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Search Results: 1 - 10 of 224007 matches for " Bollela Valdes R. "
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Problemas na padroniza??o da rea??o em cadeia da polimerase para diagnóstico da tuberculose pulmonar
Bollela,Valdes R.; Sato,Daisy N.; Fonseca,Benedito A. L.;
Revista de Saúde Pública , 1999, DOI: 10.1590/S0034-89101999000300009
Abstract: introduction: the recent increase in the number of tuberculosis cases has called the world's attention once again to a perennial health problem, especially prevalent in developing countries. the time elapsed between the diagnosis and the institution of therapy is an obstacle to tuberculosis control and there is an urgent need for the development of techniques for the disease's rapid diagnosis. to achieve this goal, molecular biology techniques have been exhaustively investigated. this work describes the use of a polymerase chain reaction for rapid diagnosis of tuberculosis in a developing country. the sensitivity and specificity of this technique is compared to standard techniques used in the microbiology laboratory. methods: this study was undertaken in ribeir?o preto, s. paulo state, brazil. forty-two sputum samples from suspected cases of tuberculosis attending the municipal health care centers were sent to the microbiology laboratory. the samples were processed for the detection of mycobacterium tuberculosis by acid-fast bacilli determination, culture in lowenstein-jensen medium, and by a polymerase chain reaction that amplified a fragment of 123 base pairs of the mycobacterium tuberculosis genome. results: of the forty-two samples studied, one was contaminated and excluded from the study, ten were culture positive, ten were positive for the presence of acid-fast bacilli, and sixteen were polymerase chain reaction positive. the sensitivity and specificity of this technique were 90% and 81%, respectively. conclusions: the polymerase chain reaction presented a sensitivity comparable to the culture and the whole procedure took only one day to complete. the results presented here make it a strong candidate for rapid diagnosis of tuberculosis in clinical settings making it possible to begin the specific therapy early in the course of the disease. however, standardization of the technique is necessary, and the correlation with clinical findings is of paramount importa
Problemas na padroniza o da rea o em cadeia da polimerase para diagnóstico da tuberculose pulmonar
Bollela Valdes R.,Sato Daisy N.,Fonseca Benedito A. L.
Revista de Saúde Pública , 1999,
Abstract: OBJETIVO: Padronizar rea o em cadeia da polimerase para diagnóstico de tuberculose pulmonar, comparando os resultados obtidos com as técnicas microbiológicas clássicas, e analisar seu uso numa regi o de alta prevalência da tuberculose. MéTODOS: Foram descontaminadas, após a baciloscopia, 42 amostras de escarro de pacientes. Em seguida, procedeu-se ao cultivo em Lowenstein-Jensen e à rea o em cadeia da polimerase com "primers" que amplificam um fragmento de 123 pares de base do genoma do Mycobacterium tuberculosis. RESULTADOS: Das 42 amostras de escarro, 10 apresentaram cultura positiva para M. tuberculosis. Dez foram positivas à baciloscopia e 16 mostraram-se positivas na rea o em cadeia da polimerase. A sensibilidade e especificidade do teste em rela o à cultura foi de 90% e 81%, respectivamente. CONCLUS ES: A rea o em cadeia da polimerase tem sensibilidade comparável à da cultura e pode ser realizada em apenas um dia, resultando em tratamento precoce e melhor controle da doen a. A padroniza o e avalia o de técnicas de biologia molecular no diagnóstico da tuberculose no Brasil é imprescindível na discuss o da implanta o deste exame na rotina diagnóstica em centros de referência.
Quebrando barreiras: integra??o do currículo de pediatria a partir da cria??o de uma matriz de competências
Naghettini, Alessandra V.;Bollela, Valdes R.;Costa, Nilce M. S. C.;Salgado, Luciana M. R.;
Jornal de Pediatria , 2011, DOI: 10.2223/JPED.2132
Abstract: objective: to describe the process of integration and revision of a pediatric program curriculum which resulted in the creation of a competency-based framework recommended in the brazilian national curricular guidelines. methods: quali-quantitative analysis of an intervention evaluating the students and professors' perception of the pediatric program curriculum (focus groups and semi-structured interviews). results were discussed during teaching development workshops. a competency-based framework was suggested for the pediatric program from the 3rd to the 6th year. the new curriculum was approved, implemented, and reevaluated six months later. results: twelve students (12%) from the 3rd to the 6th year participated in the focus groups, and 11 professors (78.5%) answered the questionnaire. most participants reported lack of integration among the courses, lack of knowledge about the learning goals of the internships, few opportunities of practice, and predominance of theoretical evaluation. in the training workshops, a competency-based curriculum was created after pediatrics and collective health professors reached an agreement. the new curriculum was focused on general competency, learning goals, opportunities available to learn these goals, and evaluation system. after six months, 93% (104/112) of students and 79% (11/14) of professors reported greater integration of the program and highlighted the inclusion of the clinical performance evaluation. conclusion: the collective creation of a competency-based curriculum promoted higher satisfaction of students and professors. after being implemented, the new curriculum was considered to integrate the teaching practices and contents, improving the quality of the clinical performance evaluation.
Students and tutors' social representations of assessment in problem-based learning tutorials supporting change
Valdes R Bollela, Manoel HC Gabarra, Caetano da Costa, Rita CP Lima
BMC Medical Education , 2009, DOI: 10.1186/1472-6920-9-30
Abstract: A random group of ten students, out of a cohort of sixty, and ten tutors (out of eighteen) were selected for semi-structured interviews. The social representations' theory was used to explore how the students and tutors made sense of "assessment in tutorials". The data were content analyzed using software for qualitative and quantitative processing of text according to lexicological distribution patterns.Even though students and tutors are aware of the broader purpose of assessment, they felt that they were not enough trained and confident to the tutorial assessment. Assigning numbers to complex behaviors on a regular basis, as in tutorials, is counter productive to cooperative group learning and self assessment. Tutors believe that students are immature and not able to assess themselves and tutors. Students believe that good grades are closely related to good oral presentation skills and also showed a corporative attitude among themselves (protecting each other from poor grades).Faculty training on PBL tutorials' assessment process and a systematic strategy to evaluate new programs is absolutely necessary to review and correct directions. It is envisaged that planners can make better-informed decisions about curricular implementation, review and reform when information of this nature is made available to them.Problem-based learning (PBL) form the backbone of theoretical learning in some medical schools that advocate student-centered teaching methods. This approach stimulates students to play an active role in the learning process as compared to the passive information transmission, typical of traditional teaching methods. PBL relies on small group as the foundation of study, and tutors facilitate learning by guiding the group process rather than teaching the group[1,2]. Medical programmes that implement PBL face several challenges when introducing this innovative teaching and learning method. One of the major challenges is the use of appropriate strategies to asses
Avalia??o do programa de Residência Médica do Departamento de Pediatria da Faculdade de Medicina da Universidade de S?o Paulo
Koch, Vera Hermina K.;Doria Filho, Ulysses;Bollela, Valdes Roberto;
Revista Brasileira de Educa??o Médica , 2011, DOI: 10.1590/S0100-55022011000400003
Abstract: introduction: graduate profile assessment is a useful means of investigating the synchronicity between training provided and professional demand. objectives: to review, by means of a standardized questionnaire, the professional profile of graduates from the paediatric medical residency program of fmusp in the period 1997-2008 and the compatibility of that profile with medical practice in the community. methods: the email addresses of 297/446 graduates were located; 150 responded to the survey, following informed consent. results: 126/150 respondents were female, average age 31.9 ± 2.8 years, 61.3% from s?o paulo state (sp), 64% worked professionally in sp. graduates from the north, northeast and central-west regions established their careers in sp. the choice of paediatric medicine was related to affection for children, preference for working with children and the general nature of the speciality. the internships considered to be of most importance for professional practice were in the area of emergency medicine, neonatal care, general paediatric units and paediatric specialities. extending the paediatric medical residency to three years was approved by 72%; 66% of whom wished for greater contact with paediatric specialities; 78% considered themselves professionally fulfilled and 22% partially fulfilled in virtue of earning less than expected or due to lack of academic qualification; 54% worked in a teaching capacity, primarily in the public sector. future expectations related mainly to starting/completing graduate studies, professional improvement/recognition and higher earnings, with a focus on private practice. conclusions: the graduates suggest more solid training in paediatric specialities and display a trend of settling in sp, and not returning to their home state.
Self- and peer assessment may not be an accurate measure of PBL tutorial process
José Machado, Valéria Machado, Waldir Grec, Valdes Bollela, Joaquim Vieira
BMC Medical Education , 2008, DOI: 10.1186/1472-6920-8-55
Abstract: The tutorial evaluation method was comprised of the students' self assessment (SA) (10%), tutor assessment (TA) (80%) and peer assessment (PA) (10%) to calculate a final educational process grade for each tutorial. We compared these three grades from each tutorial for seven semesters using ANOVA and a post hoc test.A total of 349 students participated with 199 (57%) women and 150 (42%) men. The SA and PA scores were consistently greater than the TA scores. Moreover, the SA and PA groups did not show statistical difference in any semester evaluated, while both differed from tutor assessment in all semesters (Kruskal-Wallis, Dunn's test). The Spearman rank order showed significant (p < 0.0001) and positive correlation for the SA and PA groups (r = 0.806); this was not observed when we compared TA with PA (r = 0.456) or TA with SA (r = 0.376).Peer- and self-assessment marks might be reliable but not valid for PBL tutorial process, especially if these assessments are used for summative assessment, composing the final grade. This article suggests reconsideration of the use of summative assessment for self-evaluation in PBL tutorials.The medical course of the Universidade Cidade de S?o Paulo (UNICID), in Sao Paulo, Brazil, adopted the problem-based learning (PBL) strategy as the predominant method for teaching and learning medicine since its opening in 2004. This choice was determined by the perspective that this pedagogy would improve students' critical thinking, communication skills, self-assessment skills and general professional competencies. Several changes have been introduced in medical education over the last 30 years, including the introduction of new contextualized approaches like PBL, the use of tools to enhance self-directed learning, the vertical integration of curriculum between basic and clinical sciences and the introduction of new formative and summative evaluation strategies that match with the curriculum changes [1].Theoretically, PBL should encourage p
Use of epidemiological data as the basis for developing a medical curriculum
Machado, José Lúcio Martins;Souza, Sonia Regina Pereira de;Brenna, Sylvia Michelina Fernandes;Pose, Regina Albanese;Bollela, Valdes Roberto;Vieira, Joaquim Edson;
Sao Paulo Medical Journal , 2012, DOI: 10.1590/S1516-31802012000200007
Abstract: context and objective: epidemiology may help educators to face the challenge of establishing content guidelines for the curricula in medical schools. the aim was to develop learning objectives for a medical curriculum from an epidemiology database. design and setting: descriptive study assessing morbidity and mortality data, conducted in a private university in s?o paulo. methods: an epidemiology database was used, with mortality and morbidity recorded as summaries of deaths and the world health organization's disability-adjusted life year (daly). the scoring took into consideration probabilities for mortality and morbidity. results: the scoring presented a classification of health conditions to be used by a curriculum design committee, taking into consideration its highest and lowest quartiles, which corresponded respectively to the highest and lowest impact on morbidity and mortality. data from three countries were used for international comparison and showed distinct results. the resulting scores indicated topics to be developed through educational taxonomy. conclusion: the frequencies of the health conditions and their statistical treatment made it possible to identify topics that should be fully developed within medical education. the classification also suggested limits between topics that should be developed in depth, including knowledge and development of skills and attitudes, regarding topics that can be concisely presented at the level of knowledge.
McFarland nephelometer as a simple method to estimate the sensitivity of the polymerase chain reaction using Mycobacterium tuberculosis as a research tool
Bollela, V.R.;Sato, D.N.;Fonseca, B.A.L.;
Brazilian Journal of Medical and Biological Research , 1999, DOI: 10.1590/S0100-879X1999000900003
Abstract: polymerase chain reaction (pcr) has been widely investigated for the diagnosis of tuberculosis. however, before this technique is applied on clinical samples, it needs to be well standardized. we describe the use of mcfarland nephelometer, a very simple approach to determine microorganism concentration in solution, for pcr standardization and dna quantitation, using mycobacterium tuberculosis as a model. tuberculosis is an extremely important disease for the public health system in developing countries and, with the advent of aids, it has also become an important public health problem in developed countries. using mycobacterium tuberculosis as a research model, we were able to detect 3 m. tuberculosis genomes using the mcfarland nephelometer to assess micobacterial concentration. we have shown here that mcfarland nephelometer is an easy and reliable procedure to determine pcr sensitivity at lower costs.
McFarland nephelometer as a simple method to estimate the sensitivity of the polymerase chain reaction using Mycobacterium tuberculosis as a research tool
Bollela V.R.,Sato D.N.,Fonseca B.A.L.
Brazilian Journal of Medical and Biological Research , 1999,
Abstract: Polymerase chain reaction (PCR) has been widely investigated for the diagnosis of tuberculosis. However, before this technique is applied on clinical samples, it needs to be well standardized. We describe the use of McFarland nephelometer, a very simple approach to determine microorganism concentration in solution, for PCR standardization and DNA quantitation, using Mycobacterium tuberculosis as a model. Tuberculosis is an extremely important disease for the public health system in developing countries and, with the advent of AIDS, it has also become an important public health problem in developed countries. Using Mycobacterium tuberculosis as a research model, we were able to detect 3 M. tuberculosis genomes using the McFarland nephelometer to assess micobacterial concentration. We have shown here that McFarland nephelometer is an easy and reliable procedure to determine PCR sensitivity at lower costs.
Meningitis neumococica
MARIO GONZALEZ R,SALVADOR VALDES B,OSVALDO MONTES
Revista chilena de pediatría , 1946,
Abstract:
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