Diego Manente

Diferencias en los estilos de aprendizaje desde la escuela primaria hasta el posgrado en medicina

espanolObjetivos. Describir los estilos de aprendizaje de estudiantes de medicina al ingreso y en el posgrado inmediato, de acuerdo con las modalidades preferidas para usar la informacion, y comparar estos resultados con los estilos de alumnos de la escuela primaria, a fin de hallar diferencias generacionales. Sujetos y metodos. Se administro el cuestionario VARK a 73 alumnos de septimo grado de una escuela primaria, 113 estudiantes de primer ano de medicina y 141 residentes. Se realizo un analisis exploratorio para determinar conjuntos con caracteristicas afines (analisis de conglomerados). El conteo y suma de los resultados de cada individuo represento el estilo preponderante de cada grupo, definiendose como dominante cuando se elegia en mas del 50% de las respuestas. Resultados. Los estilos preponderantes en los tres grupos fueron cinestesico (27,5%) y bimodal (37,3%), mientras que el lectoescritor crecio desde la escuela primaria hasta el posgrado (1,4% a 10,7%; p = 0.037), con una tendencia de la caida del estilo auditivo desde la primaria hasta la universidad y posgrado (19,2% a 12,2%; p = 0.269). Para el estilo bimodal, la combinacion preponderante fue auditivo-cinestesica, que disminuyo desde la primaria hasta el posgrado (65% a 31%; p = 0,002). Conclusiones. El analisis de correspondencia mostro que los alumnos de la escuela primaria preferian el estilo auditivo, los universitarios se acercaban al cinestesico y los de posgrado tenian una preferencia intermedia entre el visual y el lectoescritor. Este ultimo perfil crecio significativamente desde la escuela primaria hasta el posgrado, con una tendencia inversa del estilo auditivo y del bimodal auditivo-cinestesico entre los mismos grupos. EnglishAims. To describe learning styles observed in first-year medical students and in postgraduates, regarding sensory preferences to use information, and to compare the results with the learning styles of last-year elementary school pupils, in order to find out generational differences. Subjects and methods. The VARK questionnaire was administered to 73 last-year elementary school pupils, 113 first-year medical students and 141 residents of cardiology (postgraduate). The questionnaire consists of 16 questions and each answer was associated to a particular learning style, corresponding to visual, aural, reading/writing or kinaesthetic. Results. Most common styles were kinaesthetic (27.5%) and bimodal (37.3%) in the three groups, with some differences in reading/writing profile that increased from elementary school up to postgraduate (1.4% to 10.7%; p = 0.037), and a slight tendency to decrease aural style from that educational level to the university and the postgraduate (19.2% to 12.2%; p =0.269). Within bimodal styles, the most common combination was aural-kinaesthetic, that decreased from the elementary school to the postgraduate (65% to 31%; p = 0.002). Conclusions. Correspondence analysis showed last-year elementary school pupils preferred aural style, medical students were nearer to kinaesthetic mode, and postgraduates had an intermediate preference between visual and reading/writing styles. The last profile significantly increased from elementary school to postgraduate, with an inverse tendency of aural and aural-kinaesthetic bimodal styles among the two same levels.

Estratificación del riesgo cardiovascular en pacientes con sobrepeso u obesidad en prevención primaria. Implicaciones en la utilización de estatinas

BACKGROUND AND OBJECTIVES Cardiovascular risk estimation in patients with overweight/obesity is not standardized. Our objectives were to stratify cardiovascular risk using different scores, to analyze use of statins, to report the prevalence of carotid atherosclerotic plaque (CAP), and to determine the optimal cut-off point (OCP) of scores that discriminate between subjects with or without CAP. MATERIAL AND METHODS Non-diabetic patients with overweight or obesity in primary prevention were enrolled. The Framingham score (FS), the European score (ES), and the score proposed by the new American guidelines (NS) were calculated, and statin indication was evaluated. Prevalence of CAP was determined by ultrasound examination. A ROC analysis was performed. RESULTS A total of 474 patients (67% with overweight and 33% obese) were enrolled into the study. The FS classified the largest number of subjects as low risk. PAC prevalence was higher in obese as compared to overweight subjects (44.8% vs. 36.1%, P=.04). According to the FS, ES, and NS respectively, 26.7%, 39.1%, and 39.1% of overweight subjects and 28.6%, 39.0%, and 39.0% of obese subjects had an absolute indication for statins. All three scores were shown to acceptably discriminate between subjects with and without CAP (area under the curve>0.7). The OCPs evaluated did not agree with the risk category values. CONCLUSIONS Risk stratification and use of statins varied in the overweight/obese population depending on the function used. Understanding of the relationship between scores and presence of CAP may optimize risk estimate.