RESUMO

La auscultación pulmonar es parte fundamental del examen físico para el diagnóstico de las enfermedades respiratorias. La estandarización que ha alcanzado la nomenclatura de los ruidos respiratorios, sumado a los avances en el análisis computacional de los mismos, han permitido mejorar la utilidad de esta técnica. Sin embargo, el rendimiento de la auscultación pulmonar ha sido cuestionado por tener una concordancia variable entre profesionales de la salud. Aun cuando la incorporación de nuevas herramientas diagnósticas de imágenes y función pulmonar han revolucionado la precisión diagnóstica en enfermedades respiratorias, no existe tecnología que permita reemplazar la técnica de auscultación pulmonar para guiar el proceso diagnóstico. Por una parte, la auscultación pulmonar permite seleccionar a aquellos pacientes que se beneficiarán de una determinada técnica diagnóstica, se puede repetir cuantas veces sea necesario para tomar decisiones clínicas, y frecuentemente permite prescindir de exámenes adicionales que no siempre son fáciles de realizar o no se encuentran disponibles. En esta revisión se presenta el estado actual de la técnica de auscultación pulmonar y su rendimiento objetivo basado en la nomenclatura actual aceptada para los ruidos respiratorios, además de resumir la evidencia principal de estudios de concordancia de auscultación pediátrica y su análisis objetivo a través de nueva tecnología computacional.

Lung auscultation is an essential part of the physical examination for diagnosing respiratory diseases. The terminology standardization for lung sounds, in addition to advances in their analysis through new technologies, have improved the use of this technique. However, traditional auscultation has been questioned due to the limited concordance among health professionals. Despite the revolu tionary use of new diagnostic tools of imaging and lung function tests allowing diagnostic accuracy in respiratory diseases, no technology can replace lung auscultation to guide the diagnostic process. Lung auscultation allows identifying those patients who may benefit from a specific test. Moreover, this technique can be performed many times to make clinical decisions, and often with no need for- complicated and sometimes unavailable tests. This review describes the current state-of-the-art of lung auscultation and its efficacy based on the current respiratory sound terminology. In addition, it describes the main evidence on respiratory sound concordance studies among health professionals and its objective analysis through new technology.

Assuntos

RESUMO

Lung auscultation is an essential part of the physical examination for diagnosing respiratory diseases. The terminology standardization for lung sounds, in addition to advances in their analysis through new technologies, have improved the use of this technique. However, traditional auscultation has been questioned due to the limited concordance among health professionals. Despite the revolu tionary use of new diagnostic tools of imaging and lung function tests allowing diagnostic accuracy in respiratory diseases, no technology can replace lung auscultation to guide the diagnostic process. Lung auscultation allows identifying those patients who may benefit from a specific test. Moreover, this technique can be performed many times to make clinical decisions, and often with no need for- complicated and sometimes unavailable tests. This review describes the current state-of-the-art of lung auscultation and its efficacy based on the current respiratory sound terminology. In addition, it describes the main evidence on respiratory sound concordance studies among health professionals and its objective analysis through new technology.

Assuntos

RESUMO

This article states that the incorporation of ethical issues such as bioethics and principles of good practice, facilitates the academic management in a Faculty of Medicine. It presents some interesting aspects necessary to carry out a quality academic management that serves the university mission and its educational and research project. It underlines good practices regarding not only professional relations but also organizational aspects. It includes an analysis of academic management and its association with quality and leadership, it reflects on the ethical values of quality work and on the theory of functional or interactional leadership, a key element to boost the development of a university health institution.

Assuntos

RESUMO

This article states that the incorporation of ethical issues such as bioethics and principles of good practice, facilitates the academic management in a Faculty of Medicine. It presents some interesting aspects necessary to carry out a quality academic management that serves the university mission and its educational and research project. It underlines good practices regarding not only professional relations but also organizational aspects. It includes an analysis of academic management and its association with quality and leadership, it reflects on the ethical values of quality work and on the theory of functional or interactional leadership, a key element to boost the development of a university health institution.

Assuntos

RESUMO

Globalization of health care seems to be irreversible and beyond cultural differences and local realities; consequently, medical education needs to have a common set of core principles or standards that may be applied worldwide. The aim of participating in assessment processes is to guarantee that medical education takes place in a sufficiently rich environment to promote extensive academic purposes. The Medical School of the Pontificia Universidad Católica de Chile (PUC) participated in three assessment processes that included three stages: internal assessment, external assessment, and accreditation judgment. Two of these assessments were voluntarily carried out following the standards set by the Liaison Committee on Medical Education-LCME, and they took place in 1997 and 2007. The other assessment was based on standards set by the Chilean accrediting organism, the National Committee for Undergraduate Program Accreditation (Comité Nacional de Acreditación de Pregrado-CNAP) and took place in the year 2001. In all three experiences, internal assessment was the most enriching stage, stimulating refections among students and teachers in order to recognize areas of strengths and weaknesses. External assessment processes, especially those based on international standards, are very important for the institutional and program development of Medical Schools. The PUC Medical School on its whole learnt how to carry out an assessment process and was able to improve several weaknesses without pressure, moving from quality assurance to quality enhancement. The present paper analyzes the major challenges involved in an external assessment process.

Assuntos

RESUMO

Globalization of health care seems to be irreversible and beyond cultural differences and local realities; consequently, medical education needs to have a common set of core principles or standards that may be applied worldwide. The aim of participating in assessment processes is to guarantee that medical education takes place in a sufficiently rich environment to promote extensive academic purposes. The Medical School of the Pontificia Universidad Católica de Chile (PUC) participated in three assessment processes that included three stages: internal assessment, external assessment, and accreditation judgment. Two of these assessments were voluntarily carried out following the standards set by the Liaison Committee on Medical Education-LCME, and they took place in 1997 and 2007. The other assessment was based on standards set by the Chilean accrediting organism, the National Committee for Undergraduate Program Accreditation (Comité Nacional de Acreditación de Pregrado-CNAP) and took place in the year 2001. In all three experiences, internal assessment was the most enriching stage, stimulating refections among students and teachers in order to recognize areas of strengths and weaknesses. External assessment processes, especially those based on international standards, are very important for the institutional and program development of Medical Schools. The PUC Medical School on its whole learnt how to carry out an assessment process and was able to improve several weaknesses without pressure, moving from quality assurance to quality enhancement. The present paper analyzes the major challenges involved in an external assessment process.

Assuntos

RESUMO

An important challenge for medical schools is to recognize and stimulate the academic career of its clinical faculty. These professionals are mainly dedicated to teaching activities and play a role in the modeling of its students. Therefore, they contribute to the development of medical education. The aim of this paper is to analyze the main features of this particular kind of academics and to stimulate physicians to embrace the teaching career. The development channels of teaching academic activity are direct teaching, curricular innovation and administration, counseling, clinical investigation, education administration, leadership and assessment of the learning process. We define each of these activities, giving examples of the activities that can be carried out and how to assess them.

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Background: The work environment of an organization has to do with a set of permanent qualities that are experienced by its members. Aim: To assess the work environment perception of faculty members of a Medical School in two different periods (2005 and 2007). Material and methods: A standardized survey was applied to faculty members and Department chairs of the academic units of our Medical School. The survey used the Likert scale from 1 to 5 and included 59 items, distributed in 8 factors. Additionally, there were two groups of statements, indicating the priorities for the School and for the academic departments. Results: In the study performed in year 2005, the survey was answered by a total of 399 faculty members (68 percent) and in year 2007, it was answered by 408 members (68 percent). The global climate perceptions were 66 percent and 68 percent in 2005 and 2007, respectively (ns). Among the dimensions evaluated, communications (p =0,62) and physical conditions (p =0,008) improved in the two years period. Conclusions: The applied instrument was stable and useful to knowing the requirements of the faculty members and for improving the organizational climate.

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INTRODUCTION: Studies on Mycoplasma pneumoniae infection are scarce in Chile. OBJECTIVE: To describe clinical characteristics associated with M. pneumoniae in children requiring hospitalization. MATERIAL AND METHODS: All children with a respiratory infection requiring hospitalizations between 2000-2005, whom had a M. pneumoniae specific IgM > or = 1:32, were analyzed. RESULTS: Fifty children meeting study criteria were identified with an average length of hospitalization of 4 days (range: 1-10); mean age was 5.4 years (46% were younger than 5 years). Common clinical features were cough (92%), fever (82%), malaise (74%) and respiratory distress (72%). At admission 40/45 children had hypoxemia. Chest-X ray showed interstitial pattern (69.3%), consolidation (51%) and hyperinsuflation (28.5%). Six patients had pleural effusion. Eighty four percent of patients had a favorable clinical outcome; eight children required admission to the PICU all of whom recovered. CONCLUSION: Respiratory infections associated with M. pneumoniae in our series of children had a highly variable and non-specific clinical spectrum. Chest-X rays showed different pattern in concordance with previous publications.

Assuntos

RESUMO

An important challenge for medical schools is to recognize and stimulate the academic career of its clinical faculty. These professionals are mainly dedicated to teaching activities and play a role in the modeling of its students. Therefore, they contribute to the development of medical education. The aim of this paper is to analyze the main features of this particular kind of academics and to stimulate physicians to embrace the teaching career. The development channels of teaching academic activity are direct teaching, curricular innovation and administration, counseling, clinical investigation, education administration, leadership and assessment of the learning process. We define each of these activities, giving examples of the activities that can be carried out and how to assess them.

Assuntos