ESTIMATIVA DE ACERTOS EM TESTE DE PROGRESSO - UMA DAS POSSIBILIDADES DE AVALIAÇÃO DOS ALUNOS

Introdução: O teste de progresso é um método muito utilizado para avaliação da evolução de um acadêmico dentro da faculdade e da qualidade de ensino da mesma, porém ainda restam dúvidas se é possível ter um padrão de desenvolvimento concreto entre alunos de semestres distintos e se isso consegue ser quantificado. Objetivo: Estimar a porcentagem de acertos no Teste de Progresso baseado na etapa que o aluno se encontra em uma faculdade de medicina do estado de São Paulo.Método: Foi feito uma análise de todos os 12 testes de progresso realizados pela instituição desde sua abertura e foi levado em consideração todas as provas de cada etapa, para assim levantar uma análise estatística da taxa de acertos por aluno em determinado semestre, dos 12 semestre do curso de medicina.Resultado: Foi observado um aumento progressivo das notas dos acadêmicos ao longo dos semestres, com acentuada queda da média no 9º semestre, além disso os alunos de diferentes etapas adquiriam notas distintas.Conclusão: O teste de progresso é uma ótima ferramenta de avaliação de desenvolvimento do aluno e da instituição de ensino no geral, porém não tem uma acurácia boa o bastante para servir como padrão-ouro de avaliação, sendo necessários outros métodos de avaliação de metodologia de ensino e desenvolvimento acadêmico para obter resultados mais precisos.Palavras-chave: Teste de Progresso; Educação Médica; Medicina; Universidade.ABSTRACTIntroduction: The progress test is a widely used method for evaluating the evolution of an academic within the faculty and the quality of teaching of the same, but there are still doubts if it is possible to have a concrete pattern of development among students from different semesters and if this can be quantified. Objective: Estimate the percentage of correct answers in the Progress Test based on the stage that the student is in a medical school in the state of São Paulo.Method: An analysis was made of all 12 progress tests carried out by the institution since its opening and all the tests of each stage were taken into account, in order to carry out a statistical analysis of the success rate per student in a given semester, of the 12 semesters of the course. of medicine.Result: A progressive increase in academic grades was observed throughout the semester, with a sharp drop in the average in the 9th semester, in addition, students from different stages acquired different grades.Conclusion: The progress test is a great tool for evaluating the development of the student and the educational institution in general, but it is not accurate enough to serve as the gold standard of evaluation, requiring other methods of evaluation of teaching methodology and academic development to obtain more accurate results.Keywords: Progress Test; Medical Education; Medicine; University.

MEASURES TO REDUCE THE IMPACT OF SMOKING ON MORTALITY RATES FROM CARDIOVASCULAR DISEASES: SYSTEMATIC LITERATURE REVIEW

Introduction: The prevalence of smoking and its health risks remain high. Considered a predictor for cardiovascular diseases, health interventions and policy changes regarding tobacco consumption are increasingly necessary to reduce morbidity and mortality in the population.Aims: To identify the measures used to reduce smoking impact on mortality from cardiovascular diseases.Materials and Methods: Systematic review study using PubMed, SciELO and VHL databases to search for studies published from 2017 to 2022. The search was conducted considering the terms “cigarettes”, “smoking'', “heart disease”, “mortality”, “rates” and “reduce”. The article's quality was assessed using the Study Quality Assessment Tool from the Department of Health and Human Services (NHLBI).Results: A total of 29 studies were identified; 13 studies were eligible and included. The most prevalent ischemic and non-ischemic cardiovascular diseases associated with smoking were coronary heart disease, ischemic heart, stroke and heart attack. The increase in cigarette taxes and tobacco products, the use of pictorial warning labels on cigarette packaging, implementation of the Tobacco Control Law were the measures that demonstrated a significant reduction in mortality rates from cardiovascular diseases associated with smoking, followed by initiatives of public health and health education and prevention.Conclusion: Economic measures,  especially those that attributed an increase in the price of cigarettes and tobacco-related products, educational and public health initiatives positively impacted the reduction of smoking, and minimization of morbidity, mortality of individuals from cardiovascular diseases and health expenses.Keywords: tobacco; cardiovascular disease; morbidity; mortality; health impact assessment.    

Quality of life scores differs between genotypic groups of patients with suspected hereditary hemochromatosis

Background: Hereditary hemochromatosis (HH) encompasses a group of autosomal recessive disorders mainly characterized by enhanced intestinal absorption of iron and its accumulation in parenchymal organs. HH diagnosis is based on iron biochemical and magnetic resonance imaging (MRI) assessment, and genetic testing. Questionnaires, such as SF-36 (short form health survey), have been increasingly used to assess the impact of diseases on the patient's quality of life (QL). In addition, different genotypes are identified as results of genetic tests in patients with suspected primary iron overload. In the present study, our aim was to evaluate whether domains of QL are different according to genotypic groups in patients suspected of HH. Methods: Seventy-nine patients with primary iron overload were included and two genotypic groups were formed (group 1: homozygous genotype for the HFE p.Cys282Tyr mutationgroup 2: other genotypes). Results: Group 1 had higher means of plasma transferrin saturation (86 +/- 19%) and serum ferritin (1669 +/- 1209 ng/mL) compared to group 2 (71 +/- 12%, 1252 +/- 750 ng/mL, respectivelyp = 0.001). Four domains were significantly different among groups 1 and 2: physical functioning (p = 0.03), bodily pain (p = 0.03), vitality (p = 0.02) and social functioning (p = 0.01). Conclusions: Our main finding was that patients with p. Cys282Tyr homozygosity had a worse QL scenario assessed by SF-36, compared with patients with iron overload without the same genotype. Being aware of this relationship between genotypes and QL might be helpful in the overall management of patients suspected of hereditary hemochromatosis.Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES) [2013/09295-3]Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP), Brazil [2013/20614-3]Univ Sao Paulo, Heart Inst InCor, Lab Genet & Mol Cardiol, Med Sch, Av Doutor Eneas de Carvalho Aguiar 44, BR-05403900 Sao Paulo, SP, BrazilSanta Casa Med Sch, Hematol & Hemotherapy Sect, Sao Paulo, BrazilAcad Ciencia & Tecnol, Sao Jose Do Rio Preto, BrazilFundacao Pro Sangue, Hemoctr Sao Paulo, Sao Paulo, SP, BrazilUniv Sao Paulo, Sao Paulo, SP, BrazilUniv Sao Paulo, Med Sch, Hosp Clin, Hematol Serv, Sao Paulo, BrazilUniv Sao Paulo, Med Sch, Hosp Clin, Hematol & Hemotherapy Discipline, Sao Paulo, BrazilUniv Rennes, Pontchaillou Univ Hosp, Liver Dis Unit, Rennes, FranceNatl Reference Ctr Rare Iron Overload Dis Genet O, Rennes, FranceUniv Fed Sao Paulo UNIFESP, Dept Pharmacol, Sao Paulo, BrazilUniv Fed Sao Paulo UNIFESP, Dept Pharmacol, Sao Paulo, BrazilCAPES: 2013/09295-3FAPESP: 2013/20614-3Web of Scienc

PERCEPTION OF MEDICINE ACADEMICS IN THE ACTIVE METHODOLOGY ON THE USE OF BIOLOGICAL MATERIALS IN SURGICAL PRACTICE AND THEIR APPLICATION IN HOSPITALITY: AN OBSERVATIONAL AND CROSS-SECTIONAL STUDY

Introduction: During the medical internship, the last phase of the medical degree, the student is exposed to internships in the medical field of general surgery in health services, where he receives intensive training to start developing his skills and practical surgical notions, in this way, for the student to be introduced early to the surgical scenario, the use of biological parts during practical classes in medical education becomes a tool for the improvement of the teaching-learning process.Objective: To evaluate the perception of medical students in active methodology on the use of biological parts in the teaching of Surgical Skills and their contributions to the medical internship.Methods: A descriptive cross-sectional study was conducted online where 106 boarding students (ninth, tenth, and eleventh semesters) of the medical course of a college in the interior of São Paulo were interviewed through a questionnaire using the Google Forms™ tool.Results: 106 students were included in the study, 65 (61.3%) were female and the median age was 26 years. 30.5% intend to follow surgery as a medical specialty, and the majority (45.3%) consider the use of the surgery course and performance in the surgery internship very satisfactory. 89.6% and 92.5% stated that the use of biological parts improved skills for the internship and is important for practical classes, respectively. The most relevant procedures addressed in the Surgical Skills discipline were ATLS (79.2%), hemostasis (76%), and cricotomy (56.6%). Skills in the development of surgical procedures (51.9%), instrumentation skills (45.3%), and safety in carrying out activities were the main contributions of surgery classes to internship activities identified by medical students. And this important is the acquisition of anatomical knowledge acquired during classes (68.9%). Most participants (56.6%) identified cricotomy as the main activity enhanced by the use of biological parts. The main contents not covered in the surgical skills were: urological (26.4%) and vascular (21.7%) surgery procedures. There was no relationship between the achievement of the college's surgery course and the student's performance in the surgery internship (p=0.10).Conclusion: According to the perception of medical students in active methodology, the biological model for teaching medical skills has shown promise in  favoring students' understanding and helping them to perform the necessary surgical procedures  during their internship.Keywords: Internship; Surgical skills; Biological parts; Practice; Active method.RESUMOIntrodução: Durante o internato médico, última fase do curso de medicina, o aluno é exposto a estágios na área médica de cirurgia geral em serviços de saúde, onde recebe formação intensiva para começar a desenvolver as suas competências e noções práticas cirúrgicas, desta forma, para que o aluno seja introduzido precocemente no cenário cirúrgico, o uso de peças biológicas durante as aulas práticas na educação médica torna-se uma ferramenta para a melhoria do processo ensino-aprendizagem.Objetivo: Avaliar a percepção de estudantes de medicina em metodologia ativa sobre o uso de peças biológicas no ensino de Habilidades Cirúrgicas e suas contribuições para o internato médico.Métodos: Foi realizado um estudo transversal descritivo online, onde foram entrevistados 106 alunos internos (nono, décimo e décimo primeiro semestre) do curso de medicina de uma faculdade do interior de São Paulo, por meio de questionário utilizando a ferramenta Google Forms™.Resultados: 106 alunos foram incluídos no estudo, 65 (61,3%) eram do sexo feminino e a idade mediana foi de 26 anos. 30,5% pretendem seguir a cirurgia como especialidade médica, e a maioria (45,3%) considera muito satisfatório o aproveitamento do curso de cirurgia e o desempenho no estágio de cirurgia. 89,6% e 92,5% afirmaram que o uso de peças biológicas melhorou as habilidades para o estágio e é importante para as aulas práticas, respectivamente. Os procedimentos mais relevantes abordados na disciplina Técnicas Cirúrgicas foram ATLS (79,2%), hemostasia (76%) e cricotomia (56,6%). Habilidades no desenvolvimento de procedimentos cirúrgicos (51,9%), habilidades de instrumentação (45,3%) e segurança na realização das atividades foram as principais contribuições das aulas de cirurgia para as atividades de estágio identificadas pelos estudantes de medicina. E este importante é a aquisição de conhecimentos anatômicos adquiridos durante as aulas (68,9%). A maioria dos participantes (56,6%) identificou a cricotomia como a principal atividade potencializada pelo uso de peças biológicas. Os principais conteúdos não contemplados nas habilidades cirúrgicas foram: procedimentos cirúrgicos urológicos (26,4%) e vasculares (21,7%). Não houve relação entre o aproveitamento do curso de cirurgia da faculdade e o desempenho do aluno no estágio de cirurgia (p=0,10).Conclusão: De acordo com a percepção dos estudantes de medicina na metodologia ativa, o modelo biológico para o ensino de habilidades médicas mostrou-se promissor em favorecer a compreensão dos estudantes e auxiliá-los na realização dos procedimentos cirúrgicos necessários durante o estágio.Palavras-chave: Estágio; Habilidades cirúrgicas; Partes biológicas; Prática; Método ativo.

Quality of Life Scores Remained Different among the Genotypic Groups of Patients with Suspected Hemochromatosis, Even after Treatment Period

International audienceBACKGROUND: Hemochromatosis is a genetic condition of iron overload caused by deficiency of hepcidin. In a previous stage of this study, patients with suspected hemochromatosis had their quality of life (QL) measured. We observed that QL scores differed among genotypic groups of patients. In this reported final phase of the study, the aims were to compare QL scores after a treatment period of approximately 3 years and to analyze a possible association of the serum ferritin values with QL scores. METHODS: Sixty-five patients were enrolled in this final phase and divided into group 1 (patients that showed primary iron overload and homozygous genotype for the HFE p.Cys282Tyr mutation) and group 2 (other kinds of genotypes). Short Form 36 (SF-36) was performed and consisted of eight domains with a physical and also a mental component. RESULTS: Both groups had a significant decrease in serum ferritin concentrations: group 1 had a variation from 1844 ± 1313 ng/mL to 281 ± 294 ng/mL, and group 2 had a variation from 1216 ± 631 ng/mL to 236 ± 174 ng/mL. Group 1 had a smaller mean value for these six SF-36 domains compared with group 2, indicating a worse QL. CONCLUSIONS: In this final stage, six domains demonstrated a difference among genotypic groups (role emotional and mental health, adding to the four of the initial phase), reassuring the impact of the identified genotype on the QL of hemochromatosis patients. Furthermore, despite that both patient groups demonstrated similar and significant decreases in serum ferritin values, no association was found between the decrease in this biological parameter and the SF-36 domains

Novel mutations in the bone morphogenetic protein 6 gene in patients with iron overload and non-homozygous genotype for the HFE p.Cys282Tyr mutation

International audienceBackground - Five main genes are associated with hemochromatosis; however, current studies show that, in addition to these genes, others may be associated with primary iron overload (IO). One of these is the bone morphogenetic protein 6 (BMP6), which encodes a protein that modulates hepcidin synthesis and, consequently, iron homeostasis. Aim - To identify BMP6 gene pathogenic variants in patients with IO and non-homozygous genotype for the HFE p.Cys282Tyr mutation. Materials and methods - Fifty-three patients with primary IO and non-homozygous genotype for the HFE p.Cys282Tyr were selected. Subsequent bidirectional DNA sequencing of BMP6 exons was performed. Results - Two novel variants were found. One at homozygous state p.Gln158Ter (c.472C>T) was pathogenic, the other one at heterozygous state p.Val394Met (c.1180G>A) was of uncertain significance (VUS); the third variant at heterozygous state p.Arg257His (c.770G>A) has already been described and associated with IO. No BMP6 pathogenic variants that would explain iron overload phenotypes were detected in 94% of the studied patients. Conclusion - Identification of the BMP6 pathogenic variants in Brazilian patients with primary IO might contribute to the genetic understanding of this phenotype