II
Mitermayer Galvão dos Reis III
PALAVRAS-CHAVE:-Patologia; -Educação Médica; -Modelos Educacionais.
RESUMOObjetivo: Avaliar modificações implementadas recentemente num curso de Patologia Geral (PG)
ObjectiveTo evaluate the indications for performing magnetic resonance imaging of the
female pelvis at a referral center for cancer.Materials and MethodsThis was a retrospective, single-center study, conducted by reviewing medical
records and imaging reports. We included 1060 female patients who underwent
magnetic resonance imaging of the pelvis at a cancer center between January
2013 and June 2014. The indications for performing the examination were
classified according to the American College of Radiology (ACR)
criteria.ResultsThe mean age of the patients was 52.6 ± 14.8 years, and 49.8% were
perimenopausal or postmenopausal. The majority (63.9%) had a history of
cancer, which was gynecologic in 29.5% and nongynecologic in 34.4%. Of the
patients evaluated, 44.0% had clinical complaints, the most common being
pelvic pain (in 11.5%) and bleeding (in 9.8%), and 34.7% of patients had
previously had abnormal findings on ultrasound. Most (76.7%) of the patients
met the criteria for undergoing magnetic resonance imaging, according to the
ACR guidelines. The main indications were evaluation of tumor recurrence
after surgical resection (in 25.9%); detection and staging of gynecologic
neoplasms (in 23.3%); and evaluation of pelvic pain or of a mass (in
17.1%).ConclusionIn the majority of the cases evaluated, magnetic resonance imaging was
clearly indicated according to the ACR criteria. The main indication was
local recurrence after surgical treatment of pelvic malignancies, which is
consistent with the routine protocols at cancer centers.
ObjectiveTo evaluate the accuracy of multidetector computed tomography with a stomach
protocol in staging of gastric cancer.Materials and MethodsWe evaluated 14 patients who underwent computed tomography in a 16-channel
scanner for preoperative staging of gastric adenocarcinoma between September
2015 and December 2016. All images were analyzed by the same radiologist,
who had extensive experience in abdominal cancer imaging. The sensitivity,
specificity, and accuracy of the method were calculated by comparing it with
the pathology result. All patients underwent partial or total
gastrectomy.ResultsThe mean age was 61.5 years, and 53.8% of the patients were male. The gastric
lesions were classified as T1/T2 in 35.7% of the cases, as T3 in 28.5%, and
as T4 in 35.7%. Eleven patients (68.7%) had suspicious (N positive) lymph
nodes. The accuracy of the T1/T2, T3, T4, and lymph node staging tests was
85%, 78%, 90%, and 78%, respectively. The respective sensitivity and
specificity values were 71% and 100% for T1/T2, 66% and 81% for T3, 100% and
90% for T4, and 88% and 60% for lymph nodes.ConclusionMultidetector computed tomography with a stomach protocol, used in
conjunction with virtual gastroscopy, shows good accuracy in the tumor and
lymph node staging of gastric adenocarcinoma.
INTRODUÇÃO: O ensino da Patologia tem papel fundamental na formação médica, por ser o principal elo entre as ciências básicas e a prática clínica, assim como referência para a pesquisa científica. A Patologia insere-se no grupo de disciplinas que passam por um processo de mudanças curriculares e incorporação de novas tecnologias, sendo tal processo iniciado há duas décadas nos EUA, Austrália e Europa. OBJETIVO: Discutir as vantagens e desvantagens das mudanças que atingem o ensino da Patologia no País, a partir da experiência internacional. RESULTADOS: Na presente revisão, discutimos preocupações atuais, que incluem a marginalização da Patologia no currículo médico, a falta de contato dos estudantes com a Anatomia Patológica e as possíveis lacunas na formação do futuro médico. CONSIDERAÇÕES FINAIS: A ausência de contato com a Anatomia Patológica no curso médico, ou sua participação meramente ilustrativa, cria os problemas adicionais de pouco incentivo à escolha desta especialidade médica e gera a dificuldade dos novos médicos em lidar com solicitações e interpretações de laudos anatomopatológicos.
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