Expectativas y sentimientos de los estudiantes de Medicina ante el internado de pregrado

ResumenIntroducciónEl internado de pregrado es una etapa fundamental de la formación médica en donde el alumno pone en práctica aptitudes y actitudes adquiridas en ciclos previos, y desarrolla nuevas en un escenario real.ObjetivoExplorar las expectativas y sentimientos que los alumnos tienen al momento de la elección de plazas de internado de pregrado.Métodomuestra intencional, participaron 156 alumnos de la Carrera de Médico Cirujano de la generación 2009–2012, de la Facultad de Estudios Superiores Iztacala (FESI). Se aplicó un cuestionario que exploró elección de plaza, expectativas, cualidades y aptitudes para su desempeño, y sentir.ResultadosSe encontró que el 85.2% de la muestra seleccionó plazas del Instituto Mexicano de Seguro Social (IMSS). La mayoría eligió plaza por la cercanía a su domicilio; esperan aumentar sus conocimientos y habilidades en la realización de procedimientos médico-quirúrgicos, en la integración de diagnósticos y prescripción de tratamientos, reforzando su capacidad de razonamiento clínico. Para ello, mencionaron contar con cualidades y habilidades para un buen desempeño, apoyando al médico de base y tomando mayor responsabilidad en el trato con los pacientes y la institución hospitalaria. Refirieron tener sentimientos ambivalentes (nervioso/contento, preocupado/entusiasmado, temeroso/tranquilo) ante esta nueva etapa por vivir.ConclusionesPrevio al internado los alumnos tienen altas expectativas sobre su formación clínica, su desempeño ante los pacientes y el manejo de sus emociones en un escenario real.AbstractIntroductionThe undergraduate internship is a critical step in medical training where students put into practice skills and attitudes acquired in previous cycles and develops new in a real situation.ObjectiveThis study aims to explore expectations, beliefs and feelings that students have when choosing undergraduate internship places.MethodIt was a purposive sample, 156 students participated in the career of surgeon medical Generation 2009 – 2012, Facultad de Estudios Superiores Iztacala (FESI). A questionnaire that explored choice of square, expectations, qualities and skills to performance, and feel was applied.ResultsIt was found that 85.2% of the sample selected places of Instituto Mexicano de Seguro Social (IMSS). Most chose square for proximity to home; expect to increase their knowledge and skills in performing surgical medical procedures, integrating diagnoses and prescribing treatments, enhancing their clinical reasoning ability.To do this, they have mentioned qualities and skills to perform well, supporting the practitioner and taking greater responsibility in dealing with patients and hospital institution. Reported having ambivalent feelings (nervous/happy, worried/excited, fearful/quiet) to this new stage live.ConclusionsPrior to boarding students have high expectations of their clinical training, their performance before the patient and managing their emotions in a real scenario

Isoniazid Mono-Resistant Tuberculosis: Impact on Treatment Outcome and Survival of Pulmonary Tuberculosis Patients in Southern Mexico 1995-2010

<div><p>Background</p><p>Isoniazid mono-resistance (IMR) is the most common form of mono-resistance; its world prevalence is estimated to range between 0.0 to 9.5% globally. There is no consensus on how these patients should be treated.</p><p>Objective</p><p>To describe the impact of IMR tuberculosis (TB) on treatment outcome and survival among pulmonary TB patients treated under programmatic conditions in Orizaba, Veracruz, Mexico.</p><p>Materials and Methods</p><p>We conducted a prospective cohort study of pulmonary TB patients in Southern Mexico. From 1995 to 2010 patients with acid-fast bacilli or culture proven <i>Mycobacterium tuberculosis</i> in sputum samples underwent epidemiological, clinical and microbiological evaluation. We included patients who harbored isoniazid mono-resistant (IMR) strains and patients with strains susceptible to isoniazid, rifampicin, ethambutol and streptomycin. All patients were treated following Mexican TB Program guidelines. We performed annual follow-up to ascertain treatment outcome, recurrence, relapse and mortality.</p><p>Results</p><p>Between 1995 and 2010 1,243 patients with pulmonary TB were recruited; 902/1,243 (72.57%) had drug susceptibility testing; 716 (79.38%) harbored pan-susceptible and 88 (9.75%) IMR strains. Having any contact with a person with TB (adjusted odds ratio (aOR)) 1.85, 95% Confidence interval (CI) 1.15–2.96) and homelessness (adjusted odds ratio (aOR) 2.76, 95% CI 1.08–6.99) were associated with IMR. IMR patients had a higher probability of failure (adjusted hazard ratio (HR) 12.35, 95% CI 3.38–45.15) and death due to TB among HIV negative patients (aHR 3.30. 95% CI 1.00–10.84). All the models were adjusted for socio-demographic and clinical variables.</p><p>Conclusions</p><p>The results from our study provide evidence that the standardized treatment schedule with first line drugs in new and previously treated cases with pulmonary TB and IMR produces a high frequency of treatment failure and death due to tuberculosis. We recommend re-evaluating the optimal schedule for patients harboring IMR. It is necessary to strengthen scientific research for the evaluation of alternative treatment schedules in similar settings.</p></div

Treatment Outcomes Among Pulmonary Tuberculosis Patients According to Drug Susceptibility.

<p>Orizaba, Veracruz, 1995–2010</p

Definition of Treatment Outcomes.

<p>Definition of Treatment Outcomes.</p

Socio-demographic, Clinical, and Radiological Characteristics of Patients with Pulmonary Tuberculosis, According to Type of Resistance.

<p>Orizaba, Veracruz 1995–2010.</p

Variables Associated to IMR by Multivariate Analyses.

<p>Variables Associated to IMR by Multivariate Analyses.</p

Association of Drug Susceptibility and Selected Clinical Manifestations with Treatment Outcomes Among Patients with Pulmonary TB by Multivariate Analyses.

<p>Association of Drug Susceptibility and Selected Clinical Manifestations with Treatment Outcomes Among Patients with Pulmonary TB by Multivariate Analyses.</p