Medical Students' Opinion of Their Learning Process

The opinion of students is of utmost importance to identify areas of improvement in undergraduate studies. Medical schools would use this information to plan actions to ensure that the students achieve the necessary medical knowledge. The aim of this study was to analyse the opinion of medical students about their learning process and to analyse the influence of their experience according to their year of medical degree. A questionnaire including 21 items, divided into four sections (motivation, theory lectures, hospital internships, and research) and two overall questions, was distributed among eligible 246 students. Each item was scored from 1 (strongly disagree) to 5 (strongly agree). The opinions of intermediate-year students of medical degree (3rd and 4th) were compared to late-year students (5th and 6th). A total of 148 students answered the questionnaire (60.2% response rate). The mean scores for overall student motivation and teaching quality were 6.15 and 7.10, respectively. The student-teacher interaction and new learning technological tools were considered important for student motivation. The only differences found between the two groups of students were that late-year students wished to become part of a medical team and to learn writing scientific papers more than the intermediate-year students. This questionnaire revealed that the year of career had little influence on the medical students' opinion on their learning process during their undergraduate studies. Late-year students rated highest on being more interested in being part of a medical team and their knowledge on writing scientific articles. The use of new technologies and the student-teacher interaction is key to motivate students

Consequences of the Covid-19 pandemic on complex multimorbid elderly: Follow-up of a community-based cohort. SAMAC3 Study

©2023. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ This document is the Accepted version of a Published Work that appeared in final form in Journal of Nursing Scholarship. To access the final edited and published work see https://doi.org/10.1111/jnu.12860Background: The restrictions imposed during the management of the pandemic led to lack of care of other health problems. Purpose: To assess changes in the health status of complex multimorbidity elderly, functional and cognitive capacities, perception of the social surroundings, care pro vided by the nurses, including nursing diagnosis and interventions, use of health ser vices, adverse events, and use of devices and technical help during the first 6 months of the Covid-19 pandemic. Design: A 1-year longitudinal cohort study was conducted. Methods: Ninety-seven complex multimorbid elderly attended in primary care were evaluated every 3 months in a health area of the Spanish National Health System (SNHS). The research was called “SAMAC3 study”. Results: Significant negative changes were observed in the functional and cognitive ca pacity of the elderly, and in several nursing diagnoses. A decrease was observed in the frequency of visit to the nurses, hospital admittance, length of hospital stays, and falls. Conclusions: The functional and cognitive capacities of the cohort became worse. However, a significant decrease in the frequency of use of health services was ob served. The nurses detected significant changes in activity-exercise, cognitive perception, and roles-relationships, but their interventions were mostly centered on resolving clinical matters that required immediate attention. Clinical Relevance: The present study allowed us to observe that a situation of social and health stress has worsened the health indicators of multimorbid elderly, and the clinical care of community nurses was insufficient to providing care for the deteriora tion of the physical and cognitive domains

Retinal nerve fiber layer thickness in children with primary congenital glaucoma measured by spectral domain optical coherence tomography

Purpose: To evaluate retinal nerve fiber layer (RNFL) thickness using spectral domain optical coherence tomography (SD-OCT) in a population of children diagnosed with primary congenital glaucoma (PCG). Methods: In this cross-sectional study, 59 eyes of 59 children diagnosed with PCG and 87 eyes of 87 healthy children were evaluated by SD-OCT to measure the RNFL. The global average peripapillary RNFL thickness and sectional RNFL thickness were evaluated in both groups. Differences in global average and sectional thickness were analyzed. Results: Mean age in the PCG group was 9.61 ± 3.23 years; in the control group, 8.47 ± 2.99 years (P = 0.0516). There were statistically significant differences (P < 0.007) in all sectors between both groups. Conclusions: SD-OCT is a promising tool for evaluating the eyes of children diagnosed with PCG. Future research should examine the test–retest variability of SD-OCT parameters and their ability to diagnose progression in these children

Evaluation of a Novel Αb Εxterno MicroShunt for the Treatment of Glaucoma

The surgical management of glaucoma has been revolutionized by the introduction of minimally invasive glaucoma surgery (MIGS). The various MIGS options aim to meaningfully lower intraocular pressure with a better safety profile than traditional glaucoma surgery. The key clinical attributes and the emerging potential of an ab externo MicroShunt (PreserFlo™) are reviewed in the context of published evidence and clinical experience. This novel MicroShunt consists of an 8.5-mm-long tube that is implanted in the eye via an ab externo approach enabling aqueous humor drainage into the sub-Tenon's space through the formation of a bleb, similar in appearance to that created by trabeculectomy. The efficacy and safety of this procedure, the concomitant use of antimetabolites, the impact of tube positioning, and its future value in clinical practice are critically reviewed. Recent evidence has demonstrated the MicroShunt to be less effective than traditional filtration surgery, but with a significant improvement in safety. Cumulative data suggest that the new implant provides tangible clinical benefits to selected patients with glaucoma in need of further intraocular pressure (IOP) lowering. Future research should delineate the precise role of this and other MIGS options in the rapidly evolving glaucoma treatment algorithm.Unidad Docente de Inmunología, Oftalmología y ORLDepto. de Inmunología, Oftalmología y ORLFac. de Óptica y OptometríaFac. de MedicinaTRUEpu

Charles Bonnet syndrome in a child with congenital glaucoma

Case report: The case is presented of a 12 year-old boy with congenital glaucoma and low visual acuity diagnosed with Charles Bonnet syndrome. This consisted of the acute onset of complex, repetitive, persistent, and with visual hallucinations (people, brooms and coffeemakers) of self-limited evolution without treatment. The patient was diagnosed with congenital glaucoma at 3 years of age, and subjected to a trabeculectomy in right eye, and trabeculectomy and keratoplasty in his left eye. Discussion: Charles Bonnet syndrome symptoms have been described in adults, but their presence in children is poorly reflected in literature, with unknown characteristics and prevalence

Metallic elements in foliar material and fruits of three tree species as bioindicators

This study aimed to determine the presence of metal elements in fruits and leaves of three tree species as bioindicators in San Luis Potosi, Mexico. Ninety fruit and 90 leaf samples (30 per tree species) were collected at five sites (agricultural, suburban, commercial and services, urban, and mining), using the site and the presence of P. laevigata, S. molle, and A. farnesiana as references. Total concentrations of 13 metal elements were determined using an inductively coupled plasma mass spectrometer (ICP-MS). The species were significantly affected by Co, As, and Pb (ANOVA, p≤0.05). Considering the land use and the species, the contents determined in the leaves and fruits of the three species had sufficient and phytotoxic contents of Al, Cd, Co, Ni, Mn, Ti, and Cr, and excessive ranges with the possible phytotoxic effect of As, Cu, Pb, Zn, V, and Fe. The A. farnesiana had the highest concentrations of 12 heavy metals analyzed (HM). The variation in total metal concentrations between leaves and fruits ranged from 84.70 to 99.06%, with V, As, and Cr being prominent. The functionality of these tree species as phytoremediators and bioindicators is reviewed to evaluate environmental impacts on land use. Highlights Tree species represent a potential bioindicator for studying environmental pollutants due to their ability to accumulate heavy metals. The variation in total metal concentrations between leaves and fruits ranged from 84.70 to 99.06% The contents determined in the leaves and fruits of the three species trees had sufficient and phytotoxic HM contents. The tree species have phytoremediators capacity to evaluate environmental impacts and environmental contamination of land use.This study aimed to determine the presence of metal elements in fruits and leaves of three tree species as bioindicators in San Luis Potosi, Mexico. Ninety fruit and 90 leaf samples (30 per tree species) were collected at five sites (agricultural, suburban, commercial and services, urban, and mining), using the site and the presence of P. laevigata, S. molle, and A. farnesiana as references. Total concentrations of 13 metal elements were determined using an inductively coupled plasma mass spectrometer (ICP-MS). The species were significantly affected by Co, As, and Pb (ANOVA, p≤0.05). Considering the land use and the species, the contents determined in the leaves and fruits of the three species had sufficient and phytotoxic contents of Al, Cd, Co, Ni, Mn, Ti, and Cr, and excessive ranges with the possible phytotoxic effect of As, Cu, Pb, Zn, V, and Fe. The A. farnesiana had the highest concentrations of 12 heavy metals analyzed (HM). The variation in total metal concentrations between leaves and fruits ranged from 84.70 to 99.06%, with V, As, and Cr being prominent. The functionality of these tree species as phytoremediators and bioindicators is reviewed to evaluate environmental impacts on land use. Highlights Tree species represent a potential bioindicator for studying environmental pollutants due to their ability to accumulate heavy metals. The variation in total metal concentrations between leaves and fruits ranged from 84.70 to 99.06% The contents determined in the leaves and fruits of the three species trees had sufficient and phytotoxic HM contents. The tree species have phytoremediators capacity to evaluate environmental impacts and environmental contamination of land use

La imagen y la Narrativa como Herramientas para el Abordaje Psicosocial en Escenarios de Violencia - Departamentos de Cundinamarca y Tolima.

La imagen y la Narrativa como Herramientas para el Abordaje Psicosocial en Escenarios de Violencia - Departamentos de Cundinamarca y Tolima.El presente documento hace parte del trabajo desarrollado para el diplomado Acompañamiento Psicosocial en Escenarios de Violencia, que se orienta al fortalecimiento de las habilidades de los profesionales vinculados a la atención psicosocial en el establecimiento de estrategias para el abordaje de problemáticas relacionadas con las diferentes dinámicas de la violencia generada principalmente por el conflicto armado en Colombia. La exploración del tema ha permitido reconocer y analizar la complicada situación de las víctimas del conflicto armado, que no sólo han sido vulnerados en sus derechos fundamentales por actores armados de todos los frentes en conflicto, sino que se han visto revictimizados por el desplazamiento y la desatención que en muchos casos los obliga a reducirse a condiciones de miseria y mendicidad, haciéndose invisibles ante los agentes estatales y la sociedad en general. La negociación con el grupo armado FARC y la posterior firma de un acuerdo de paz entre este y el gobierno nacional, abrió las puertas para el descubrimiento y narración de múltiples sucesos que permanecían bajo la superficie, silenciados por el miedo a la retaliación de los victimarios y el generalizado sentimiento de inseguridad manifiesto en la población, principalmente en aquellos que han sido víctimas tanto directas como indirectas del conflicto armado en el país. Los relatos abordados en el presente documento dan cuenta de dicho silenciamiento, pasando de la perspectiva individual de la víctima de violencia y desplazamiento a la tragedia comunitaria de desarraigo, hacinamiento y desatención social, siendo esta una muestra de tantos relatos que se repiten en distintas partes del territorio nacional, dejando huellas psicológicas en las víctimas que no están siendo atendidas eficientemente por los programas psicosociales y haciendo necesario y apremiante el establecimiento de estrategias de abordaje que se orienten a la atención de las víctimas y la generación de procesos encaminados a la superación del trauma y la reintegración social, apoyados en la imagen y la narrativa como herramientas de liberación y superación de un discurso de tragedia y dolor, dirigidas a la creación de nuevos discursos de esperanza y construcción de sociedad.This document is part of the work developed for the diploma course of Psychosocial Accompaniment in Violence Scenarios, which is aimed at strengthening the skills of professionals linked to psychosocial care in the establishment of strategies for addressing problems related to the different dynamics of violence generated mainly by the armed conflict in Colombia. The exploration of the issue has made it possible to recognize and to analyze the complicated situation of the victims of the armed conflict, who have not only been violated in their fundamental rights by armed actors from all fronts in conflict, but have been seen re-victimized by the displacement and neglect that in many cases forces them to reduce themselves to conditions of misery and begging, making themselves invisible to state actors and society at large. The negotiation with the armed group FARC and the subsequent signing of a peace agreement between it and the national government, opened the doors for the discovery and narration of multiple events that remained beneath the surface, silenced by the fear of retaliation of the victims and the widespread sense of manifest insecurity in the population, mainly in those who have been directly and indirect victims of the armed conflict in the country. The accounts addressed in this document give an account of this silencing, moving from the individual perspective of the victim of violence and displacement, to the community tragedy of uprooting, overcrowding and social neglect, this being a sign of so many stories that are repeated in different parts of the national territory, leaving psychological traces on the victims that are not being efficiently addressed by psychosocial programs and making it necessary and pressing to establish approach strategies that focus on the care of victims and the generation of processes aimed at overcoming trauma and social reintegration, supported by the image and narrative as liberation tools and overcoming a discourse of tragedy and pain, aimed at creation new discourses of hope and building society

Histology and embryology teaching virtualization during the COVID-19 pandemic

Fil: Fernández, Javier Elías. Universidad Nacional de Córdoba. Facultad de Odontología. Cátedra de Histología y Embriología A; Argentina.Fil: Fernández, Javier Elías. Universidad Nacional de Córdoba. Facultad de Odontología. Cátedra de Diagnóstico por Imágenes A. Departamento de Patología Bucal; Argentina.Fil: Fernández, Javier Elías. Universidad Nacional de Córdoba. Facultad de Odontología. Área de Imagenología y Diagnóstico Digital; Argentina.Fil: Lucero, Rosita. Universidad Nacional de Córdoba. Facultad de Odontología. Cátedra de Histología y Embriología A; Argentina.Fil: Plavnik, Luis Mario. Universidad Nacional de Córdoba. Facultad de Odontología. Cátedra de Histología y Embriología A; Argentina.Fil: Fontana, Sebastián. Universidad Nacional de Córdoba. Facultad de Odontología. Cátedra de Histología y Embriología A; Argentina.Fil: Méndez, Emilce. Universidad Nacional de Córdoba. Facultad de Odontología. Cátedra de Histología y Embriología A; Argentina.Fil: Gómez Rosso, Araceli. Universidad Nacional de Córdoba. Facultad de Odontología. Cátedra de Histología y Embriología A; Argentina.Fil: Hernández, Lea Florencia. Universidad Nacional de Córdoba. Facultad de Odontología. Cátedra de Histología y Embriología A; Argentina.Fil: Samar, Maria Elena. Universidad Nacional de Córdoba. Facultad de Odontología. Cátedra de Histología y Embriología A; Argentina.La enfermedad Covid-19 es una pandemia mundial con graves con secuencias. La Universidad Nacional de Córdoba, Argentina, al igual que todas las universidades del país, suspendió el dictado de clases presenciales y desarrolló unproceso de enseñanza-aprendizaje centrado en un entorno virtual para cumplir con el aislamiento obligatorio y continuar con el dictado de los contenidos en sus facultades y escuelas. Objetivo: El objetivo del presente trabajo fue analizar las condiciones de acceso tecnológico y competencias informáticas con las que los estudiantes desarrollaron el aprendizaje virtual de las CienciasMorfológicas en el actual contexto de pandemia Covid-19. Materiales y métodos: Se realizó un estudio transversal y descriptivo de los datos obtenidos en una encuesta anónima y voluntaria que se distribuyó y circuló aleatoriamente entre los alumnos del curso de Histología y Embriología ?A? de la Facultad de Odontología de la Universidad Nacional de Córdoba.Resultados:El 95,7% de los estudiantes tenía los dispositivos tecnológicos necesarios y el 49,3% se consideró competente digital y el 37.9% principiante. Solo el 26,4% de los estudiantes requirió ayuda para el empleo de la tecnología.Conclusiones: El análisis de loslogros y las dificultades con que docentes y estudiantes transitamos la enseñanza de las Ciencias Morfológicas en pandemia permitió crear un espacio enriquecedor de reflexión para los desafíos de la educación post-pandemia y promover nuevas formas del proceso de enseñanza-aprendizaje que integren instancias presenciales y virtuales que contribuyan al enriquecimiento de la formación universitaria de los futuros profesionales de las Ciencias de la Salud.The Covid-19 disease is a globally spreading pandemic with serious consequences. The Universidad Nacional de Córdoba like all universities of Argentina ordered the suspension of face-to-face education and developed a teaching-learning process focused on a virtual environment that would allow compliance with mandatory isolation and at the same time continue with the dictation of the contents in their schools. Objective: The aim of this work was to obtain and analyze information regarding the conditions of technological access and e-competences with which the students developed the virtual activities for morphological sciences learning in the current context of covid-19 pandemic. Materials and methods: A cross-sectional and descriptive study of the data obtained of anonymous and voluntary survey among students course of Histology and Embryology A was carried out. Facultad de Odontología. Universidad Nacional de Córdoba. Results: 95.7% of the students had the necessary technological devices and 49.3% considered themselves digitally proficient and 37.9% beginners. Only 26.4% of the students required help for the use of technology. Conclusion: The analysis of successes and difficulties with which we go through the teaching of morphological sciences in pandemic will allow creating a reflection space for us to be better prepared for the challenges of a post-pandemic education and promoting new teaching-learning forms that combine and integrate elements of the face-to-face class and virtual learning thus contributing to improving the future health professional’s university education.https://revistas.unc.edu.ar/index.php/RevFacOdonto/article/view/38415/38443info:eu-repo/semantics/publishedVersionFil: Fernández, Javier Elías. Universidad Nacional de Córdoba. Facultad de Odontología. Cátedra de Histología y Embriología A; Argentina.Fil: Fernández, Javier Elías. Universidad Nacional de Córdoba. Facultad de Odontología. Cátedra de Diagnóstico por Imágenes A. Departamento de Patología Bucal; Argentina.Fil: Fernández, Javier Elías. Universidad Nacional de Córdoba. Facultad de Odontología. Área de Imagenología y Diagnóstico Digital; Argentina.Fil: Lucero, Rosita. Universidad Nacional de Córdoba. Facultad de Odontología. Cátedra de Histología y Embriología A; Argentina.Fil: Plavnik, Luis Mario. Universidad Nacional de Córdoba. Facultad de Odontología. Cátedra de Histología y Embriología A; Argentina.Fil: Fontana, Sebastián. Universidad Nacional de Córdoba. Facultad de Odontología. Cátedra de Histología y Embriología A; Argentina.Fil: Méndez, Emilce. Universidad Nacional de Córdoba. Facultad de Odontología. Cátedra de Histología y Embriología A; Argentina.Fil: Gómez Rosso, Araceli. Universidad Nacional de Córdoba. Facultad de Odontología. Cátedra de Histología y Embriología A; Argentina.Fil: Hernández, Lea Florencia. Universidad Nacional de Córdoba. Facultad de Odontología. Cátedra de Histología y Embriología A; Argentina.Fil: Samar, Maria Elena. Universidad Nacional de Córdoba. Facultad de Odontología. Cátedra de Histología y Embriología A; Argentina.Otras Ciencias de la Salu

Synergistic DNA-damaging effect in multiple myeloma with the combination of zalypsis, bor tezomib and dexamethasone

Despite new advances in multiple myeloma treatment and the consequent improvement in overall survival, most patients relapse or become refractory to treatment. This suggests that new molecules and combinations that may further inhibit important survival pathways for these tumor cells are needed. In this context, zalypsis is a novel compound, derived from marine organisms, with a powerful preclinical anti-myeloma effect based on the sensitivity of malignant plasma cells to DNA-damage induction; and it has already been tested in a phase I/II clinical trial in multiple myeloma. We hypothesized that the addition of this compound to the combination of bortezomib plus dexamethasone may improve efficacy with acceptable toxicity. The triple combination demonstrated strong synergy and higher efficacy compared with double combinations; not only in vitro, but also ex vivo and, especially, in in vivo experiments. The triple combination triggers cell death, mainly through a synergistic induction of DNA damage and a decrease in the nuclear localization of nuclear factor kappa B. Our findings support the clinical evaluation of this combination for relapsed and refractory myeloma patients.This work was in part funded by the Spanish ISCIII-FIS (PI 15/0067 and PI15/02156) and FEDER, the Spanish RTICC (RD12/0036/0058), "Asociación Española Contra el Cancer" (AECC, GCB120981SAN), the regional Council from “Castilla y León” (GRS 1175/A/15 and FIC335U14) and a research grant from Pharmamar SAU. MMS were also supported by the Network of Centers for Regenerative Medicine and Cellular Therapy from Castilla y León, Spain. A-A López-Iglesias was supported by a grant from the Spanish Society of Hematology and Hemotherapy.Peer Reviewe

DNA methylation-based prognosis and epidrivers in hepatocellular carcinoma

Epigenetic deregulation has emerged as a driver in human malignancies. There is no clear understanding of the epigenetic alterations in hepatocellular carcinoma (HCC) and of the potential role of DNA methylation markers as prognostic biomarkers. Analysis of tumor tissue from 304 patients with HCC treated with surgical resection allowed us to generate a methylation-based prognostic signature using a training-validation scheme. Methylome profiling was done with the Illumina HumanMethylation450 array (Illumina, Inc., San Diego, CA), which covers 96% of known cytosine-phosphate-guanine (CpG) islands and 485,000 CpG, and transcriptome profiling was performed with Affymetrix Human Genome U219 Plate (Affymetrix, Inc., Santa Clara, CA) and miRNA Chip 2.0. Random survival forests enabled us to generate a methylation signature based on 36 methylation probes. We computed a risk score of mortality for each individual that accurately discriminated patient survival both in the training (221 patients; 47% hepatitis C-related HCC) and validation sets (n = 83; 47% alcohol-related HCC). This signature correlated with known predictors of poor outcome and retained independent prognostic capacity of survival along with multinodularity and platelet count. The subset of patients identified by this signature was enriched in the molecular subclass of proliferation with progenitor cell features. The study confirmed a high prevalence of genes known to be deregulated by aberrant methylation in HCC (e.g., Ras association [RalGDS/AF-6] domain family member 1, insulin-like growth factor 2, and adenomatous polyposis coli) and other solid tumors (e.g., NOTCH3) and describes potential candidate epidrivers (e.g., septin 9 and ephrin B2). Conclusions: A validated signature of 36 DNA methylation markers accurately predicts poor survival in patients with HCC. Patients with this methylation profile harbor messenger RNA-based signatures indicating tumors with progenitor cell features