Canine visceral leishmaniasis (CVL) diagnosis is still a challenge in endemic areas with limited diagnostic resources. This study proposes a score with the potential to distinguish positive CVL cases from negative ones. We studied 265 dogs that tested positive for CVL on ELISA and parasitological tests. A score ranging between 0 and 19 was recorded on the basis of clinical signs. Dogs with CVL had an overall higher positivity of the majority of clinical signs than did dogs without CVL or with ehrlichiosis. Clinical signs such as enlarged lymph nodes (83.93%), muzzle/ear lesions (55.36%), nutritional status (51.79%), bristle condition (57.14%), pale mucosal colour (48.21%), onychogryphosis (58.93%), skin lesion (39.28%), bleeding (12.50%), muzzle depigmentation (41.07%), alopecia (39.29%), blepharitis (21.43%), and keratoconjunctivitis (42.86%) were more frequent in dogs with CVL than in dogs with ehrlichiosis or without CVL. Moreover, the clinical score increased according to the positivity of all diagnostic tests (ELISA, p < 0.001; parasite culture, p = 0.0021; and smear, p = 0.0003). Onychogryphosis (long nails) [odds ratio (OR): 3.529; 95% confidence interval (CI): 1.832-6.796; p < 0.001], muzzle depigmentation (OR: 4.651; 95% CI: 2.218-9.750; p < 0.001), and keratoconjunctivitis (OR: 5.400; 95% CI: 2.549-11.441; p < 0.001) were highly associated with CVL. Interestingly, a score cut-off value ≥ 6 had an area under the curve of 0.717 (p < 0.0001), sensitivity of 60.71%, and specificity of 73.64% for CVL diagnosis. The clinical sign-based score for CVL diagnosis suggested herein can help veterinarians reliably identify dogs with CVL in endemic areas with limited diagnostic resources.

A compreensão dos princípios científicos e a interpretação de artigos é necessária em qualquer especialidade médica. Entretanto, inexistem publicações sobre o conhecimento teórico e prático dos otorrinolaringologistas brasileiros. OBJETIVO: Avaliar a formação e o conhecimento científico de médicos da área de Otorrinolaringologia. MÉTODO: Durante dois congressos nacionais da especialidade, os participantes foram convidados a preencher questionário sobre prática e conhecimento científico para residentes e especialistas dessa área. RESULTADOS E CONCLUSÃO: Participaram do estudo 73 médicos (52% otorrinolaringologistas e 38% residentes), com idade entre 18 e 65 anos. Cerca de dois terços envolveram-se em alguma atividade científica durante a graduação e/ou referiram já ter escrito um artigo científico. Os médicos que já participaram de projetos de pesquisa sentem-se mais preparados para interpretar um artigo científico e conduzir um projeto de pesquisa (p = 0,0103 e p = 0,0240, respectivamente). Aqueles que participaram de projetos de pesquisa ou já escreveram um artigo tiveram melhor desempenho nos conceitos científicos teóricos (p = 0,0101 e p = 0,0103, respectivamente). Entretanto, o índice geral de acertos nas questões referentes ao conhecimento científico foi de 46,1%. Dessa forma, identificamos que há deficiências na formação científica dos otorrinolaringologistas brasileiros que podem ser atenuadas pela participação em projetos de pesquisa.

Physicians from all medical specialties are required to understand the principles of science and to interpret medical literature. Yet, the levels of theoretical and practical knowledge held by Brazilian otorhinolaryngologists has not been evaluated to date. OBJECTIVE: To assess the background and level of scientific knowledge of Brazilian otorhinolaryngologists. METHOD: Participants of two national ENT meetings were invited to answer a questionnaire to assess scientific practice and knowledge. RESULTS AND CONCLUSION: This study included 73 medical doctors (52% otorhinolaryngologists and 38% residents) aged between 18 and 65 years. About two-thirds have been involved in some form of scientific activity during undergraduate education and/or reported to have written at least one scientific paper. Physicians who took part in research projects felt better prepared to interpret scientific papers and carry out research projects (p = 0.0103 and p = 0.0240, respectively). Respondents who claimed to have participated in research or to have written papers had higher scores on theoretical scientific concepts (p = 0.0101 and p = 0.0103, respectively). However, the overall rate of right answers on questions regarding scientific knowledge was 46.1%. Therefore, a deficiency was observed in the scientific education of Brazilian otorhinolaryngologists. Such deficiency may be mitigated through participation in research.

It is not well established whether cytokine production differs in response to different clinical forms of visceral leishmaniasis (VL). In this work, we performed a cross-sectional study to investigate the plasma levels of cytokines [interferon (IFN)-γ, tumour necrosis factor (TNF)-α, interleukin (IL)-2, IL-4, IL-10 and IL-12] involved in the pathogenesis of VL in 80 subjects from VL endemic areas, including subjects with active VL, subjects with asymptomatic infection, subjects with cured VL and uninfected controls. The patients were recruited by sampling from a referral hospital and by random selection from a population-based cohort study. The results showed significant differences in the plasma concentration of all cytokines between the groups (p < 0.05). Patients with the active disease had higher plasma levels of IL-10, IL-4, INF-γ and TNF-α relative to the other groups and they produced more IL-12 than asymptomatic and cured subjects. Only the IL-2 concentration was higher in the asymptomatic and cured subjects relative to the patients with active disease (p < 0.05). Our results suggest that these cytokines can be used as markers in epidemiological studies conducted in endemic areas to distinguish between different clinical forms of VL. However, their usefulness should be confirmed in investigations conducted in other endemic areas.

RESUMO Objetivo: A exposição à educação científica durante a faculdade pode afetar o perfil do estudante, e a experiência na pesquisa pode estar associada com um melhor desempenho profissional. Hipotetizamos que o impacto da experiência na pesquisa obtida durante a graduação varia entre os currículos profissionais e entre os cursos de graduação. Métodos: Um questionário validado de múltipla escolha sobre conceitos científicos foi dado aos alunos do primeiro e quarto anos das faculdades de Medicina e Direito em uma instituição pública brasileira de ensino. Resultados: Os estudantes de Medicina participaram com mais frequência de programas de iniciação científica em relação aos estudantes de Direito, e essa tendência aumentou do primeiro ao quarto ano de faculdade. Em ambos os currículos, os alunos do quarto ano apresentaram uma maior porcentagem de acertos que os alunos do primeiro ano. A maior proporção de alunos do quarto ano definiu corretamente os conceitos de hipótese científica e teoria científica. Nas áreas de interpretação e escrita de artigos científicos, os alunos do quarto ano, em ambos os currículos, se sentiram mais confiantes do que os estudantes do primeiro ano. Embora os estudantes de Medicina tenham se sentido menos confiantes no planejamento e na realização de projetos de pesquisa que os estudantes de Direito, eles estavam mais envolvidos em atividades de pesquisa. Conclusão: A graduação em Medicina parece favorecer o desenvolvimento da maturidade crítica científica do que a graduação em Direito. A existência de políticas específicas nas escolas médicas é uma explicação razoável para a participação de estudantes de Medicina em mais atividades científicas.

ABSTRACT Objective: Exposure to science education during college may affect a student's profile, and research experience may be associated with better professional performance. We hypothesized that the impact of research experience obtained during graduate study differs among professional curricula and among graduate courses. Methods: A validated multiple-choice questionnaire concerning scientific concepts was given to students in the first and fourth years of medical and law school at a public Brazilian educational institution. Results: Medical students participated more frequently in introductory scientific programs than law students, and this trend increased from the first to the fourth years of study. In both curricula, fourth-year students displayed a higher percentage of correct answers than first-year students. A higher proportion of fourth-year students correctly defined the concepts of scientific hypothesis and scientific theory. In the areas of interpretation and writing of scientific papers, fourth-year students, in both curricula, felt more confident than first-year students. Although medical students felt less confident in planning and conducting research projects than law students, they were more involved in research activities. Conclusion: Medical graduation seems to favor the development of critical scientific maturity than law graduation. Specific policy in medical schools is a reasonable explanation for medical students’ participation in more scientific activities.