Depression in medical students: insights from a longitudinal study

Background: Factors associated with depression of medical students are poorly understood. The purpose of this study is to determine the prevalence of depression in medical students, its change during the course, if depression persists for affected students, what are the factors associated with depression and how these factors change over time. Methods: A prospective, longitudinal observational study was conducted at the Medical School of the University of Minho, Portugal, between academic years 2009-2010 to 2012-2013. We included students who maintained their participation by annually completing a questionnaire including Beck Depression Inventory (BDI). Anxiety and burnout were assessed using the State Trait Anxiety Inventory and Maslach Burnout Inventory. Surveys on socio-demographic variables were applied to evaluate potential predictors, personal and academic characteristics and perceived difficulties. ANOVA with multiple comparisons were used to compare means of BDI score. The medical students were organized into subgroups by K-means cluster analyses. ANOVA mixed-design repeated measurement was performed to assess a possible interaction between variables associated with depression. Results: The response rate was 84, 92, 88 and 81% for academic years 2009-2010, 2010-2011,2011-2012 and 2012/2013, respectively. Two hundred thirty-eight medical students were evaluated longitudinally. For depression the prevalence ranged from 21.5 to 12.7% (academic years 2009/2010 and 2012/2013). BDI scores decreased during medical school. 19.7% of students recorded sustained high BDI over time. These students had high levels of trait-anxiety and choose medicine for anticipated income and prestige, reported more relationship issues, cynicism, and decreased satisfaction with social activities. Students with high BDI scores at initial evaluation with low levels of trait-anxiety and a primary interest in medicine as a career tended to improve their mood and reported reduced burnout, low perceived learning problems and increased satisfaction with social activities at last evaluation. No difference was detected between men and women in the median BDI score over time. Conclusions: Our findings suggest that personal factors (anxiety traits, medicine choice factors, relationship patterns and academic burnout) are relevant for persistence of high levels of BDI during medical training. Medical schools need to identity students who experience depression and support then, as early as possible, particularly when depression has been present over time.info:eu-repo/semantics/publishedVersio

Mental health problems among medical students in Brazil: a systematic review and meta-analysis

Objective: To provide a comprehensive picture of mental health problems (MHPs) in Brazilian medical students by documenting their prevalence and association with co-factors. Methods: We systematically searched the MEDLINE/PubMed, SciELO, LILACS, and PsycINFO databases for cross-sectional studies on the prevalence of MHPs among medical students in Brazil published before September 29, 2016. We pooled prevalences using a random-effects meta-analysis, and summarized factors associated with MHP. Results: We included 59 studies in the analysis. For meta-analyses, we identified the summary prevalence of different MHPs, including depression (25 studies, prevalence 30.6%), common mental disorders (13 studies, prevalence 31.5%), burnout (three studies, prevalence 13.1%), problematic alcohol use (three studies, prevalence 32.9%), stress (six studies, prevalence 49.9%), low sleep quality (four studies, prevalence 51.5%), excessive daytime sleepiness (four studies, prevalence 46.1%), and anxiety (six studies, prevalence 32.9%). Signs of lack of motivation, emotional support, and academic overload correlated with MHPs. Conclusion: Several MHPs are highly prevalent among future physicians in Brazil. Evidence-based interventions and psychosocial support are needed to promote mental health among Brazilian medical students

Ellis van Creveld syndrome-a report of two siblings

Chondro-ectodermal dysplasia is a rare autosomal recessive disorder which affects the ectodermal, mesodermal and endodermal derivatives. There are numerous conditions reported under this title which include Ellis van Creveld syndrome. The oral findings include multiple gingivolabial frena, dental abnormality, malocclusion and hypodontia. The diagnosis of Ellis van Creveld syndrome is based on the presence of oral mucosal changes like notching of the lower alveolus, fusion of the upper lip and gingival mucosa; dental changes like oligodontia, conical shape of anterior teeth and occasional presence of neonatal teeth. The authors report a rare case of Ellis van Creveld syndrome occurring among two siblings with oral mucosal, dental and skeletal abnormalities

Bilateral disciform keratitis: A rare feature of Reiter′s syndrome

Reiter′s syndrome is a relatively rare seronegative spondyloarthropathy characterized by a triad of urethritis, arthritis, and conjunctivitis. Human leukocyte antigen B27 (HLA B27) is positive in over two-thirds of the patients. Involvement of the cornea in the form of a bilateral disciform keratitis in a first episode of Reiter′s is an extremely rare feature, with only one previous report. Other report indicates the occurrence of disciform keratitis in patients with chronic recurring episodes of Reiter′s syndrome. We report acase of a young girl who developed bilateral disciform keratitis against a clinical background of arthritis of the left knee. There was preceding history of acute infective diarrhea, 1 month earlier. Initially, the keratitis was thought to be viral, but response to antiviral treatment was poor. A clinical suspicion of Reiter′s syndrome was confirmed by a positive HLA B27 test. Definitive treatment with steroids and sulfasalazine resulted in resolution of the keratitis

Electrodeposition of copper applied to the manufacture of seamless superconducting rf cavities

Niobium thin film coated copper superconducting radio frequency elliptical cavities have demonstrated for many years their strong potential as an alternative to bulk niobium cavities. The thin film lower performance at high rf field is often attributed to the defects observed in the elaborated Nb layer, sometimes originated from defects inherited from the substrate itself. The currently used methods of manufacturing the copper elliptical substrates include several steps of electron-beam welding in order to join the half cells and the cutoffs which can contribute to defects and porosities. Seamless methods are nowadays developed in order to avoid welding steps and to decrease the global manufacturing cost of the cavities. We propose in this study an innovative alternative route in which the cavity is formed by electrodeposition of copper on a sacrificial aluminum mandrel. The strength of the process relies on the total absence of welding joints. Two different electroforming techniques using either direct current or pulsed plating have been investigated. The electroformed copper exhibited similar mechanical robustness, cryogenic properties and purity as the oxygen-free copper. In addition, the fabrication process was validated on test mandrels which mimic the geometry of 1.3 GHz cavities