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71.
72.
Carlos Guillen-Astete Iria Miguens-Blanco Miguel Zamorano-Serrano Elena Machin-Muñoz Paloma Gallego-Rodríguez Cristina de-la-Casa-Resino 《Educación Médica》2019
Introduction
The care activity of internal resident doctors is common to practically all medical and surgical training programs; however, there are no national data available regarding the situation of this activity from the perspective of the resident. The present study has sought to collect the opinion of the resident internal physicians on the health care performance and the teaching character that links them to their corresponding emergency departments, in the following areas: overall training value, appreciation of the workload, characteristics of the morning rotation, supervision or tutoring, etc.Method
The study was performed using a questionnaire that was distributed at the national level through the network of representatives of the SEMES-MIR group of the Spanish Society of Emergency and Emergency Medicine.Results
A total of 1083 questionnaires were collected from 38 hospitals, corresponding to a response rate of 28%. The most significant educational contribution was the general knowledge about emergency medical care and the interpretation of complementary tests, while the less significant were aspects related to pharmacoeconomics, sustainability and cost-benefit of medical and non-medical processes related to medicine Emergency. As for the burden of care during a day of continuous care, the first year residents saw a mean of 12.3 patients) (SD 2.2), the second and third year 18.1 (SD 2.2), and the older residents 14.5 (SD 2.4). Less than half (44%) of the respondents identified their supervision model as «direct», while 37.2% identified it as «semi-pyramidal». A minority (14.2%) of respondents acknowledged having been encouraged to undertake scientific activities related to emergency medicine.Conclusions
The results of this questionnaire should serve as a basis for the future planning of new models of teaching and care for residents and emergency services, as well as to stratify the priorities of attention to the relationship between emergency services and resident physicians. 相似文献73.
A functional survey of the enhancer activity of conserved non-coding sequences from vertebrate Iroquois cluster gene deserts 总被引:7,自引:4,他引:7
de la Calle-Mustienes E Feijóo CG Manzanares M Tena JJ Rodríguez-Seguel E Letizia A Allende ML Gómez-Skarmeta JL 《Genome research》2005,15(8):1061-1072
Recent studies of the genome architecture of vertebrates have uncovered two unforeseen aspects of its organization. First, large regions of the genome, called gene deserts, are devoid of protein-coding sequences and have no obvious biological role. Second, comparative genomics has highlighted the existence of an array of highly conserved non-coding regions (HCNRs) in all vertebrates. Most surprisingly, these structural features are strongly associated with genes that have essential functions during development. Among these, the vertebrate Iroquois (Irx) genes stand out on both fronts. Mammalian Irx genes are organized in two clusters (IrxA and IrxB) that span >1 Mb each with no other genes interspersed. Additionally, a large number of HCNRs exist within Irx clusters. We have systematically examined the enhancer activity of HCNRs from the IrxB cluster using transgenic Xenopus and zebrafish embryos. Most of these HCNRs are active in subdomains of endogenous Irx expression, and some are candidates to contain shared enhancers of neighboring genes, which could explain the evolutionary conservation of Irx clusters. Furthermore, HCNRs present in tetrapod IrxB but not in fish may be responsible for novel Irx expression domains that appeared after their divergence. Finally, we have performed a more detailed analysis on two IrxB ultraconserved non-coding regions (UCRs) duplicated in IrxA clusters in similar relative positions. These four regions share a core region highly conserved among all of them and drive expression in similar domains. However, inter-species conserved sequences surrounding the core, specific for each of these UCRs, are able to modulate their expression. 相似文献
74.
75.
González MB Gutiérrez NC García JL Schoenmakers EF Solé F Calasanz MJ San Miguel JF Hernández JM 《Cancer Genetics and Cytogenetics》2004,150(2):136-143
Abnormalities in the long arm of chromosome 7 are a frequent chromosomal aberration in myeloid disorders. Most studies have focused on the analysis of del(7q), demonstrating the presence of several minimal deleted regions in 7q22 approximately q31. By contrast, few studies in myeloid disorders have been devoted to the analysis of translocations, either balanced or unbalanced, involving 7q. In this study, we used fluorescence in situ hybridization (FISH) to characterize the 7q31.3 approximately q34 region (markers D7S480-D7S2227) in patients with deletion or translocation of 7q. A total of 910 cases of myeloid disorders were studied by conventional cytogenetics. Fifty-eight (6%) patients had structural aberrations of 7q. FISH studies were carried out in the 27 patients with involvement of 7q31 approximately q34: 14 cases had an acute myelogenous leukemia and 13 cases had a myelodysplastic syndrome. FISH analysis revealed the existence of high complexity in the 7q31.3 approximately q34 region in patients with unbalanced translocations. No breakpoints in 7q31.3 approximately q34 were found in the cases with deletion or balanced translocation. Nevertheless, studies of unbalanced translocations showed several breakpoints in markers D7S480-D7S2227, which delineate a commonly altered region. The complexity of 7q rearrangements suggests that a synergy of different genetic factors, rather than the alteration of a single tumor suppressor gene, could be involved in the pathogenesis of del(7q) in myeloid disorders. 相似文献
76.
Ricardo Baptista Hugo Silva Miguel Rocha 《Journal of medical engineering & technology》2020,44(4):153-161
AbstractThe stethoscope is a major symbol of modern medicine. It is used for diagnosis of different conditions and enables physicians to listen to internal body sounds. Electrocardiography was only introduced in medicine in the beginning of the twentieth century. Today measuring heart’s electrical activity is also fundamental cardiac diseases diagnosis. Although performed with independent devices, requiring physician and patient presence in the same physical space, in combination they enhance cardiovascular assessment. In this paper, a digital stethoscope encapsulation was designed, adding new functionality to this advanced medical device. Today wired and wireless communications enable different medical devices to share data and information, over long distances. Using low-cost hardware technologies, the encapsulation will add the ability to acquire and transmit via Bluetooth the Electrocardiographic activity, determined in the same cardiac focus and synchronised with the Phonocardiographic sound recordings. Several encapsulation concepts were developed and prototyped using 3D printing. They were easily fitted to the digital stethoscope and tested in a hospital environment for ergonomics, acoustic and electric signals acquisition. The best concept was chosen with the help of a physician’s opinion and the final prototype performance was very satisfactory. 相似文献
77.
78.
Summary We have cloned the Cephalosporium acremonium pyr4 gene by cross-hybridization with the equivalent gene from Neurospora crassa, the closest relative from which this gene is available. The C. acremonium pyr4 gene complements an E. coli pyrF mutant lacking orotidine-5-phosphate decarboxylase (OMPdecase), and most probably does not contain introns. Maxicell analysis in E. coli shows that it encodes a 46 kDa polypeptide. The C. acremonium OMPdecase contains a highly conserved pentadecapeptide characteristic for this category of enzyme. Extensive sequence comparison suggests an important role of this region in enzymatic activity. 相似文献
79.
Ana Grangeia Miguel Leão Carla P. Moura 《American journal of medical genetics. Part A》2020,182(1):25-28
Wiedemann‐Steiner syndrome (WSS) is a rare genetic disorder characterized by growth retardation, facial dysmorphism, hypertrichosis cubiti and neurodevelopment delay. It is caused by pathogenic variants in the KMT2A gene. This report describes two unrelated Portuguese patients, age 11 and 17 years, with a phenotype concordant with WSS and clinical and molecular diagnosis of WSS by the identification of two novel frameshift variants in the KMT2A gene. This work also highlights the presence of certain clinical features in patients with growth retardation and development delay and should draw attention to the diagnosis of WSS, when hirsutism, particularly hypertrichosis cubiti is present. 相似文献
80.
P. Alonso A. Orduña M. A. Bratos A. San Miguel A. Rodríguez Torres 《European journal of clinical microbiology & infectious diseases》1998,17(6):371-376
The purpose of this study was to evaluate the clinical usefulness of a commercial ligase-based gene amplification method (LCxMycobacterium tuberculosis test; Abbott Laboratories, USA) for detection ofMycobacterium tuberculosis. The tuberculosis infection rate among clinical samples was 10.6%. The sensitivity, specificity, and positive and negative predictive values were 23.5%, 100%, 100%, and 91.7%, respectively, with the fluorochrome auramine stain; 32.4%, 100%, 100%, and 92.6%, respectively, with culture; and 76.5%, 95.8%, 68.4% and 97.2%, respectively, with the gene amplification method. When only samples from patients without current or previous treatment were studied, the sensitivity was 36.4% with the auramine stain, 63.6% with culture, and 100% with the gene amplification assay. The mean treatment time for culture-negative and assay-negative samples was greater than that of culture-negative and assay-positive samples. The LCxMycobacterium tuberculosis test is a sensitive method for detection and identification ofMycobacterium tuberculosis. It produces few false-positive results. However, as it can remain positive after the culture becomes negative, it is not recommended for evaluation of treatment efficiency. 相似文献