1,721,099 research outputs found
Interplay between personal and professional growth in Italian medical education
Full text linkIntroduction: Generational change is impacting medical education and driving the adaptation and reform of teaching and clinical practice to successfully educate the next generation of physicians. Aim of the study was to establish undergraduates’ needs by analyzing the strengths and weaknesses of their soft skills from the start of medicine school. Method: We conducted a cross-sectional study to evaluate the personalities and soft skills of first-, third-, and sixth-year undergraduates in medical school. Of the eligible participants (N = 333), 127 of them (38.1%) were evaluated for their soft skills. The assessment was based on psychological and behavioral assessments. Results: Results showed the strong need of the young to understand themselves and know how to improve their personal growth during academic study. Mediation statistical analyses showed significant direct and indirect effects of the factors (year level in medical school) and mediators (conscientiousness/extroversion and openness) on the soft skills indexes. Conscientiousness was a predictive factor for all soft skills examined: self-determination (β = 0.54), resilience (β = 0.48), empathy (β = 0.36), assertiveness (β = 0.24), social support (β = 0.18), and teamwork (β = 0.30). Openness was correlated and predictive for empathy (β = 0.19). The model of the multilayered construct of medical competence represents a fruitful framework and using the lens of Self-Determination theory, medical undergraduates could be engaged and buffered against the stressors of patient care. Discussion: In this scenario, the interaction with medical leaders is relevant, clinical trainers and medical undergraduates should model the professional learning; escalated clinical skills should build advanced knowledge in medicine
[Comparison of electrocardiographic and echocardiographic findings in acute myocardial infarct].
No full textThe aim of this study was to evaluate, in a large series of patients (420 males, 104 females, mean age 59 +/- 9.4 years) with acute myocardial infarction (AMI), the role of electrocardiography and two-dimensional echocardiography in identifying the site and the extension of the necrotic area, with regard to the treatment (thrombolysis or not) and the extent of coronary artery disease. Our results have shown a good correlation between ECG and echo in evaluating the infarct size, with a larger extension in echo examinations. Regarding the infarct site, a good correlation was found in anterior AMI, but not in inferior AMI. Thrombolytic therapy does not seem to introduce significant variations in this regard. Furthermore, the results of coronary angiography have shown that two-dimensional echocardiography allows us to identify the infarct-related coronary artery in a larger number of patients (90%) compared to ECG (80%). On the contrary, the two methods are similar in evaluating the extent of coronary artery disease, with correct identification of only one third of patients, the majority of them with single-vessel disease. Finally, we observed that the presence of abnormal apical wall motion is frequent (47%), in the majority of cases associated with anterior wall motion abnormalities, while in 5% of the cases the apex alone is involved. This finding suggests an analogy between these "apex infarctions" and the non Q wave infarctions, in which necrosis is present only in a little zone of a larger area at risk
Should sports activity be encouraged or contraindicated in hypertensive subjects?
No full textHypertension is considered one of the major risk factors for
cardiovascular disease. There are a number of different
approaches to the prevention, control and treatment of
hypertension. One of these provides lifestyle modification
as a means to facilitate drug step-down or drug withdrawal
in hypertensive patients subjected to a pharmacological
treatment, but also as a means to control blood pressure
and reduce the risk of developing hypertension in subjects
that have abnormal blood pressure but are not candidates
for drug therapy. Lifestyle modification includes physical
activity, and there is an ever-increasing amount of evidence
that physical activity can modify the history of hypertension,
acting as a reducer either of blood pressure or of the other
cardiovascular risk factors. The aim of this article was to
analyse the effects of exercise on blood pressure (neurohormonal,
hormonal and vessel effects), illustrate which are the influences of age and gender on exercise-induced
reduction of blood pressure, indicate how much exercise (in
terms of intensity, frequency and duration) is required to
induce positive modification of blood pressure and evaluate
current Italian criteria for sports ability in athletes with
hypertensio
Measurements of mechanical asynchrony in patients with heart failure: is the puzzle completed?
No full textEfficacy and Safety of Nonvitamin K Oral Anticoagulants in Patients with Atrial Fibrillation and Cancer: A Study-Level Meta-Analysis
No full textIn this study-level meta-analysis, we evaluated the clinical outcome with nonvitamin K antagonist oral anticoagulants (NOACs) versus vitamin K antagonists (VKAs) in atrial fibrillation (AF) patients with cancer
Updating the relationship of Chlamydia pneumoniae with atherosclerotic cardiovascular diseases. A systematic review of reviews
No full textChlamydia pneumoniae is the etiologic agent of respiratory tract infections in humans, including community-acquired pneumonia, and has been associated with atherosclerotic cardiovascular diseases. The present systematic review of reviews aimed at answering important questions on the involvement of C. pneumoniae in the pathogenesis of atherosclerosis, its cellular and molecular mechanisms, and whether there is evidence of a causal relationship. The databases PubMed/Med-line, Scopus, and Web of Science were searched for all review articles published from 2003 to the end of 2023. A total of 27 reviews, systematic reviews, and systematic reviews with metanalysis were included. Overall, current evidence suggests that C. pneumoniae is a biologically plausible candidate for the causation of atherosclerosis, albeit not all the 4 Koch postulates are fulfilled; oxidative stress and inflammation are the most likely pathogenic mechanisms mediated by C. pneumoniae. However, it is still unclear how the persistent form, responsible for chronic inflammation, fits into this etiopathogenetic scenario. In the future, the newly-designed transformation systems for the genomic manipulation of C. pneumoniae will surely help expand our knowledge on the role of this pathogen in atherogenesis
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