ABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Hutchinson's Melanotic Freckle/etiology , Herpes Zoster Ophthalmicus/diagnosis , Acyclovir/therapeutic useABSTRACT
Objetivos. Evaluar el efecto de las dosis altas de corticoides en pacientes ingresados por exacerbación de una enfermedad pulmonar obstructiva crónica (EPOC). Pacientes y métodos. Estudio de cohortes prospectivo de enfermos hospitalizados con EPOC entre enero y marzo de 2015, agrupados en función de la dosis de glucocorticoides recibida (punto de corte: 40mg de prednisona/día). Se compararon los resultados de estancia hospitalaria, y de reingreso y mortalidad a los 3 meses del alta. Resultados. Se analizaron 87 pacientes. La mediana de la dosis diaria recibida fue de 60mg de prednisona/día (rango intercuartílico: 46,67-82,33mg/día); la vía de administración fue endovenosa en el 96,6% de los casos. Se estableció un riesgo relativo (RR) de estancia superior a 8 días de 1,095 [intervalo de confianza (IC) 95%: 0,597-2,007; p=0,765] cuando se usaban dosis de esteroides superiores a 40mg/día. Además, en estos pacientes la hazard ratio (HR) para el reingreso durante los 3 meses siguientes al alta fue de 0,903 [IC 95%: 0,392-2,082; p=0,811] y la mortalidad de 1,832 (IC 95%: 0,229-16,645; p=0,568]. Ni el RR ni las HR observadas variaron de forma estadísticamente significativa tras el ajuste por factores de confusión. Conclusiones. Una dosis superior a 40mg diarios de prednisona en pacientes ingresados por exacerbación de EPOC no se asocia a una menor estancia hospitalaria ni a una disminución del reingreso y de la mortalidad a los 3 meses (AU)
Objectives. To assess the effect of high doses of corticosteroids in patients hospitalised for exacerbation of chronic obstructive pulmonary disease (COPD). Patients and methods. A prospective cohort study was conducted on patients hospitalized with COPD between January and March 2015, grouped according to the glucocorticoid dosage administered (cutoff, 40mg of prednisone/day). We compared the results of hospital stay, readmission and mortality at 3 months of discharge. Results. We analysed 87 patients. The median daily dose was 60mg of prednisone (interquartile range, 46.67-82.33mg/day), and the administration route was intravenous in 96.6% of the cases. We established a relative risk (RR) for hospital stays longer than 8 days of 1.095 (95% CI 0.597-2.007; P=.765) when steroid dosages greater than 40mg/day were employed. In these patients, the hazard ratio (HR) for readmission in the 3 months after discharge was 0.903 (95% CI 0.392-2.082; P=.811), and the mortality was 1.832 (95% CI 0.229-16.645; P=.568). Neither the RR nor the HR varied in a statistically significant manner after adjusting for confounding factors. Conclusions. A daily dose greater than 40mg of prednisone in patients hospitalised for COPD exacerbation was not associated with a shorter hospital stay or a reduction in readmissions or mortality at 3 months (AU)
Subject(s)
Humans , Adrenal Cortex Hormones/administration & dosage , Pulmonary Disease, Chronic Obstructive/drug therapy , Prednisone/administration & dosage , Recurrence , Prospective Studies , Treatment Outcome , Length of Stay/statistics & numerical data , Patient Readmission/statistics & numerical data , Indicators of Morbidity and MortalityABSTRACT
OBJECTIVES: To assess the effect of high doses of corticosteroids in patients hospitalised for exacerbation of chronic obstructive pulmonary disease (COPD). PATIENTS AND METHODS: A prospective cohort study was conducted on patients hospitalized with COPD between January and March 2015, grouped according to the glucocorticoid dosage administered (cutoff, 40mg of prednisone/day). We compared the results of hospital stay, readmission and mortality at 3 months of discharge. RESULTS: We analysed 87 patients. The median daily dose was 60mg of prednisone (interquartile range, 46.67-82.33mg/day), and the administration route was intravenous in 96.6% of the cases. We established a relative risk (RR) for hospital stays longer than 8 days of 1.095 (95% CI 0.597-2.007; P=.765) when steroid dosages greater than 40mg/day were employed. In these patients, the hazard ratio (HR) for readmission in the 3 months after discharge was 0.903 (95% CI 0.392-2.082; P=.811), and the mortality was 1.832 (95% CI 0.229-16.645; P=.568). Neither the RR nor the HR varied in a statistically significant manner after adjusting for confounding factors. CONCLUSIONS: A daily dose greater than 40mg of prednisone in patients hospitalised for COPD exacerbation was not associated with a shorter hospital stay or a reduction in readmissions or mortality at 3 months.
ABSTRACT
Fundamento y objetivos. El médico residente desempeña una labor importante, aunque escasamente evaluada, en la enseñanza del estudiante de medicina. El objetivo de este estudio fue conocer la opinión de los estudiantes sobre la actividad docente del residente. Material y método. Encuesta autocumplimentada por estudiantes de medicina de la Universidad de Alcalá (España) durante el último año de su formación universitaria. Se evaluó la opinión de los estudiantes en relación con las habilidades docentes y asistenciales de los residentes y de los facultativos especialistas según una escala de Likert de 5 puntos. Resultados. Se obtuvieron 104 encuestas. Un 69,9% de los alumnos percibían al residente como fuente de más de la mitad de lo aprendido durante sus prácticas. Los estudiantes piensan que la labor docente del residente no está suficientemente reconocida (94,2%), creen necesaria la adquisición de habilidades docentes durante la residencia (82,7%) y se muestran favorables a tutorizar a alumnos de cursos anteriores (88,5%). Además, puntúan mejor al residente en habilidades relacionales en comparación con los facultativos especialistas. Conclusiones. Existe una percepción positiva del residente como docente entre los estudiantes de medicina, lo que sugiere la necesidad de mejorar las habilidades docentes del residente (AU)
Background and objectives. Residents play an important but scanty assessed role in medical students teaching. The aim of this study was to assess the perception of medical students about residents teaching activity. Material and methods. Autofilled survey provided to medical students of the University of Alcalá (Spain) in the final year in their school of medicine. Student opinion about care and teaching abilities of residents and physicians was evaluated using a 5-point Likert scale. Results. 104 surveys were collected. A 69,9% of students consider that as much as 50% of their knowledge came from rounds with residents. Students believe that resident teaching lacks enough academical acknowledgment (94.2%); they estimate necessary to acquire teaching skills during residency (82,7%), and they would like to provide tutoring other medical students (88,5%). Students rated residents better than physicians on relational and motivational abilities. Conclusions. There is a positive view about resident as a teacher among medical students, which suggests the need to improve the resident's teaching skills (AU)
Subject(s)
Humans , Male , Female , Students, Medical/statistics & numerical data , Education, Medical/methods , Education, Medical/trends , Internship and Residency/methods , Internship and Residency/statistics & numerical data , Internship and Residency/standards , Health Knowledge, Attitudes, Practice , Data Collection/methods , Socioeconomic Survey , 28599ABSTRACT
BACKGROUND AND OBJECTIVES: Residents play an important but scanty assessed role in medical students teaching. The aim of this study was to assess the perception of medical students about residents' teaching activity. MATERIAL AND METHODS: Autofilled survey provided to medical students of the University of Alcalá (Spain) in the final year in their school of medicine. Student opinion about care and teaching abilities of residents and physicians was evaluated using a 5-point Likert scale. RESULTS: 104 surveys were collected. A 69,9% of students consider that as much as 50% of their knowledge came from rounds with residents. Students believe that resident teaching lacks enough academical acknowledgment (94.2%); they estimate necessary to acquire teaching skills during residency (82,7%), and they would like to provide tutoring other medical students (88,5%). Students rated residents better than physicians on relational and motivational abilities. CONCLUSIONS: There is a positive view about resident as a teacher among medical students, which suggests the need to improve the resident's teaching skills.
ABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Pathology, Clinical/education , Pathology, Clinical/methods , Pathology, Clinical/trends , Teaching/methods , Teaching/organization & administration , Internal Medicine/education , Internal Medicine/methods , Internal Medicine/organization & administration , Internal Medicine/standards , Internship and Residency/methods , Internship and Residency/organization & administration , Internship and Residency/standardsABSTRACT
El médico residente desempeña un papel importante en la enseñanza clínica del estudiante de medicina. Esa labor, que se supone útil y beneficiosa para ambos, ha sido pocas veces evaluada y tiene un escaso reconocimiento académico. A pesar de que los estudiantes valoran positivamente la docencia que reciben de los residentes, estos no se sienten preparados para afrontar el reto de enseñar. Se han diseñado algunos programas para mejorar las habilidades docentes del residente con buenos resultados. La asociación entre hospitales y universidades es fundamental para elaborar y dotar de reconocimiento académico estos programas, cuya financiación debe ser compartida. La Medicina Interna debe participar de forma activa en la enseñanza clínica y potenciar la figura del residente como docente a través de actividades de formación que se adapten a los nuevos tiempos de nuestra especialidad(AU)
Residents play an important role in the clinical teaching of medical students. Although this role is usually considered beneficial for both students and residents, it has rarely been evaluated and lacks academic recognition. Despite the fact that students value the teaching provided by residents positively, residents feel unprepared to teach. Some programs to improve resident teaching skills have been successfully developed. Association between hospitals and universities is essential to develop and provide with academic recognition these programs, whose funding should be shared. Internal Medicine should participate actively in clinical teaching and promote the figure of the resident as teacher by means of training activities adapted to the new times of our speciality(AU)
Subject(s)
Humans , Male , Female , Internship and Residency/ethics , Education, Medical/methods , Education, Medical/trends , Internal Medicine/methods , Internal Medicine/trends , Education, Medical/ethics , Education, Medical/organization & administration , Education, Medical/standards , Internal Medicine/education , Internal Medicine , Internal Medicine/organization & administrationSubject(s)
Pneumonia, Mycoplasma/complications , Pneumonia, Mycoplasma/diagnosis , Pneumonia, Mycoplasma/drug therapy , Nontuberculous Mycobacteria/isolation & purification , Mycobacterium Infections, Nontuberculous/complications , Mycobacterium Infections, Nontuberculous/diagnosis , Mycobacterium Infections, Nontuberculous/drug therapy , Chickenpox/complications , Chickenpox/diagnosis , Pneumonia, Mycoplasma/microbiology , Nontuberculous Mycobacteria/metabolism , Mycobacterium Infections, Nontuberculous/microbiology , Mycobacterium Infections, Nontuberculous/physiopathologyABSTRACT
Residents play an important role in the clinical teaching of medical students. Although this role is usually considered beneficial for both students and residents, it has rarely been evaluated and lacks academic recognition. Despite the fact that students value the teaching provided by residents positively, residents feel unprepared to teach. Some programs to improve resident teaching skills have been successfully developed. Association between hospitals and universities is essential to develop and provide with academic recognition these programs, whose funding should be shared. Internal Medicine should participate actively in clinical teaching and promote the figure of the resident as teacher by means of training activities adapted to the new times of our speciality.
