ABSTRACT
Patients with monogenic obesity display numerous medical features on top of hyperphagic obesity, but no study to date has provided an exhaustive description of their semiology. Two reviewers independently conducted a systematic review of MEDLINE, Embase, and Web of Science Core Collection databases from inception to January 2022 to identify studies that described symptoms of patients carrying pathogenic mutations in at least one of eight monogenic obesity genes (ADCY3, LEP, LEPR, MC3R, MC4R, MRAP2, PCSK1, and POMC). Of 5207 identified references, 269 were deemed eligible after title and abstract screening, full-text reading, and risk of bias and quality assessment. Data extraction included mutation spectrum and mode of inheritance, clinical presentation (e.g., anthropometry, energy intake and eating behaviors, digestive function, puberty and fertility, cognitive features, infectious diseases, morphological characteristics, chronic respiratory disease, and cardiovascular disease), biological characteristics (metabolic profile, endocrinology, hematology), radiological features, and treatments. The review provides an exhaustive description of mandatory, non-mandatory, and unique symptoms in heterozygous and homozygous carriers of mutation in eight monogenic obesity genes. This information is critical to help clinicians to orient genetic testing in subsets of patients with suspected monogenic obesity and provide actionable treatments (e.g., recombinant leptin and MC4R agonist).
ABSTRACT
The paper proposes a methodology that emphasis techno-pedagogy, namely the constructivist and the adaptive intelligent learning of specialized semiology of COVID-19. An e-learning built on a constructivist pedagogy with a technology such adaptive intelligent environment, can be individualized (adaptive learning), can enhance learners' interactions with others (collaborative learning), and transforming the role of the teacher as facilitators of learning and assessor of competency. To make our system intelligent, we cope with Artificial Intelligence and Big data.
Subject(s)
COVID-19 , Computer-Assisted Instruction , Education, Medical , Humans , Computer-Assisted Instruction/methods , Artificial Intelligence , Learning , Education, Medical/methods , TeachingABSTRACT
En la actualidad existe desarrollo de la tecnociencia aplicada a la medicina con tendencia a relegar a un segundo plano el método clínico. Las diferentes escuelas de medicina del mundo, incluyendo la cubana, han comenzado una modernización del método clínico, el cual está basado en un método científico, por lo que es importante centrar su enseñanza en aspectos eminentemente prácticos, además de usar adecuadamente los exámenes complementarios para ratificar el diagnóstico, pronóstico y tratamiento del enfermo. El objetivo de esta investigación es aunar criterios sobre la enseñanza y aplicación del método clínico, para ello se hacen algunas reflexiones sobre su utilidad práctica, los programas actuales de su enseñanza y los textos en los que se basa. La conceptualización del método clínico es fruto de la Escuela Cubana de Clínica, donde los internistas han tenido una función importante en los últimos 50 años. Los especialistas de esta área del conocimiento, junto a todos los médicos asistenciales que están en la necesidad de utilizar este método para el manejo de sus enfermos, están llamados a continuar con la tarea de mantener y transmitir la esencia misma de la clínica, en medio de un ambiente inestable y cambiante(AU)
At present, due to the development of techno science applied to medicine, there is a tendency to overshadow the clinical method. Different medical schools in the world, including the Cuban school, have begun the modernization of the clinical method, which is based on the scientific method. Therefore, it is important to focus teaching on the eminently practical aspects, in addition to properly using complementary tests to confirm the patient´s diagnosis, prognosis and treatment. The objective of this research is to combine criteria on the teaching and use of the clinical method. Some reflections arise from its practical convenience, current syllabus and the texts on which it is based. The conceptualization of the clinical method is the result of the Cuban School of Clinic, where internists have played important role in the last 50 years. The specialists of this area of knowledge, together with all the medical assistants who need to use this method for treating their patients, are called to continue with the task of maintaining and transmitting the very essence of the clinic, in the midst of unstable and changing circumstances(AU)
Subject(s)
Humans , Technology Assessment, Biomedical/ethics , Clinical Diagnosis/diagnosis , Clinical Diagnosis/education , Education, Medical, Undergraduate/methodsABSTRACT
En la lucha por la excelencia en todos los servicios de salud el empleo sistemático y generalizado del método clínico, es sin duda, un factor clave. Existen deficiencias encontradas en la didáctica de impartición de los contenidos del programa de estudio del 3er. año de la carrera de Medicina por parte de los docentes. El objetivo del presente trabajo es insistir en las didácticas particulares de impartición, que garantizan la formación y sientan las bases para el posterior desarrollo de los métodos de trabajo de la profesión médica, encaminadas a que el estudiante logre las habilidades que se requieren en la correcta aplicación del método clínico y esto se lo enseña la Semiología y la Clínica Propedéutica. Cada tarea docente posee definido el objetivo a alcanzar por el alumno, la habilidad a adquirir. Debe haber un dominio del programa de la asignatura por los profesores: conocer bien los objetivos, los contenidos y las orientaciones metodológicas y didácticas para su impartición...
In striving for excellence in all health services, the systematic and generalized use of the clinical method is beyond any doubt a key factor. There are deficiencies in teaching the contents of the 3rd year medical curricula. The objective of the present paper was to put emphasis on the particular didactics that guarantee the formation and lay the bases for the further development of the working methods of the medical profession; they are also aimed at making the student attain the required abilities to correctly follow the clinical method and this is specifically taught in Semiology and Clinical Propaedeutics. Each educational task has the defined goal that the student should meet and the ability that he should acquire. The professors must master the curricula of their subject, which includes knowing well the objectives, the contents and the methodological and didactic guidelines to teach it...
Subject(s)
Humans , Education, Medical/methods , Education, Medical/organization & administrationABSTRACT
En la lucha por la excelencia en todos los servicios de salud el empleo sistemático y generalizado del método clínico, es sin duda, un factor clave. Existen deficiencias encontradas en la didáctica de impartición de los contenidos del programa de estudio del 3er. año de la carrera de Medicina por parte de los docentes. El objetivo del presente trabajo es insistir en las didácticas particulares de impartición, que garantizan la formación y sientan las bases para el posterior desarrollo de los métodos de trabajo de la profesión médica, encaminadas a que el estudiante logre las habilidades que se requieren en la correcta aplicación del método clínico y esto se lo enseña la Semiología y la Clínica Propedéutica. Cada tarea docente posee definido el objetivo a alcanzar por el alumno, la habilidad a adquirir. Debe haber un dominio del programa de la asignatura por los profesores: conocer bien los objetivos, los contenidos y las orientaciones metodológicas y didácticas para su impartición(AU)
In striving for excellence in all health services, the systematic and generalized use of the clinical method is beyond any doubt a key factor. There are deficiencies in teaching the contents of the 3rd year medical curricula. The objective of the present paper was to put emphasis on the particular didactics that guarantee the formation and lay the bases for the further development of the working methods of the medical profession; they are also aimed at making the student attain the required abilities to correctly follow the clinical method and this is specifically taught in Semiology and Clinical Propaedeutics. Each educational task has the defined goal that the student should meet and the ability that he should acquire. The professors must master the curricula of their subject, which includes knowing well the objectives, the contents and the methodological and didactic guidelines to teach it(AU)
Subject(s)
Education, Medical/methods , Education, Medical/organization & administrationABSTRACT
This text develops three interwoven issues: first, a succinct comparative analysis of medical and psychiatric semiology, which proposes that the lack of referring relations between psychiatric symptoms and brain/psychic dysfunction is a fundamental distinction between medical and psychiatric semiology. Second, the multiple features of psychiatric semiology are reviewed. Third, a new approach to psychopathology is introduced, proposing three different ways to shape symptoms (perception, linguistic structure, praxis); highlighting its role as a cognitive activity that creates intelligibility from undifferentiated experiences; and distinguishing psychopathology and semiology on an activity/product relation basis.
