Dimensión ética en la práctica odontológica: visión personalista / Dimensão ética na prática odontológica: visão personalista / Ethical dimension in dentristy practice: personalist viewpoint

En la práctica odontológica, los profesionales enfrentan permanentemente diversos dilemas éticos. Cada odontólogo debe tomar determinaciones sobre si tiene o no competencia para realizar un diagnóstico particular o para llevar a cabo tratamientos específicos en determinadas circunstancias clínicas. Asuntos como éstos han dado lugar a un número cada vez mayor de discusiones y debates respecto de la ética en cuidados de la salud. Las preocupaciones de carácter ético resultan especialmente relevantes en el campo de la odontología, en virtud de que, a medida que crece el número de estudios en este campo, se estrecha la línea que separa la práctica de la obtención de información con fines de investigación.

In the practice of dentistry, professionals face diverse ethical dilemmas permanently. Every dentist must make determinations whether he/she has competence for a particular diagnose or to carry out specific treatments in specific clinical circumstances. Issues such as these have given place to increasing discussions and debates with respect to health care ethics. Ethical worries are specially relevant in dentistry field, since while number of studies increase in this field, the limit separating practice from obtaining information for research purposes is narrowed.

Na prática odontológica, os profissionais enfrentam permanentemente diversos dilemas éticos. Cada odontólogo deve tomar decisões acerca de sua competência ou não para realizar um diagnóstico particular ou levar a cabo tratamentos específicos em determinadas circunstâncias clínicas. Assuntos como estes têm dado lugar a um número cada vez maior de discussões e debates a respeito da ética em cuidados da saúde. As preocupações de caráter ético resultam especialmente relevantes no campo da odontologia, em virtude de que, à medida que cresce o número de estudos neste campo, se estreita a linha que separa a prática da obtenção de informação com finalidades de investigação.

Composición corporal en niños preescolares: comparación entre métodos antropométricos simples, bioimpedancia y absorciometría de Doble Haz de Rayos X / Body composition by simple anthropometry, bioimpedance and DXA in Preschool Children: interrelationships among methods

Objetivo. Comparar la composición corporal estimadapor dos métodos antropométricos simples ypor impedanciometría (BIA, por sus siglas en inglés)y absorciometría de doble haz de rayos X(DXA, por sus siglas en inglés) y estudiar las correlacionesexistentes entre ellos, en una poblaciónpreescolar de Argentina.Población, material y métodos. Se estudió transversalmenteuna población clínicamente sana, deedad comprendida entre 4 y 6 años, de 230 niños(118 varones y 112 niñas), que concurrían a JardinesIntegrales de La Matanza, Argentina. Se determinóel índice de masa corporal (IMC), la circunferenciade cintura (Cci) y el contenido de grasa corporal,expresado como porcentaje, por BIA (Maltron BF-900) y por DXA (densitómetro Lunar DPX-L, softwarepediátrico).Resultados. En IMC y Cci no se observaron diferenciasestadísticamente significativas entre ambossexos, pero sí en el porcentaje de grasa corporal porBIA o DXA. La correlación entre BIA y ambos métodosantropométricos fue moderada (r de Pearson=0,43-0,53), al igual que entre DXA y Cci (r= 0,66),mientras que las demás correlaciones fueron fuertes(r= 0,71-0,83). Las medidas obtenidas por BIA yDXA no concordaron (prueba de Bland Altman); sinembargo, las diferencias se distribuyeron en formahomogénea a lo largo del eje horizontal e independientementede las medias. BIA reprodujo valoresmás bajos de porcentaje de grasa corporal que DXA(p <0,0001).Conclusiones. Existe buena correlación entre losmétodos antropométricos sencillos y la bioimpedanciay DXA. Sin embargo, los resultados no sonintercambiables, incluso entre BIA y DXA

Objective. To examine the interrelationships of body composition variables derived from simple anthropometry, bioelectrical impedance (BIA) and dualenergy X-ray absorptiometry (DXA). Population, material and methods. A total of 230 healthy preschool children (118 males and 112 females) age 4-6 years, attending a day care center, were examined to determine body mass index (BMI) and waist circumference (WC). Percentage of body fat content (%BF) was predicted by BIA (Maltron BF- 900) and DXA (Lunar DPX-L, pediatric software). Results. BMI and WC did not show significant differences among sex, while %BF by BIA or DXA did. BIA measures were lower than DXA´s (p <0.0001). Correlation between BIA vs. anthropometric methods and WC vs. DXA were moderate (Pearson r= 0.43 to 0.53), whereas the other correlations were strong (r= 0.71 to 0.83). However Bland Altman comparison showed wide limits of agreementbetween BIA and DXA; BIA significantly underestimated %BF as determined by DXA (p <0.0001). Conclusion. The methods used to estimate body composition in healthy preschool children highly correlated. However, the Bland Altman procedure suggests that BIA and DXA should not be used interchangeably.

The need for pedagogical qualifications for teaching Cardiology to undergraduate students / Necessidade de referências pedagógicas para o ensino de Cardiologia, no curso de graduação

OBJECTIVE: To report a training program in cardiology emphasizing changes in its pedagogical practice. These changes were put into practice by some teachers at the Medical School of Porto Alegre of the University of Rio Grande do Sul (FAMED/UFRGS) aiming to make faculty and student activities more dynamic and to promote more efficacious learning. The training program is directed at 5th semester medical students and aims at a behavioral change in teachers and students to promote more interaction, to favor exchanges, and to make the teaching-learning process easier, always maintaining the patient in the center of the medical activity. METHODS: The program emphasizes the definition of general and specific objectives for each activity to be developed by the students, with training in the area of admission to the cardiology service, with special emphasis on behavioral change in the cognitive, motor, affective, and attitudinal areas. Knowledge was developed by means of interactive seminars with initial and final assessment tests to identify students' and teachers' performance. The students were evaluated in an immediate, continuous, and progressive way in their daily activities and through comparison of the results of 2 tests, one applied at the beginning of the training and the other at its end. These 2 tests contained the same questions. RESULTS: We systematically assessed 560 students over 4 years. The mean grades of the tests performed prior to and after the 244 seminars were 7.38±1.66 and 9.17± 0.82, respectively (p<0.0001). For the tests applied at the beginning and at the end of the training, the mean grades were 5.61±1.61 and 9.37±0.90, respectively (p<0.0001). CONCLUSION: The program proved to be efficient both for the students' learning and for assessing their performance in a systematic and objective way