[Disciplinar thematic integration in medicine: a proposal from histology and embryology]. / Integración temática disciplinar en medicina: una propuesta desde histología y embriología.

This paper intends to clarify a concept with multiple meanings and a complex reality. It starts providing varied histological and embryological examples apt to contribute the stimulation of teacher and student imaginations in favor of a crucial skill, as thematic integration is, into the present and changing curricula in Medicine in particular and Health Sciences in general. In this sense, it offers linear and branched sequences as well as consolidation graphics which focusing in both disciplines may also include other basic ones, key for clinic diagnosis, among the competences to be developed. After registering some preliminary results revealing the need of its continuous and progressive training along the complete medical career, its own integrative value and the integrative one for their teachers due to its natural link with other basic ones is outlined, its relevance for undergraduate is reaffirmed and possible future variations for them are previewed, considering the present exponential growth of science and technology.

Este trabajo intenta aclarar un concepto con múltiples significados y una realidad compleja y proveer ejemplos de distinta dificultad centrados en la Histología y la Embriología, potencialmente útiles para currículos tradicionales y, esencialmente, para aquéllos en vías de transformación dentro de la Medicina en particular y de las Ciencias de la Salud en general. En ese sentido, propone secuencias lineales, ramificadas y gráficas de consolidación que, pivoteando en ambas disciplinas, pueden comprender también a otras ciencias básicas, todas de significado clave para el diagnóstico clínico. Tras registrar algunos resultados que, aunque limitados, revelarían la necesidad de su entrenamiento continuo y en complejidad creciente a lo largo de la carrera médica, se subraya su valor integrador intrínseco así como la potencialidad integradora que desarrolla en quienes las cultivan en virtud de su ligazón natural con otras disciplinas básicas. Asimismo, a la par que se reafirma la relevancia de una y otra en el grado, se vislumbran posibles variaciones en las mismas en virtud de los exponenciales avances científico-tecnológicos de la hora.

Integración temática disciplinar en medicina: una propuesta desde histología y embriología / [Disciplinar thematic integration in medicine: a proposal from histology and embryology].

This paper intends to clarify a concept with multiple meanings and a complex reality. It starts providing varied histological and embryological examples apt to contribute the stimulation of teacher and student imaginations in favor of a crucial skill, as thematic integration is, into the present and changing curricula in Medicine in particular and Health Sciences in general. In this sense, it offers linear and branched sequences as well as consolidation graphics which focusing in both disciplines may also include other basic ones, key for clinic diagnosis, among the competences to be developed. After registering some preliminary results revealing the need of its continuous and progressive training along the complete medical career, its own integrative value and the integrative one for their teachers due to its natural link with other basic ones is outlined, its relevance for undergraduate is reaffirmed and possible future variations for them are previewed, considering the present exponential growth of science and technology.

Integración temática disciplinar en medicina: una propuesta desde histología y embriología. / [Disciplinar thematic integration in medicine: a proposal from histology and embryology].

This paper intends to clarify a concept with multiple meanings and a complex reality. It starts providing varied histological and embryological examples apt to contribute the stimulation of teacher and student imaginations in favor of a crucial skill, as thematic integration is, into the present and changing curricula in Medicine in particular and Health Sciences in general. In this sense, it offers linear and branched sequences as well as consolidation graphics which focusing in both disciplines may also include other basic ones, key for clinic diagnosis, among the competences to be developed. After registering some preliminary results revealing the need of its continuous and progressive training along the complete medical career, its own integrative value and the integrative one for their teachers due to its natural link with other basic ones is outlined, its relevance for undergraduate is reaffirmed and possible future variations for them are previewed, considering the present exponential growth of science and technology.

Olvido de los contenidos de histologia en alumnos de medicina / Forgetfulness of the histology curriculum in medical students

Memoria: capacidad de grabación, archivo, clasificación y recuperación posterior de información., esencial en el procesamiento de información y el aprendizaje en analogía con la computadora. Olvido: fracaso para transferir información de la memoria a corto plazo a la memoria a largo plazo o para recuperar información de esta Objetivo: evaluar en los alumnos el olvido de los contenidos de Histología un año y medio después del cursado; recabar el grado de utilidad asignado a los mismos en las asignaturas de segundo y tercer año Alumnos de alto rendimiento en 2002 (n=26) fueron evaluados con 20 preguntas de citología y tejidos y 20 de organografía Con respuesta sugeridas 20 y 20 de breve completación. Expresaron el grado de utilidad de los contenidos en el cursado de Fisiología y Físico-Química, y en el primer cuatrimestre de Anatomía Patológica, Microbiología y Farmacología. Se cotejó el rendimiento del curso 2002 con la prueba actual y en esta los resultados de preguntas de citología y tejidos versus órganos y de respuesta sugerida versus a completar. La pérdida fue del orden del 50% en la rememoración de los contenidos (37.07 :!: 1,76 = 92,6% vs. l8,52:!: 4,33 = 46,3%) sin diferencia entre citología y tejidos versus órganos ni entre respuesta sugerida versus a completar. La mayor utilidad de los contenidos se refiere a Anatomía Patológica (69%) y Fisiología (50%) y la menor a Fisicoquímica. (7%) Estimamos que el olvido en nuestros alumnos hubiese sido aun mayor sin el empleo de técnicas activas de aprendizaje.

MEMORY: ability to record, file, classify and later recover of information., essential in processing information and learning, in analogy with a computer. FORGETFULNESS: failure to transfer information from short term memory to long term memory or to recover information from the latter. AIM: to study forgetfulness in contents of Histology in students one and half year after regular course. To evaluate level of re-utilization of contents in second and third year courses. Students with high performance in 2002 (n=26) were evaluated with 20 cytology and histology questions and 20 questions related to organs. 20 multiple choice and 20 brief filled answers were used, expressing the level of usefulness of the contents in Physiology and Physicochemistry, and in the first quarter of Pathology, Microbiology and Pharmacology. The performance of 2002 course was compared with the current test, results of cytology and histology questions versus organs ones and multiple choice answers versus brief filled answers. The loss was in the order of 50% in the recovery of contents (37.07 +/- 1,76 = 92,6% vs. 18,52 +/- 4,33 = 46,3%) without difference between cytology and histology versus organs neither among multiple choice answers versus brief filled answers. The highest usefulness in the contents refers to Pathology (69%) and Physiology (50%) and the lesser to PhysicoChemistry.(7%) We estimate that forgetfulness in our students would have been even higher without the employment of active techniques of learning.

Olvido de los contenidos de histologia en alumnos de medicina / Forgetfulness of the histology curriculum in medical students

Memoria: capacidad de grabación, archivo, clasificación y recuperación posterior de información., esencial en el procesamiento de información y el aprendizaje en analogía con la computadora. Olvido: fracaso para transferir información de la memoria a corto plazo a la memoria a largo plazo o para recuperar información de esta Objetivo: evaluar en los alumnos el olvido de los contenidos de Histología un año y medio después del cursado; recabar el grado de utilidad asignado a los mismos en las asignaturas de segundo y tercer año Alumnos de alto rendimiento en 2002 (n=26) fueron evaluados con 20 preguntas de citología y tejidos y 20 de organografía Con respuesta sugeridas 20 y 20 de breve completación. Expresaron el grado de utilidad de los contenidos en el cursado de Fisiología y Físico-Química, y en el primer cuatrimestre de Anatomía Patológica, Microbiología y Farmacología. Se cotejó el rendimiento del curso 2002 con la prueba actual y en esta los resultados de preguntas de citología y tejidos versus órganos y de respuesta sugerida versus a completar. La pérdida fue del orden del 50% en la rememoración de los contenidos (37.07 :!: 1,76 = 92,6% vs. l8,52:!: 4,33 = 46,3%) sin diferencia entre citología y tejidos versus órganos ni entre respuesta sugerida versus a completar. La mayor utilidad de los contenidos se refiere a Anatomía Patológica (69%) y Fisiología (50%) y la menor a Fisicoquímica. (7%) Estimamos que el olvido en nuestros alumnos hubiese sido aun mayor sin el empleo de técnicas activas de aprendizaje.(AU)

MEMORY: ability to record, file, classify and later recover of information., essential in processing information and learning, in analogy with a computer. FORGETFULNESS: failure to transfer information from short term memory to long term memory or to recover information from the latter. AIM: to study forgetfulness in contents of Histology in students one and half year after regular course. To evaluate level of re-utilization of contents in second and third year courses. Students with high performance in 2002 (n=26) were evaluated with 20 cytology and histology questions and 20 questions related to organs. 20 multiple choice and 20 brief filled answers were used, expressing the level of usefulness of the contents in Physiology and Physicochemistry, and in the first quarter of Pathology, Microbiology and Pharmacology. The performance of 2002 course was compared with the current test, results of cytology and histology questions versus organs ones and multiple choice answers versus brief filled answers. The loss was in the order of 50% in the recovery of contents (37.07 +/- 1,76 = 92,6% vs. 18,52 +/- 4,33 = 46,3%) without difference between cytology and histology versus organs neither among multiple choice answers versus brief filled answers. The highest usefulness in the contents refers to Pathology (69%) and Physiology (50%) and the lesser to PhysicoChemistry.(7%) We estimate that forgetfulness in our students would have been even higher without the employment of active techniques of learning.(AU)

[Enteroendocrine cells modifications in Helicobacter pylori gastritis]. / Modificaciones de las células enteroendócrinas en gastritis por Helicobacter pylori.

OBJECTIVE: The aim of the present study was to analyze the modifications in the number and distribution of enteroendocrine cells (EEC) in antrum of patients with Helicobacter pylori (HE) gastritis. We also wanted to demonstrate their possible participation in the immune response. MATERIAL AND METHODS: Twenty-six (26) biopsies of gastric antrum from patients between the ages of 40 and 60 were used. Slides were stained with H&E, Giemsa for HP, and chromogranin A to visualize EEC. Five (5) patients were normal controls. Eleven (11) patients had antral chronic gastritis (ACG) with different grades of activity, and ten (10) patients had multifocal atrophic gastritis (MAG), both groups associated to HP. EEC were quantified in relation to 100 epithelial cells. Results were statistically compared. RESULTS: In the normal control group, EEC were sparsely distributed, deep in antral glands, with an average 19.51 EEC/100 epithelial cells. In ACG there were 12.01/100. Besides EEC were irregularly distributed, close to inflammatory areas, or near lymphoid follicles. CONCLUSION: The decrease in EEC is probably due to degranulation and later to a disappearance or inhibition of stem cells by inflammatory products in HP gastritis. The proximity of EEC to prominent inflammatory zones may indicate EEC modulate the immune response. They produce and excrete peptides that interact with membrane receptors found in T lymphocytes and macrophages.

Modificaciones de las células enteroendocrinas en gastritis por Helicobacter pylori / Enteroendocrine cells modifications in Helicobacter pylori gastritis

Objetivo: Estudiar las modificaciones en número y distribución de las células entero endocrinas (CEE) en el antro gástrico de pacientes con infección por Helicobacter pylori (HP), para demostrar su participación en la respuesta inmune. Material y Método: Se utilizaron biopsias de antro gástrico de veintiseis (26) pacientes, entre 40 y 60 años de edad. Las muestras se colorearon con HE y giemsa modificado e inmunomarcaron con Cromogranina A. Cinco pacientes integraron el grupo control. Once pacientes mostraron gastritis crónica activa y los diez restantes gastritis atrófica multifocal (AMF), ambas asociadas a HP. Las CEE se cuantificaron refiriéndoselas cada 100 células epiteliales y se evaluó el patrón de distribución de las mismas. Resultados: En antros de pacientes controles (normales), la distribución de las CEE relacionadas fue uniforme con una media de 19,51 CEE/100. En los procesos inflamatorios, se detectó 12.01 CEE/100 en las gastritis crónicas y 6.31 CEE/100 en las AMF. Asimismo se observó una distribución irregular de las CEE relacionadas con áreas inflamatorias o con folículos linfoides. Conclusiones: La disminución de las CEE correspondería a una degranulación y luego debido a la agresión del HP, a la desaparición o inhibición de las stem cell hacia la línea endócrina. La persistencia de CEE en proximidad a las áreas de mayor infiltrado inflamatório, sugeriría su participación modulando esta respuesta, probablemente liberando péptidos que interactúan con linfócitos T, macrófagos y eosinófilos. Las CEE en el antro gástrico tendrían una intervención activa en la reacción inmune provocada por el HP.

Modificaciones de las células enteroendocrinas en gastritis por Helicobacter pylori / Enteroendocrine cells modifications in Helicobacter pylori gastritis

Objetivo: Estudiar las modificaciones en número y distribución de las células entero endocrinas (CEE) en el antro gástrico de pacientes con infección por Helicobacter pylori (HP), para demostrar su participación en la respuesta inmune. Material y Método: Se utilizaron biopsias de antro gástrico de veintiseis (26) pacientes, entre 40 y 60 años de edad. Las muestras se colorearon con HE y giemsa modificado e inmunomarcaron con Cromogranina A. Cinco pacientes integraron el grupo control. Once pacientes mostraron gastritis crónica activa y los diez restantes gastritis atrófica multifocal (AMF), ambas asociadas a HP. Las CEE se cuantificaron refiriéndoselas cada 100 células epiteliales y se evaluó el patrón de distribución de las mismas. Resultados: En antros de pacientes controles (normales), la distribución de las CEE relacionadas fue uniforme con una media de 19,51 CEE/100. En los procesos inflamatorios, se detectó 12.01 CEE/100 en las gastritis crónicas y 6.31 CEE/100 en las AMF. Asimismo se observó una distribución irregular de las CEE relacionadas con áreas inflamatorias o con folículos linfoides. Conclusiones: La disminución de las CEE correspondería a una degranulación y luego debido a la agresión del HP, a la desaparición o inhibición de las stem cell hacia la línea endócrina. La persistencia de CEE en proximidad a las áreas de mayor infiltrado inflamatório, sugeriría su participación modulando esta respuesta, probablemente liberando péptidos que interactúan con linfócitos T, macrófagos y eosinófilos. Las CEE en el antro gástrico tendrían una intervención activa en la reacción inmune provocada por el HP. (Au)

Modificaciones de las células enteroendócrinas en gastritis por Helicobacter pylori. / [Enteroendocrine cells modifications in Helicobacter pylori gastritis]

OBJECTIVE: The aim of the present study was to analyze the modifications in the number and distribution of enteroendocrine cells (EEC) in antrum of patients with Helicobacter pylori (HE) gastritis. We also wanted to demonstrate their possible participation in the immune response. MATERIAL AND METHODS: Twenty-six (26) biopsies of gastric antrum from patients between the ages of 40 and 60 were used. Slides were stained with H&E, Giemsa for HP, and chromogranin A to visualize EEC. Five (5) patients were normal controls. Eleven (11) patients had antral chronic gastritis (ACG) with different grades of activity, and ten (10) patients had multifocal atrophic gastritis (MAG), both groups associated to HP. EEC were quantified in relation to 100 epithelial cells. Results were statistically compared. RESULTS: In the normal control group, EEC were sparsely distributed, deep in antral glands, with an average 19.51 EEC/100 epithelial cells. In ACG there were 12.01/100. Besides EEC were irregularly distributed, close to inflammatory areas, or near lymphoid follicles. CONCLUSION: The decrease in EEC is probably due to degranulation and later to a disappearance or inhibition of stem cells by inflammatory products in HP gastritis. The proximity of EEC to prominent inflammatory zones may indicate EEC modulate the immune response. They produce and excrete peptides that interact with membrane receptors found in T lymphocytes and macrophages.

[Erroneous extrapolation as a frequent defect in medical students]. / La extrapolación errónea como defecto frecuente en alumnos de medicina.

Scientific aptitude development, useful for methodic management of information, is indispensable for teaching and learning, investigation, medical practice and customary life. Correct extrapolation is one of its components. This work deals with appropriate use of extrapolation among medical students. 118 students from a potentially experimented, interested and adapted population were analyzed (103 coursing 2nd. year and the others, last years). All of them were exposed simultaneously and without opportunities of exchanging opinions, to three tests: graphical, clinical and general (open answer). Results point out extrapolation as a current defect in the studied population. Deficiencies in related teaching experiences are also revealed. On the other hand, certain designs--although in the general low level of correct answers--appeared more familiar than others to the students. A deepening of analysis in extrapolation scientific aptitude and preventive exposition to valid experiences since 1st. year of medical career is proposed.

La extrapolación errónea como defecto frecuente en alumnos de medicina. / [Erroneous extrapolation as a frequent defect in medical students]

Scientific aptitude development, useful for methodic management of information, is indispensable for teaching and learning, investigation, medical practice and customary life. Correct extrapolation is one of its components. This work deals with appropriate use of extrapolation among medical students. 118 students from a potentially experimented, interested and adapted population were analyzed (103 coursing 2nd. year and the others, last years). All of them were exposed simultaneously and without opportunities of exchanging opinions, to three tests: graphical, clinical and general (open answer). Results point out extrapolation as a current defect in the studied population. Deficiencies in related teaching experiences are also revealed. On the other hand, certain designs--although in the general low level of correct answers--appeared more familiar than others to the students. A deepening of analysis in extrapolation scientific aptitude and preventive exposition to valid experiences since 1st. year of medical career is proposed.

[Design, evaluation and application of a model for evaluating the cognitive abilities related to scientific aptitude in medical students]. / Diseño, validación y aplicación de un modelo evaluador de habilidades cognitivas relacionadas con la aptitud científica en alumnos de medicina.

A model for evaluating the cognitive ability related to scientific aptitude consisting of 10 different problems is presented. The design conditions, validity and the application of the model to selected second year Medical students as well as randomly chosen first, third and sixth year students are described. The authors record and analyze global results as well as the results of individual or group of problems, concluding on the validity and fiability of the model as well as on the detection of failures in student's performances inspite of the effort made. Future action is proposed.

[Innovative approach of teaching-learning of histology and embriology]. / Enfoque innovador de la enseñanza-aprendizaje de histología y embriología.

The paper presents an innovative approach to the teaching-learning of histology and embryology. The traditional teaching of the subject in the Faculty of Medical Sciences of Rosario National University, Santa Fe, Rosario, Argentina, up to 1974 is subjected to critical analysis, and on this basis the need for the innovation is propounded and the method for applying it proposed. A detailed account is given of the theoretical framework of the experiment reported, of the general and specific objectives of the teaching-learning technique, and of the thematic units into which the curriculum was divided. In the teaching-learning plan followed--described in the article--the conventional professorial lecture and its accompanying practical demonstrations are replaced by round tables and theoretical-practical tasks requiring active involvement and integrating theory and practice, in which teams tackle problems under teacher coordination. It also provides for evaluation of the students, teachers and course and eliminates the conventional examination.

Enfoque innovador de la enseñanza-aprendizaje de histología y embriología / Innovative approach of teaching-learning of histology and embriology

The paper presents an innovative approach to the teaching-learning of histology and embryology. The traditional teaching of the subject in the Faculty of Medical Sciences of Rosario National University, Santa Fe, Rosario, Argentina, up to 1974 is subjected to critical analysis, and on this basis the need for the innovation is propounded and the method for applying it proposed. A detailed account is given of the theoretical framework of the experiment reported, of the general and specific objectives of the teaching-learning technique, and of the thematic units into which the curriculum was divided. In the teaching-learning plan followed--described in the article--the conventional professorial lecture and its accompanying practical demonstrations are replaced by round tables and theoretical-practical tasks requiring active involvement and integrating theory and practice, in which teams tackle problems under teacher coordination. It also provides for evaluation of the students, teachers and course and eliminates the conventional examination (Au)