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CLINICAL METHODOLOGY I (NO EXAM)

Academic year and teacher
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Versione italiana
Academic year
2022/2023
Teacher
ROBERTO DE GIORGIO
Credits
6
Didactic period
Primo Semestre

Training objectives

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Modulo: 005987 - CHIRURGIA GENERALE
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The course of Clinical Methodology I consists of three modules: Internal Medicine, General Surgery and Medical Humanities (Diagnostic methodology. The module of INTERNAL MEDICINE aim to give to the student knowledge on how to investigate and evaluate clinical signs and symptoms of diseases, interpreting them from the physiopathological point of view, how to properly collect the medical history and to approach the physical examination for diseases respectively of surgical and medical interest. The module of MEDICAL HUMANITIES (DIAGNOSTIC METHODOLOGY) aims to provide to the students the proper conceptual tools to understands the outcomes of a clinical test and a of clinical trial, in particular their probabilistic aspects. The module of GENERAL SURGERY aims to teach how to establish a correct approach with the patient and how to collect in the appropriate way clinical signs and symptoms of diseases, classifying them in the physio-pathologic context, through anamnestic , physical and instrumental investigations. The basic procedures must be applied in the diagnosis of surgical diseases affecting the abdomen and the cardiovascular system; in cardiovascular, respiratory, gastroenteric, renal, endocrine and haematologic diseases of medical interest, as well as in infectious diseases, for which the host-pathogen relationships, the evaluation of the host defensive response and the identification of the pathogen are important.
Knowledge and understanding:
At the end of the course the student will:
- recognize the clinical manifestations of cardiovascular, respiratory, abdominal, nephrologic,
endocrine, haematological diseases
- be able to correctly handle the probabilistic meaning of a clinical test and of a clinical trial

Applying knowledge and understanding:
At the end of the course the student will have developed the ability to:
- collect the medical history of the patient and perform the physical examination
- understand and correctly employ the main diagnostic exams as well as imaging techniques
- distinguish sensibility/specificity from positive/negative predictive values
- distinguish confidence interval from clinical significance
- interpreting the p-value


------------------------------------------------------------
Modulo: 24441 - MEDICINA INTERNA
------------------------------------------------------------
The course of Clinical Methodology I consists of three modules: Internal Medicine, General Surgery and Medical Humanities (Diagnostic methodology. The module of INTERNAL MEDICINE aim to give to the student knowledge on how to investigate and evaluate clinical signs and symptoms of diseases, interpreting them from the physiopathological point of view, how to properly collect the medical history and to approach the physical examination for diseases respectively of surgical and medical interest. The module of MEDICAL HUMANITIES (DIAGNOSTIC METHODOLOGY) aims to provide to the students the proper conceptual tools to understands the outcomes of a clinical test and a of clinical trial, in particular their probabilistic aspects. The module of GENERAL SURGERY aims to teach how to establish a correct approach with the patient and how to collect in the appropriate way clinical signs and symptoms of diseases, classifying them in the physio-pathologic context, through anamnestic , physical and instrumental investigations. The basic procedures must be applied in the diagnosis of surgical diseases affecting the abdomen and the cardiovascular system; in cardiovascular, respiratory, gastroenteric, renal, endocrine and haematologic diseases of medical interest, as well as in infectious diseases, for which the host-pathogen relationships, the evaluation of the host defensive response and the identification of the pathogen are important.
Knowledge and understanding:
At the end of the course the student will:
- recognize the clinical manifestations of cardiovascular, respiratory, abdominal, nephrologic,
endocrine, haematological diseases
- be able to correctly handle the probabilistic meaning of a clinical test and of a clinical trial

Applying knowledge and understanding:
At the end of the course the student will have developed the ability to:
- collect the medical history of the patient and perform the physical examination
- understand and correctly employ the main diagnostic exams as well as imaging techniques
- distinguish sensibility/specificity from positive/negative predictive values
- distinguish confidence interval from clinical significance
- interpreting the p-value

------------------------------------------------------------
Modulo: 63696 - MEDICAL HUMANITIES
------------------------------------------------------------
The course of Clinical Methodology I consists of three modules: Internal Medicine, General Surgery and Medical Humanities (Diagnostic methodology. The module of INTERNAL MEDICINE aim to give to the student knowledge on how to investigate and evaluate clinical signs and symptoms of diseases, interpreting them from the physiopathological point of view, how to properly collect the medical history and to approach the physical examination for diseases respectively of surgical and medical interest. The module of MEDICAL HUMANITIES (DIAGNOSTIC METHODOLOGY) aims to provide to the students the proper conceptual tools to understands the outcomes of a clinical test and a of clinical trial, in particular their probabilistic aspects. The module of GENERAL SURGERY aims to teach how to establish a correct approach with the patient and how to collect in the appropriate way clinical signs and symptoms of diseases, classifying them in the physio-pathologic context, through anamnestic , physical and instrumental investigations. The basic procedures must be applied in the diagnosis of surgical diseases affecting the abdomen and the cardiovascular system; in cardiovascular, respiratory, gastroenteric, renal, endocrine and haematologic diseases of medical interest, as well as in infectious diseases, for which the host-pathogen relationships, the evaluation of the host defensive response and the identification of the pathogen are important.
Knowledge and understanding:
At the end of the course the student will:
- recognize the clinical manifestations of cardiovascular, respiratory, abdominal, nephrologic,
endocrine, haematological diseases
- be able to correctly handle the probabilistic meaning of a clinical test and of a clinical trial

Applying knowledge and understanding:
At the end of the course the student will have developed the ability to:
- collect the medical history of the patient and perform the physical examination
- understand and correctly employ the main diagnostic exams as well as imaging techniques
- distinguish sensibility/specificity from positive/negative predictive values
- distinguish confidence interval from clinical significance
- interpreting the p-value

Prerequisites

------------------------------------------------------------
Modulo: 005987 - CHIRURGIA GENERALE
------------------------------------------------------------

INTERNAL MEDICINE:
Adequate knowledge of anatomy, physiology and physiopathology of the circulatory, respiratory, endocrine, gastroenteric and renal systems
MEDICAL HUMANITIES (DIAGNOSTIC METHODOLOGY):
Basic notion in medical statistics

GENERAL SURGERY:
Adequate knowledge of anatomy, physiology and physiopathology of the circulatory, respiratory, endocrine, gastroenteric and renal systems and basic elements of general psychology, epidemiology, microbiology, general pathology, genetics and molecular biology. Passing the exam of Physiology II and Pathophysiology and Pathology.



------------------------------------------------------------
Modulo: 24441 - MEDICINA INTERNA
------------------------------------------------------------

INTERNAL MEDICINE:
Adequate knowledge of anatomy, physiology and physiopathology of the circulatory, respiratory, endocrine, gastroenteric and renal systems
MEDICAL HUMANITIES (DIAGNOSTIC METHODOLOGY):
Basic notion in medical statistics

GENERAL SURGERY:
Adequate knowledge of anatomy, physiology and physiopathology of the circulatory, respiratory, endocrine, gastroenteric and renal systems and basic elements of general psychology, epidemiology, microbiology, general pathology, genetics and molecular biology. Passing the exam of Physiology II and Pathophysiology and Pathology.



------------------------------------------------------------
Modulo: 63696 - MEDICAL HUMANITIES
------------------------------------------------------------

INTERNAL MEDICINE:
Adequate knowledge of anatomy, physiology and physiopathology of the circulatory, respiratory, endocrine, gastroenteric and renal systems
MEDICAL HUMANITIES (DIAGNOSTIC METHODOLOGY):
Basic notion in medical statistics

GENERAL SURGERY:
Adequate knowledge of anatomy, physiology and physiopathology of the circulatory, respiratory, endocrine, gastroenteric and renal systems and basic elements of general psychology, epidemiology, microbiology, general pathology, genetics and molecular biology. Passing the exam of Physiology II and Pathophysiology and Pathology.


Course programme

------------------------------------------------------------
Modulo: 005987 - CHIRURGIA GENERALE
------------------------------------------------------------
INTERNAL MEDICINE
General physical examination. Anamnesis preparation.
Inspection, palpation and percussion of the precordial and abdominal regions. Identification of outbreaks auscultation, heart rhythm, heart sounds and their variations, the added tones systolic and diastolic, systolic murmurs. Exploration of peripheral pulses. Inspection, palpation and percussion of the abdomen and chest. Interpretation of the appearance of a jaundiced condition, particularly non-obstructive jaundice. Search for signs of portal hypertension and ascites.
Anamnesis and clinical evaluation of the possible causes of proteinuria; identification of symptoms and signs of hyperglycemia, ketoacidosis and hypoglycemia. Indicative signs of dyslipidemia: Evaluation of medical history and objective elements that militate for a condition of anemia or polycythemia.
Particular attention to possible specific sex/gender factors in an integrated diagnostic-therapeutic pathway.

MEDICAL HUMANITIES (DIAGNOSTIC METHODOLOGY)
- Sensibility and specificity
- Bayes theorem and clinical relevance of a test result
- ROC curves
- The meaning of the p-value
- Confidence interval, statistical relevance and clinical relevance

GENERAL SURGERY
Cycle of exercises. For a description, see the second semester (see course programme for Clinical Methodology II)




------------------------------------------------------------
Modulo: 24441 - MEDICINA INTERNA
------------------------------------------------------------
INTERNAL MEDICINE
General physical examination. Anamnesis preparation.
Inspection, palpation and percussion of the precordial and abdominal regions. Identification of outbreaks auscultation, heart rhythm, heart sounds and their variations, the added tones systolic and diastolic, systolic murmurs. Exploration of peripheral pulses. Inspection, palpation and percussion of the abdomen and chest. Interpretation of the appearance of a jaundiced condition, particularly non-obstructive jaundice. Search for signs of portal hypertension and ascites.
Anamnesis and clinical evaluation of the possible causes of proteinuria; identification of symptoms and signs of hyperglycemia, ketoacidosis and hypoglycemia. Indicative signs of dyslipidemia: Evaluation of medical history and objective elements that militate for a condition of anemia or polycythemia.
Particular attention to possible specific sex/gender factors in an integrated diagnostic-therapeutic pathway.

MEDICAL HUMANITIES (DIAGNOSTIC METHODOLOGY)
- Sensibility and specificity
- Bayes theorem and clinical relevance of a test result
- ROC curves
- The meaning of the p-value
- Confidence interval, statistical relevance and clinical relevance

GENERAL SURGERY
Cycle of exercises. For a description, see the second semester (see course programme for Clinical Methodology II)




------------------------------------------------------------
Modulo: 63696 - MEDICAL HUMANITIES
------------------------------------------------------------
INTERNAL MEDICINE
General physical examination. Anamnesis preparation.
Inspection, palpation and percussion of the precordial and abdominal regions. Identification of outbreaks auscultation, heart rhythm, heart sounds and their variations, the added tones systolic and diastolic, systolic murmurs. Exploration of peripheral pulses. Inspection, palpation and percussion of the abdomen and chest. Interpretation of the appearance of a jaundiced condition, particularly non-obstructive jaundice. Search for signs of portal hypertension and ascites.
Anamnesis and clinical evaluation of the possible causes of proteinuria; identification of symptoms and signs of hyperglycemia, ketoacidosis and hypoglycemia. Indicative signs of dyslipidemia: Evaluation of medical history and objective elements that militate for a condition of anemia or polycythemia.
Particular attention to possible specific sex/gender factors in an integrated diagnostic-therapeutic pathway.

MEDICAL HUMANITIES (DIAGNOSTIC METHODOLOGY)
- Sensibility and specificity
- Bayes theorem and clinical relevance of a test result
- ROC curves
- The meaning of the p-value
- Confidence interval, statistical relevance and clinical relevance

GENERAL SURGERY
Cycle of exercises. For a description, see the second semester (see course programme for Clinical Methodology II)



Didactic methods

------------------------------------------------------------
Modulo: 005987 - CHIRURGIA GENERALE
------------------------------------------------------------
INTERNAL MEDICINE
The Internal Medicine module provides frontal lectures and on-line assisted teaching. The on-line teaching hours of moodle platform certification service consist in the insights of some topics presented during the frontal lessons
MEDICAL HUMANITIES (DIAGNOSTIC METHODOLOGY)
The course provides frontal lectures and on-line assisted teaching. The on-line material consists in papers concerning what is taught in class and supplementary articles useful to better understand the issues discussed.

GENERAL SURGERY
The module of Surgery provides lectures, frequency of the surgical ward and clinics alongside staff, with focus on methodological and diagnostic aspects, and on-line assisted teaching. The on-line teaching hours of moodle platform certification service consist in the insights of some topics presented during the frontal lessons. The teaching activity is also integrated by practical activity with tutor which consists in physical visit and instrumental diagnosis of chronic venous insufficiency and of arterial diseases. Simulation in a diagnostic lab with phantoms and/or normal subjects. Further details are reported in the second semester (see Teaching Methods for Clinical Methodology II)




------------------------------------------------------------
Modulo: 24441 - MEDICINA INTERNA
------------------------------------------------------------
INTERNAL MEDICINE
The Internal Medicine module provides frontal lectures and on-line assisted teaching. The on-line teaching hours of moodle platform certification service consist in the insights of some topics presented during the frontal lessons
MEDICAL HUMANITIES (DIAGNOSTIC METHODOLOGY)
The course provides frontal lectures and on-line assisted teaching. The on-line material consists in papers concerning what is taught in class and supplementary articles useful to better understand the issues discussed.

GENERAL SURGERY
The module of Surgery provides lectures, frequency of the surgical ward and clinics alongside staff, with focus on methodological and diagnostic aspects, and on-line assisted teaching. The on-line teaching hours of moodle platform certification service consist in the insights of some topics presented during the frontal lessons. The teaching activity is also integrated by practical activity with tutor which consists in physical visit and instrumental diagnosis of chronic venous insufficiency and of arterial diseases. Simulation in a diagnostic lab with phantoms and/or normal subjects. Further details are reported in the second semester (see Teaching Methods for Clinical Methodology II)




------------------------------------------------------------
Modulo: 63696 - MEDICAL HUMANITIES
------------------------------------------------------------
INTERNAL MEDICINE
The Internal Medicine module provides frontal lectures and on-line assisted teaching. The on-line teaching hours of moodle platform certification service consist in the insights of some topics presented during the frontal lessons
MEDICAL HUMANITIES (DIAGNOSTIC METHODOLOGY)
The course provides frontal lectures and on-line assisted teaching. The on-line material consists in papers concerning what is taught in class and supplementary articles useful to better understand the issues discussed.

GENERAL SURGERY
The module of Surgery provides lectures, frequency of the surgical ward and clinics alongside staff, with focus on methodological and diagnostic aspects, and on-line assisted teaching. The on-line teaching hours of moodle platform certification service consist in the insights of some topics presented during the frontal lessons. The teaching activity is also integrated by practical activity with tutor which consists in physical visit and instrumental diagnosis of chronic venous insufficiency and of arterial diseases. Simulation in a diagnostic lab with phantoms and/or normal subjects. Further details are reported in the second semester (see Teaching Methods for Clinical Methodology II)



Learning assessment procedures

INTERNAL MEDICINE
The assessment of the learning will be carried out by means of a written exam with 31 questions with multiple choice questions relating to all the training objectives defined above. There will be no penalty for incorrect or unsuccessful answers. Each correct answer will be evaluated 1.0 point. To pass the exam the student must answer correctly to at least 18 question. Honors will be awarded to those who pass the rounded score of 30. The final score (expressed in thirtieths) will be used for the calculation of the grade of the integrated course, by taking into account the weight in terms of CFU of the course module. The duration of the whole test will be increased for students with "Specific Learning Disorder".

MEDICAL HUMANITIES (DIAGNOSTIC METHODOLOGY)
Written exam, consisting of open questions. Time available 1 hour. The exams are scheduled according the university caslendar.

GENERAL SURGERY
Examinations scheduled for the second semester (see Teaching Methodology for Clinical Methodology II)

Reference texts

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Modulo: 005987 - CHIRURGIA GENERALE
------------------------------------------------------------
INTERNAL MEDICINE
Amoroso A, Rossi Fanelli F, Afeltra A, Basili S, Manfredini R, Sasso FC, Semeiotica Medica e Metodologia Clinica, 2.a edizione, Antonio Delfino Editore, 2017.
Fradà, Semeiotica Medica, Piccin Ed.
Rasario, Manuale di Semeiotica Medica, Idelson
Wilms, Manuale di Semeiotica Medica, Mc Graw-HillHarrison’s, Principles of internal medicine, Mc Graw-Hill
Harrison’s, Principles of internal medicine, Mc Graw-Hill
MEDICAL HUMANITIES (DIAGNOSTIC METHODOLOGY)
Materials is provided in the professor’s web page.
Notes for the lessons and papers suggested over the course
GENERAL AND VASCULAR SURGERY
Dionigi, Chirurgia generale e specialistica, Masson
Oxford Textbook in Vascular Surgery, Oxford University Press 2016
Setacci C. Chirurgia Vascolare, Minerva Medica 2015

Files with lecture slides will be also provided by the lecturer to the students




------------------------------------------------------------
Modulo: 24441 - MEDICINA INTERNA
------------------------------------------------------------
INTERNAL MEDICINE
Amoroso A, Rossi Fanelli F, Afeltra A, Basili S, Manfredini R, Sasso FC, Semeiotica Medica e Metodologia Clinica, 2.a edizione, Antonio Delfino Editore, 2017.
Fradà, Semeiotica Medica, Piccin Ed.
Rasario, Manuale di Semeiotica Medica, Idelson
Wilms, Manuale di Semeiotica Medica, Mc Graw-HillHarrison’s, Principles of internal medicine, Mc Graw-Hill
Harrison’s, Principles of internal medicine, Mc Graw-Hill
MEDICAL HUMANITIES (DIAGNOSTIC METHODOLOGY)
Materials is provided in the professor’s web page.
Notes for the lessons and papers suggested over the course
GENERAL AND VASCULAR SURGERY
Dionigi, Chirurgia generale e specialistica, Masson
Oxford Textbook in Vascular Surgery, Oxford University Press 2016
Setacci C. Chirurgia Vascolare, Minerva Medica 2015

Files with lecture slides will be also provided by the lecturer to the students




------------------------------------------------------------
Modulo: 63696 - MEDICAL HUMANITIES
------------------------------------------------------------
INTERNAL MEDICINE
Amoroso A, Rossi Fanelli F, Afeltra A, Basili S, Manfredini R, Sasso FC, Semeiotica Medica e Metodologia Clinica, 2.a edizione, Antonio Delfino Editore, 2017.
Fradà, Semeiotica Medica, Piccin Ed.
Rasario, Manuale di Semeiotica Medica, Idelson
Wilms, Manuale di Semeiotica Medica, Mc Graw-HillHarrison’s, Principles of internal medicine, Mc Graw-Hill
Harrison’s, Principles of internal medicine, Mc Graw-Hill
MEDICAL HUMANITIES (DIAGNOSTIC METHODOLOGY)
Materials is provided in the professor’s web page.
Notes for the lessons and papers suggested over the course
GENERAL AND VASCULAR SURGERY
Dionigi, Chirurgia generale e specialistica, Masson
Oxford Textbook in Vascular Surgery, Oxford University Press 2016
Setacci C. Chirurgia Vascolare, Minerva Medica 2015

Files with lecture slides will be also provided by the lecturer to the students