São Paulo medical journal = Revista paulista de medicina
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Different approaches to learning can exert considerable influence on the teaching-learning process in medical education. This study aimed to investigate the association of surface and deep learning with study patterns, preferred type of assessment, practices of cheating and quality of sleep among medical students. ⋯ The type of learning approach was associated with study patterns and choices among medical students. Educators need to be attentive to the type of learning their students use and think of measures that impact teaching and assessment methods.
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Psychosocial care centers for alcohol and drug users (CAPS-ad) are reference services for treatment of drug users within the Brazilian National Health System. Knowledge of their total costs within the evidence-based decision-making process for public-resource allocation is essential. The aims here were to estimate the total costs of a CAPS-ad and the costs of packages of care (according to intensity of care); to ascertain the ratio between total CAPS-ad costs and the federal funding allocated; and to describe the methods for estimating unit costs for each CAPS-ad cost component. ⋯ The federal budget allocation covered 62.1% of the CAPS-ad costs and the remaining 37.9% end up funded by the municipal government. The cost of the intensive package of care was 18 times greater than the non-intensive package. Developing criteria for using services and different packages of care based on patients' needs, and optimizing human resources according to specific actions, may improve people's mental health and avoid wasted resources.
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Case Reports
A psychotic experience during adolescence: reasoning about differential diagnosis. case report.
The aim of the present clinical review was to illustrate the diagnostic difficulty associated with psychotic experiences during adolescence, in the light of the multiplicity of circumstances interplaying during this period. It was also intended to illustrate the observation that not all hallucinations occur in the context of a declared psychotic disorder. ⋯ Conversive hallucinations are rare in the psychiatric literature. This diagnostic hypothesis only gained consistency over a long period of follow-up within a child and adolescent psychiatry outpatient service, which was fundamental for appropriate diagnostic clarification. The authors discuss psychotic experiences that can arise from a neurotic setting and share the reasoning that was constructed in relation to the differential diagnosis. The psychogenesis and phenomenology of this young patient's conversive hallucinations and the therapeutic strategies adopted over the course of the follow-up are also discussed.
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Secondary prevention of stroke is a very important goal for achieving continuous reduction in stroke mortality rates over the next decades. ⋯ In this sample of individuals with better access to healthcare services, use of secondary prevention for stroke was low, which may suggest that the situation in the general population is worse. Sex was the most important sociodemographic variable associated with low use of secondary prevention.
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Serological tests are practical, with low cost, but no noninvasive tests are available for diagnosing Helicobacter pylori (H. pylori) infection in Brazil. The aim here was to develop and validate enzyme-linked immunosorbent assay (ELISA) serological tests to detect anti-H. pylori immunoglobulin G antibodies, based on cultured strains from Brazilian patients. ⋯ The polyclonal serological test developed using local strains presented better diagnostic performance among children and adolescents, while the monoclonal test was better among adults. The results from both tests suggest that these in-house serological tests could be used to detect anti-H. pylori antibodies in our population, for screening purposes.