RESUMO
BACKGROUND: Penile prostheses are the third option in the treatment of erectile dysfunction, however, despite their proven effectiveness, the occurrence of infections, advanced age of patients and comorbidities are the main limiting factors for this treatment modality. In the continuous search for biointegrated, clinically durable and minimally invasive treatment options, a possible model of penile prosthesis was sought through the use of intracavernous bacterial cellulose (BC) gel, in an experimental model of orchiectomized rabbits. METHODS: Thirty adult New Zealand rabbits were equally distributed into three groups: BC; vehicle and control. Each group was then subdivided according to the follow-up time of 3 and 6 months. Bilateral orchiectomy was performed 3 weeks before injection in the BC and vehicle groups. Pachymetry measurements of the penile axis, diameter and length were performed in situ. Histomorphometry analyzes of the corpora cavernosa (CC), thickness of the tunica albuginea, cell density, collagen and elastic fibers post-injection were also performed, in addition to immunohistochemistry for newly formed vessels. RESULTS: The implant of BC increased both the length and thickness of the penis three and six months after the last injection, with a consequent increase in the diameter of the CC. On the other hand, the filling effect was not observed in the control and vehicle groups, confirming the degradation of this tissue after orchiectomy and the effectiveness of BC as a filling agent. Histomorphometry analyzes corroborate the mass effect of BC integrated into the tissue, permeated by predominantly lymphomononuclear inflammatory infiltrate, multinucleated giant foreign body cells, fibroblasts, elastic fibers and newly formed vessels, without degradation or loss of volume, even after six months of implantation. CONCLUSIONS: Biocompatibility and biointegration to the host tissue make BC a prosperous penile filling material, with local application and minimally invasive.
RESUMO
ABSTRACT Background Medical students' skills in radiographic image interpretation is neither known nor assessed in the case of most medical schools in Brazil. Objective The purpose of this study was to assess intern students' performance in the interpretation of radiographic images of the chest and abdomen. Methods A 10-item test was developed using non-contrasted radiological images from the chest and abdomen. Internship students from two public medical schools (Classroom Group, n=50) and doctors (Control Group, n=20) answered the test. A third group (Online Group, n=38) composed of students from different medical schools answered a web-based form with the same 10-item test. Results Doctors and students were able to accurately interpret only 30% of the radiographic images; 50% of the students and 30% of the doctors performed poorly. The rest produced average levels of performance. There were minimal differences between the Classroom and Online Groups. A point-by-point analysis of their answers has been presented and discussed. Conclusion Efforts must be made, including the framing of medical curricula interventions, to improve student interns' skills in radiological image interpretation.
RESUMO Introdução Habilidades de internos em medicina para interpretação de exames radiológicos não são avaliadas nem tampouco conhecidas pela maioria das escolas Médicas. Objetivo investigar o desempenho de estudantes do internato de medicina para interpretação de exames radiológicos de tórax e abdome. Métodos um teste com 10 radiografias não contrastadas de tórax e abdome com diagnósticos simples foi respondido por estudantes de internato (grupo Estudantes, n=50) e médicos (grupo Controle, n=20) e enviado a estudantes de internato por via eletrônica (Grupo Online, n=38). As respostas do grupo Estudantes foram comparadas ao Controle e ao Grupo Online separadamente. Resultados Em apenas 20% casos tanto médicos e estudantes tiveram um rendimento satisfatório, 40% dos casos dos médicos e em 50% dos estudantes o desempenho foi realmente ruim (menos e 40% de respostas corretas) e no restante das respostas o desempenho foi apenas mediano. Os estudantes do grupo Online obtiveram desempenho próximo aos estudantes do grupo Estudantes em 80% das questões. Uma análise ponto a ponto das respostas é cuidadosamente apresentada. Conclusões O desenvolvimento da competência em diagnóstico radiológico deve ser aprimorado. As escolas médicas devem se preocupar em desenvolver intervenções curriculares efetivas para aperfeiçoá-las.
