Search

Roland Asmar1, Juan Garcia-Puig2, Philippe Gosse3, Yuri A Karpov4, Peter Wilhem De Leeuw5, Dieter Magometschniggs6, Lajos Matos7, Roland Schmieder81Institut Cardiovasculaire, Paris, France; 2Hospital La Paz, Madrid, Spain; 3Hôpital Saint André, Bordeaux, France; 4Russian Academy of Medical Sciences, Moscow, Russia; 5Academisch Ziekenhuis, Maastricht, the Netherlands; 6Institut für Hypertoniker, Vienna, Austria; 7Hungarian Institut of Cardiology, Budapest, Hungary; 8Medizinische FakultÄt, Erlangen GermanyBackground: Ambulatory blood pressure (BP) is more sensitive than office BP and is highly correlated with the left ventricular mass (LVM) of hypertensive patients with left ventricular hypertrophy (LVH). Methods: In this prospectively designed ancillary study of the PICXEL trial, the effects of first-line combination perindopril/indapamide on ambulatory BP were compared with those of monotherapy with enalapril in 127 patients. Hypertensive patients with LVH received once daily either perindopril 2 mg/indapamide 0.625 mg (n = 65) or enalapril 10 mg (n = 62) for 52 weeks. Dose adjustments were allowed for uncontrolled BP. Twenty-four-hour ambulatory BP and echocardiographic parameters were measured at baseline, week 24, and week 52. Results: At study end, both treatments significantly improved ambulatory BP compared with baseline (p ≤ 0.01). Perindopril/indapamide treatment reduced 24-hour and daytime systolic BP (SBP) and pulse pressure (PP) significantly more than enalapril treatment (p < 0.01). No significant between-group differences were noted for diastolic BP (DBP) or for night-time measurements. Trough/peak ratios were higher with perindopril/indapamide than with enalapril (88.5 vs 65.8 for SBP and 86.7 vs 63.9 for DBP, respectively). The global smoothness index was higher with perindopril/indapamide than with enalapril (6.6 vs 5.2 for SBP and 5.6 vs 4.9 for DBP, respectively). With perindopril/indapamide treatment, LVM index was significantly reduced (−9.1 g/m2 from baseline; p vs baseline

Resumen: El examen clínico objetivo y estructurado (ECOE) evalúa las competencias adquiridas por los estudiantes al terminar el grado de medicina. La competencia es el conjunto de conocimientos y habilidades para resolver un problema profesional, con una actitud adecuada. La Conferencia de decanos de las 40 facultades de medicina de España ha establecido que todos los estudiantes del grado de medicina que finalizasen sus estudios en el curso 2015/2016 deberían superar una prueba (ECOE) que evaluase 8 competencias clínicas: anamnesis; exploración física; comunicación; habilidades técnicas; juicio clínico, manejo diagnóstico y tratamiento; prevención y promoción de la salud; relaciones interprofesionales; y aspectos éticos y legales.La Facultad de Medicina de la Universidad Autónoma de Madrid se ha incorporado a este proyecto y ha organizado su primer ECOE para los 197 alumnos de 6.° curso, con 25 estaciones o pruebas. Este trabajo describe las 7 etapas o procesos esenciales que se han seguido para la instauración del ECOE y que puede resultar de utilidad para la comprensión de este complejo examen y su implantación. Abstract: The Objective Structured Clinical Examination (OSCE) evaluates clinical skills of medical students at the end of medical school training. Professional competence is the set of knowledge and clinical skills that helps to solve professional problems with the correct attitude. The Conference of Deans from all 40 Schools of Medicine in Spain agreed that all students completing their medical training in the 2015/16 academic year should take an exam to assess 8 competency areas: medical history, physical examination, communication skills, clinical judgment, diagnosis, management and treatment, prevention and health promotion, inter-professional relationships, and ethical and legal aspects. The Madrid Autonomous University Medical School took part in this national project, and conducted its first OSCE, with 25 tests, for the 197 students that concluded their training in 2016. This paper describes the 7 stages, or essential processes followed in order to establish the OSCE. This experience may be useful for the understanding and implementation of this complex competence evaluation process. Palabras clave: Enseñanza Medicina, Examen clínico objetivo estructurado, Rotatorio, Evaluadores, Actores, Keywords: Medical training, Objective structured clinical examination, Rotation, Assessors, Players