Undergraduate Teaching in Geriatrics and Pediatrics in Portuguese Medical Schools: An Observational Study.

INTRODUCTION: Motivated by the contracting nature of the Portuguese age pyramid, and thereby the ever increasing geriatric population, the aim of this study was to compare the number of European Credit Transfer and Accumulation System Credits dedicated to Geriatrics with Pediatrics in Portuguese Medical Schools. MATERIAL AND METHODS: An observational, descriptive and cross-sectional study was conducted and included six Portuguese Medical Schools that have six years of training and a total of 360 credits. The study plans were obtained from the medical schools' websites or requested. Schools were grouped in modular/classic teaching methodology and the courses were categorized in mandatory/optional and specific/related. The credits of Geriatrics and Pediatrics were compared. RESULTS: Four schools had classical methodology and two had a modular one. Overall, they had more credits dedicated to Pediatrics than Geriatrics. Three schools offered mandatory courses specifically oriented to Geriatrics (1.5 - 8 credits) compared to all schools mandatory courses courses on Pediatrics (5.7 - 26.5 credits). The ratio of averages of mandatory specific courses (Pediatrics/Geriatrics) was 12.4 in the classical and 1.5 in the modular group. DISCUSSION: Pediatrics teaching has revealed to be superior to Geriatrics in all categories. Based on our results, we consider the Portuguese Geriatrics' undergraduate teaching sub-optimal. CONCLUSION: Nowadays, geriatric population is quantitatively similar to pediatric population. Efforts should be made to adequate Geriatrics teaching to our reality in order to provide a more adequate health care to this age group.

Introdução: Motivados pelo aumento do número de idosos em Portugal, propusemo-nos a comparar o número de créditos atribuídos a Geriatria e a Pediatria pelo Sistema Europeu de Transferência de Créditos nas Escolas Médicas Portuguesas. Material e Métodos: Estudo observacional, descritivo e transversal incluindo seis Escolas Médicas com seis anos de formação e um total de 360 créditos. Os dados foram colhidos em março e abril de 2016, dos sítios da Internet das faculdades ou pedidos quando não disponibilizados. As Escolas foram divididas pela metodologia de ensino (clássica/modular) e as disciplinas por categorias (obrigatória/ opcional e específica/relacionada). Os créditos obtidos para a Geriatria e Pediatria foram comparados. Resultados: Das Escolas Médicas incluídas, duas tinham metodologia modular e as restantes clássica, dedicando globalmente mais créditos ao ensino de Pediatria que Geriatria. Três ofereciam cadeiras obrigatórias específicas para Geriatria (1,5 - 8 créditos), enquanto que todas ofereciam cadeiras obrigatórias específicas para Pediatria (5,7 - 26,5 créditos). O rácio das médias de créditos obrigatórios e específicos (Pediatria/Geriatria) foi de 12,4 nas clássicas e 1,5 nas modulares. Discussão: Globalmente, o ensino da Pediatria é superior ao da Geriatria em todas as categorias. Através dos resultados obtidos, consideramos que o ensino pré-graduado de Geriatria em Portugal não é adequado. Conclusão: Apesar da população geriátrica ser epidemiologicamente semelhante à pediátrica, as Escolas Médicas Portuguesas dedicam mais tempo ao ensino da Pediatria. São necessários ajustes aos planos de estudo para melhorar os cuidados de saúde prestados a este grupo populacional.

Genomic characterization of two large Alu-mediated rearrangements of the BRCA1 gene.

To determine whether a large genomic rearrangement is actually novel and to gain insight about the mutational mechanism responsible for its occurrence, molecular characterization with breakpoint identification is mandatory. We here report the characterization of two large deletions involving the BRCA1 gene. The first rearrangement harbored a 89,664-bp deletion comprising exon 7 of the BRCA1 gene to exon 11 of the NBR1 gene (c.441+1724_oNBR1:c.1073+480del). Two highly homologous Alu elements were found in the genomic sequences flanking the deletion breakpoints. Furthermore, a 20-bp overlapping sequence at the breakpoint junction was observed, suggesting that the most likely mechanism for the occurrence of this rearrangement was nonallelic homologous recombination. The second rearrangement fully characterized at the nucleotide level was a BRCA1 exons 11-15 deletion (c.671-319_4677-578delinsAlu). The case harbored a 23,363-bp deletion with an Alu element inserted at the breakpoints of the deleted region. As the Alu element inserted belongs to a still active AluY family, the observed rearrangement could be due to an insertion-mediated deletion mechanism caused by Alu retrotransposition. To conclude, we describe the breakpoints of two novel large deletions involving the BRCA1 gene and analysis of their genomic context allowed us to gain insight about the respective mutational mechanism.