Estilos de aprendizaje en estudiantes universitarios y médicos residentes / Learning styles in university students and medical residents

Objetivos. Describir los estilos de aprendizaje a los que recurren los estudiantes de medicina al ingresar en la universidad, compararlos con los estilos al finalizar la carrera y en el posgrado inmediato, analizar la relación entre estilo de aprendizaje y desempeño académico, y estudiar la asociación entre estilos y la tendencia a elegir una especialidad al finalizar la carrera. Sujetos y métodos. Durante2006 se incluyeron de forma prospectiva 102 estudiantes de medicina de segundo año (grupo pregrado inicio), 52estudiantes del último año (grupo pregrado final) y 45médicos de segundo año de residencia (grupo posgrado).Se determinó el estilo de aprendizaje con el cuestionario de Honey-Alonso. En la muestra pregrado final se incluyó la preferencia por una especialidad clínica o quirúrgica al finalizar la carrera, datos que fueron relacionados con los estilos preponderantes. Resultados. En pregrado inicio, la preferencia para adquirir información fue teórica en el77% y el uso fue fundamentalmente reflexivo en el 86%. En posgrado, la adquisición de información fue predominantemente teórica en el 67% y el uso reflexivo en el 70%. La comparación demostró la disminución del modo reflexivo y el aumento del activo cuando se empleó la información al acercarse al posgrado (p = 0,069). En pregrado inicio hubo una tendencia al estilo ‘asimilador’ (70,6%), mientras que el ‘convergente’ fue el más raro (6,9%). Al comparar pregrado final y posgrado se demuestra en este último una reducción del estilo ‘asimilador’(p = 0,040), a expensas del crecimiento ‘convergente’ (p = 0,034). Conclusiones. Los estudiantes tuvieron un estilo preponderantemente teórico y reflexivo (asimilador) al comenzar la carrera. Al finalizarla y en el posgrado disminuyó el estilo ‘asimilador’, en especial a expensas del crecimiento ‘convergente’. No se pudo demostrar una relación entre los estilos de aprendizaje y el desempeño académico en anatomía. Al evaluar la presunta asociación entre estilo de aprendizaje y preferencia por una especialidad, se encontró que esta relación estaba más vinculada al efecto ‘confundidor’ del género; así, en las mujeres preponderó el estilo ‘divergente’ y la especialidad clínica, mientras que en los varones se observó un perfil ‘asimilador’ y la opción por una especialidad quirúrgica (AU)

Aims. To identify the prevalent learning styles among students beginning Medical School and to compare these preferences with those found at the end of the carrier and during the residency program. The relationship between learning style and academic performance, as well as the association between learning preferences and postgraduate specialty selection were additionally studied. Subjects and methods. The Honey-Alonso learning style questionnaire was administered to 102second-year students (pregraduate initial group), 52 last year students (pregraduate final group) and 45 physiciansat a cardiology residency program (postgraduate group).Learning styles were compared within and between groups. The relationship between learning styles and academic performance in anatomy was assessed in the pregraduateinitial group). The association between learning preferences and postgraduate specialty selection was studied in the pregraduate final group. Results. Learning preferences in the pregraduate initial group was theoretic (70%) for acquiring information and reflexive (86%) for using information respectively. In postgraduate group, preferences were theoretic(67%) and reflexive (70%), showing a marked decrease of the last style with respect to pregraduate initial (p = 0.069),at expense of an increase in active style. pregraduate initial showed a tendency towards ‘assimilator’ style (70.6%), while ‘convergent’ one was the rarest (6.9%). When comparing pregraduate final to postgraduate group, a reduction of ‘assimilator’ style (p = 0.040) and an increase of ‘convergent’ one (p = 0.034) was observed. Conclusions. Students’ learning preferences for acquiring and using information were theoretic and reflexive (assimilator) predominantly at the beginning of the carrier. At the end and at the postgraduate period, ‘assimilator’ style decreased at expense of an increase of the rest, especially at ‘convergent’ (theoretic and active)one. Although the ‘assimilator’ was the commoner, increase of ‘convergent’ style showed that at residency, individuals learn by solving problems and using knowledge in practice; this increase was done at expense of the active over the reflexive style. On the other hand, no relationship between learning style and academic performance in anatomy was found. Finally, an association between learning styles and postgraduate specialty selection showed that the last was more related to genre than to learning preferences (AU)

[The relationship between oxygen consumption and the the rate of rewarming during extracorporeal circulation with induced hypothermia]. / Relación entre consumo de oxígeno y velocidad de recalentamiento durante la circulación extracórporea con hipotermia inducida.

This study was performed to investigate the relation between total oxygen consumption (VO2) and the velocity of reheating in patients undergoing cardiopulmonary bypass with hypothermia. A total of 17 males undergoing this procedure were studied prospectively (mean age: 63 years, range: 52-72); during surgery they were cooled at 28 degrees C whole-body temperature. Before rewarming, patients were divided at random in two groups. Group A (n = 8) was reheated between 10 and 25 minutes, and group B (n = 9) between 26 and 50 minutes. In group A, VO2 expressed in ml.min-1 x m-2 increased from 76.6 +/- 6.99 at 28 degrees C until 100.0 +/- 6.72 at 34 degrees C; in group B increased from 68.4 +/- 4.55 until 129.1 +/- 4.73 at similar temperatures (analysis of variance: p < 0.01 at 28 degrees C). A greater VO2 in group B could indicate that slow rewarming would cause an even distribution of temperature with enough time for tissues to rid of their oxygen debt.

Cholesterol embolization following coronary angioplasty.

Cholesterol emboli syndrome is an uncommon complication seen after an invasive vascular procedure or surgery in a patient with atherosclerotic disease. The obstruction of small arteries by cholesterol crystals may be responsible for its clinical features, such as livedo reticularis, "purple toe" syndrome, renal failure, involvement of the gastrointestinal tract, coronary arteries, central nervous system or the multiple cholesterol emboli syndrome. Certain laboratory abnormalities are frequently associated: an elevated erythrocyte sedimentation rate and eosinophilia, BUN and creatinine increase in the cases with renal failure and creatine phosphokines augmentation suggesting muscle involvement. Disseminated microemboli composed mainly of cholesterol crystals are the usual pathological findings. A case of cholesterol embolism occurring after left heart catheterization and percutaneous transluminal coronary angioplasty is reported. Twenty-four hours after the procedure, the patient developed purplish discoloration of toes and soles, livedo reticularis on lumbar region, buttocks and limbs, and renal failure. Patient did well two months after anticoagulant therapy. Prognosis of these cases is related to the extent of systemic involvement and the most significant impact on this syndrome can be made by its prevention.