Origem física das curvas sigmoidais respiratórias pressão-volume: recrutamento alveolar e elasticidade não-linear

An important unsolved problem in medical science concerns the physical origin of the sigmoidal shape of pressure volume curves of healthy (and some unhealthy) lungs. Such difficulties are expected because the lung, which is the most important structure in the respiratory system, is extremely complex. Its rheological properties are unknown and seem to depend on phenomena occurring from the alveolar scale up to the thoracic scale. Conventional wisdom holds that linear response, i.e., Hooke s law, together with alveolar overdistention, play a dominant role in respiration, but such assumptions cannot explainthe crucial empirical sigmoidal shape of the curves. In this doctorate thesis, we propose an alternative theory to solve this problem, based on the alveolar recruitment together with the nonlinear elasticity of the alveoli. This theory suggests that recruitment may be the predominant factor shaping these curves in the entire range of pressures normally employed in experiments. The proposed model correctly predicts the observed sigmoidal pressure volume curves, allowing us to discuss adequately the importance of this result, as well as its implications for medical practice

A simulação como método de ensino de habilidades no curso de medicina: relato de uma experiência com punção lombar

The teaching of the lumbar puncture (LP) technique with simulator is not well systematized in the curricula of medical schools. Studies show that training in the simulator provides learning technical skills, acquisition and retention of knowledge, improve self-confidence of the learner and enables the transfer to clinical practice. We intend this study to introduce simulated training in LP in medical course at the Universidade Federal do Rio Grande do Norte evaluating the experience taking into account quantitative aspects (performance on standardized tests) and qualitative (perception of the students regarding the method and the teaching process learning). The study was conducted in two phases. In the first phase practical training in PL was introduced in the 3rd year of medical school. Seventy-seven students were trained in small groups, guided by a checklist developed in the model Objective Structured Assessment of Technical Skill (OSATS), at this moment they knew they were not under performance evaluation. They were also asked whether they had prior chances to make an LP in patients. At the end of the first phase the students evaluated training in the following areas: teaching technique, simulator realism, time available per group, number of participants per group and relevance to medical practice. In the second phase, two years later, 18 students trained in first stage performed a new LP on the mannequin simulator, and its performance was evaluated through the same checklist of training in order to verify the technical retention. In addition, they answered a multiple choice test about practical aspects of the LP technique. Each participant received individual feedback on their performance at the end of their participation in the study. In the first phase of the study we found that only 4% of students had performed a lumbar puncture in patients until the 3rd year. The training of LP technique with simulator mannequin was considered relevant and the teaching methods was thoroughly evaluated. In the second phase, all participants were successful in implementing the lumbar puncture on the mannequin simulator, compliance with the most steps in a reasonable time, suggesting that would be able to perform the procedure in a patient.

A Humanização e a Formação Médica na Perspectiva dos Estudantes de Medicina da Universidade Federal do Rio Grande do Norte

The aim of this study is to understand the perception of medical students at the Federal University of Rio Grande do Norte (UFRN) about humanization in the context of their medical formation, using a qualitative approach. The focus group and participant observation techniques were used, involving a multidisciplinary team composed of professionals from the areas of anthropology and psychology, as well as professors from the medical course, who studied two groups of nine students in their final year. The data were analyzed using the categorical thematic content analysis technique, from which emerged three categories: student/patient relationship, teaching/learning and student/professor relationship. The first allows us to identify that student-patient contact is an essential experience for adopting a more humanized view of the disease process. The second category shows that unqualified professors in the pedagogic practices inherent to the teaching profession and the theory the practical dichotomy hinder the autonomous and holistic formation of knowledge. Similarly, the lack of practices outside the academic environment and the absence of multiprofessional stimulation interfere in the construction of an integral view of the individual. From the third category, the student/professor relationship, emerge two opposing subcategories (professor model and assymetric relationships), which reflect the importance of the professor`s ethical humanist position, as opposed to an authoritarian attitude, to form the professional attitude of the student. The results point important aspects of the medical formation that may open a discussion about humanization, in the context of new national curricular guidelines

ISE-SPL: Uma abordagem baseada em linha de produtos de software aplicada à geração automática de sistemas para educação médica na plataforma E-learning

E-learning, which refers to the use of Internet-related technologies to improve knowledge and learning, has emerged as a complementary form of education, bringing advantages such as increased accessibility to information, personalized learning, democratization of education and ease of update, distribution and standardization of the content. In this sense, this paper aims to develop a tool, named ISE-SPL, whose purpose is the automatic generation of E-learning systems for medical education, making use of concepts of Software Product Lines. It consists of an innovative methodology for medical education that aims to assist professors of healthcare in their teaching through the use of educational technologies, all based on computing applied to healthcare (Informatics in Health). The tests performed to validate the ISE-SPL were divided into two stages: the first was made by using a software analysis tool similar to ISE-SPL, called SPLOT and the second was performed through usability questionnaires to healthcare professors who used ISESPL. Both tests showed positive results, proving it to be an efficient tool for generation of E-learning software and useful for professors in healthcare