaching Hospital (CCTH). Design: This was a cross-sectional study carried out among adults living with diabetes and receiving care at CCTH. Data on socio-demographic characteristics and anti-glycaemic medication-taking were gathered using a structured questionnaire. A scale consisting of 4 domains (filling prescribed medication; taking medications appropriately ac-cording to the instructions of healthcare professionals; practising behavioural modifications, and showing up for fol-low-up appointments) and eight items was used to measure the level of anti-glycaemic medication-taking. Descriptive statistics, chi-square test (and Fisher's exact test where appropriate), bivariate and multivariate logistic regression models were used in analysing the data. Setting: The study was carried out in the diabetes clinic in Cape Coast Teaching Hospital. Participants: The total enumerative sampling technique was used to select 250 adults living with diabetes and receiv-ing care at CCTH.Main outcome measures: Anti-glycaemic medication-taking Results: Out of 250 participants studied, 42% had high anti-glycaemic medication-taking. Predictors of anti-glycae-mic medication-taking included; forgetfulness (aOR=0.02, 95% CI: 0.00-0.64, p<0.001), patient's involvement in treatment plan (aOR=0.12, 95% CI: 0.02-0.64, p=0.014) and having good knowledge about one's medication (aOR=2.34, 95% CI: 1.10-4.98, p=0.028). Conclusion: Less than half of the sample population (42%) had high anti-glycaemic medication-taking, with forget-fulness, involvement in the treatment plan and good knowledge about anti-glycaemic medications, predicting medi-cation-taking