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AIMS: Chagas disease (ChD) affects approximately 7 million people in Latin America, with benznidazole being the most commonly used treatment. METHODS: Data from a retrospective cohort study in Argentina, covering January 1980 to July 2019, was reanalysed to identify and characterize benznidazole-related adverse drug reactions (ADRs). RESULTS: The study included 518 patients: 449 children and 69 adults (median age in children: 4 years; adults: 25 years; age ranges: 1 month-17.75 years and 18-59 years, respectively). The median benznidazole doses received were 6.6 mg/kg/day for at least 60 days in children and 5.6 mg/kg/day for a median of 31 days in adults. Overall, 29.34% (152/518) of patients developed benznidazole-related ADRs, with an incidence of 25.83% (116/449) in children and 52.17% (36/69) in adults (odds ratio [OR] = 0.32, 95% confidence interval [CI] = 0.19-0.54, P < .001). The incidence rate was 177 cases per 1000 person-years (95% CI = 145-214) in children and 537 per 1000 person-years (95% CI = 360-771) in adults. There were 240 ADRs identified, primarily mild to moderate. Severe ADRs occurred in 1.11% (5/449) of children and 1.45% (1/69) of adults. The skin was the most affected system. A total of 10.23% (53/518) of patients discontinued treatment. More adults than children discontinued treatment (OR = 3.36, 95% CI = 1.7-6.4, P < .001). CONCLUSIONS: Although 29.34% of patients experienced ADRs, most were mild to moderate, indicating a manageable safety profile for benznidazole. While optimized dosing schedules and new drugs are needed, avoiding benznidazole solely due to safety concerns is not justified.
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Introducción: el ejercicio de la docencia universitaria por parte de estudiantes de Medicina ofrecería múltiples beneficios. Sin embargo, no hay evidencia de que mejore el desempeño en los exámenes estandarizados en el posgrado. El objetivo de este estudio fue describir la diferencia de los puntajes en el examen de residencias médicas municipales entre ayudantes y no ayudantes, y evaluar la autopercepción del efecto de ser ayudante sobre el desempeño en dicho examen y sobre las habilidades académicas. Métodos: estudio observacional, descriptivo, de corte transversal, con un muestreo por conveniencia de médicos participantes del examen de residencias médicas municipales de la Ciudad Autónoma de Buenos Aires (CABA) de 2018, a partir del listado oficial. Se excluyeron aquellos a quienes fue imposible contactar, que se negaran a participar o cuya identidad discrepara con la de la persona seleccionada para incluir en el estudio. Resultados: de los 3579 médicos que concursaron en el examen de residencias médicas básicas municipales de CABA 2018, se tomó una muestra aleatoria de 300 sujetos, de los cuales se contactó a 87. De ellos, 20 sujetos cumplían con criterios de exclusión; por lo tanto fueron 67 sujetos los que finalmente participaron del estudio. La proporción de respuestas con respecto a los sujetos que pudieron ser contactados mediante redes sociales fue 77%. El puntaje de examen entre los ayudantes fue de 32,3 ± 5,7 puntos mientras que entre los no ayudantes fue 29,5 ± 6,1 puntos. Entre los ayudantes, el 68% informó percibir que el hecho de haber realizado una ayudantía en el pregrado tuvo un efecto de levemente a muy positivo sobre su desempeño en el examen, un 76% refirió la profundización de conocimientos específicos, el 73% informó una mejoría en sus habilidades comunicacionales y el 59% una mayor capacidad para jerarquizar contenidos. Conclusión: el desarrollo de una actividad docente en el pregrado sería percibida por quienes la desarrollan como una actividad promotora de habilidades comunicacionales y de jerarquización de contenidos y, ulteriormente, como una influencia positiva en el desempeño académico en el examen de residencias médicas municipales. Estas conclusiones deben confirmarse con estudios futuros. (AU)
Introduction: medical students could benefit from teaching university courses. However, there is no evidence showing that this activity improves academic performance on standardized tests in graduate school. The objective of this study was to describe the differences in scores on the municipal medical residency exam between physicians who were teaching assistants and those who weren't, and to evaluate the self-perception of the effect of being a teaching assistant on the performance on this exam and on academic skills in general. Methods: this is an observational, descriptive, cross-sectional study, with a convenience sample of physicians participating in the 2018 municipal medical residency exam of the Autonomous City of Buenos Aires (CABA) based on official lists. Those who could not be contacted, refused to participate, or whose identity diverged from the person selected to include in the study, were excluded. Results: of the 3,579 physicians who participated in the basic municipal medical residency exam in CABA 2018, a random sample of 300 subjects was taken, of which 87 were contacted. Of those, 20 subjects met the exclusion criteria, having 67 subjects finally participating in the study. The proportion of subjects who could be contacted through social networks was 77%. The exam score among physicians who were teaching assistants was 32.3 ± 5.7 points while among the non-teaching assistants it was 29.5 ± 6.1 points. Among the teaching assistants, 68% perceived that the fact of having been a teaching assistant as an undergraduate had a slight to very positive effect on their performance in the exam, 76% referred the deepening of their specific knowledge on the subject they taught, 73% reported an improvement in their communication skills, and 59% referred a greater ability to rank content. Conclusions: undergraduate teaching would be perceived as an activity that promotes communication skills and ability to rank content and, therefore, as a positive influence on academic performance in the municipal medical residency exam. These conclusions need to be confirmed with future studies. (AU)