[Evaluating the professors visits on the care of patients with knee osteoarthrosis]. / Evaluación de la visita de profesores en la atención de la osteoartrosis de rodilla.

BACKGROUND: visits of professors is an educational strategy (ES) that allow the exchange of clinical experience between specialists and physicians of first contact and let to both reconsider their daily work, incorporate useful tools to promote learning, and implement strategies to solve problems in clinical work. The aim was to describe an ES carried out in a program of knee osteoarthritis, differentiating clinical competence from professional performance. METHODS: ten family physicians and an orthopaedic specialist participated. The ES took place by assessing competence in clinical cases; clinical performance with an observation guide as well as reviewing grounds for transfers to a second level. RESULTS: competence skills had found an initial media of 25 and at the end of 38 (p=0.025). On the observation guide a middle initial of 29 and final 91; finally, in submission evaluation a 50 % was adequate at the beginning of the ES with a 100 % at the end. CONCLUSIONS: development in doctors' clinical competence skill was observed and a better performance in medical care.

[Developing critical skills to analyze research reports in nuclear medicine]. / Alcances de una estrategia educativa desde una perspectiva participativa de la educación en el desarrollo de lectura crítica de informes de investigación en médicos residentes de medicina nuclear.

OBJECTIVE: To estimate the impact of an educational strategy aimed at developing critical reading of research reports among medical residents enrolled in a nuclear medicine course. METHODS: We carried out an intervention study to measure the degree to which students developed critical reading skills in a one month period (May-June, 2007). We developed an instrument that included five summaries of research articles in nuclear medicine and 96 sentences that measured four indicators (interpret, judge, propose, and assessment of technical and technological aspects). The instrument's internal validity was measured using the Kuder-Richardson test (KR 20 = 0.89) stratified in five scores: very low (17-32), low (33-48), medium (49-64), high (65-80) and very high (81-96). Non-paramentric statistics was employed to determine significant differences. RESULTS: At the beginning of the intervention, 0.80 of participating residents scored in the "very low" domain of critical reading even after controlling for a random effect. At the end of the study, 0.90 scored in the "medium" category. Results were statistically significant (p = 0.02). CONCLUSIONS: The educational strategy tested, fostered the development of critical reading skills among a sample of nuclear medicine residents.

Alcances de una estrategia educativa desde una perspectiva participativa de la educación en el desarrollo de lectura crítica de informes de investigación en médicos residentes de medicina nuclear / Developing critical skills to analyze research reports in nuclear medicine

Objetivo: Estimar los alcances de una estrategia educativa en el desarrollo de la lectura crítica de informes de investigación en médicos residentes de medicina nuclear. Métodos: Estudio de intervención entre mayo y junio de 2007 para medir el grado de desarrollo de lectura crítica en médicos residentes de medicina nuclear. Se elaboró un instrumento con cinco resúmenes de informes de investigación en medicina nuclear, con 96 enunciados que exploraron cuatro indicadores (interpretar, enjuiciar, proponer y valoración de aspectos técnicos y tecnológicos). Se estimó la confiabilidad interna con la prueba de Kuder-Richardson 20 (0.89). Se conformaron cinco categorías: muy bajo (17-32), bajo (33-48), medio (49-64), alto (65-80) y muy alto (81-96). El análisis estadístico se realizó con estadística no paramétrica. Resultados: Al inicio de la estrategia, 80 % de los residentes mostró un grado de dominio de lectura crítica muy bajo e incluso calificaciones dentro de lo explicable por efecto del azar; al final de la misma, 90% alcanzó un dominio medio. Las diferencias fueron estadísticamente significativas (p=0.02). Conclusiones: La estrategia educativa propició un avance en el desarrollo de lectura crítica de informes de investigación en medicina nuclear.

OBJECTIVE: To estimate the impact of an educational strategy aimed at developing critical reading of research reports among medical residents enrolled in a nuclear medicine course. METHODS: We carried out an intervention study to measure the degree to which students developed critical reading skills in a one month period (May-June, 2007). We developed an instrument that included five summaries of research articles in nuclear medicine and 96 sentences that measured four indicators (interpret, judge, propose, and assessment of technical and technological aspects). The instrument's internal validity was measured using the Kuder-Richardson test (KR 20 = 0.89) stratified in five scores: very low (17-32), low (33-48), medium (49-64), high (65-80) and very high (81-96). Non-paramentric statistics was employed to determine significant differences. RESULTS: At the beginning of the intervention, 0.80 of participating residents scored in the [quot ]very low[quot ] domain of critical reading even after controlling for a random effect. At the end of the study, 0.90 scored in the [quot ]medium[quot ] category. Results were statistically significant (p = 0.02). CONCLUSIONS: The educational strategy tested, fostered the development of critical reading skills among a sample of nuclear medicine residents.

Uptake of 153Sm-DTPA-bis-biotin and 99mTc-DTPA-bis-biotin in rat as-30D-hepatoma cells.

Labeled biotin has been used mainly for pretargeted therapy, an approach for increasing the amount of radioactivity delivered to a cancer cell. The aim of this investigation was to prepare (153)Sm-DTPA-bis-biotin and (99m)Tc-DTPA-bis-biotin in order to study their in vitro and in vivo uptake in rat AS-30D hepatoma cells found in ascites and in implanted tumor. DTPA-bis-biotin (pH 8) was (153)Sm labeled with (153)SmCl(3) and (99m)Tc-DTPA-bis-biotin was prepared via SnCl(2) reduction. Radiochemical purity was >98% in both cases. AS-30D hepatoma cells were obtained from ascites of a rat with hepatoma and were propagated in the peritoneum cavity of normal rats. In vitro ascites cell (153)Sm-DTPA-bis-biotin uptake was compared with (153)SmCl(3) cell uptake. The ratio cell (153)Sm-DTPA-bis-biotin/(153) SmCl(3) was 39.6 and when avidin was added it increased to 50. The ratio (99m)Tc-DTPA-bis-biotin/TcO(4)Na was 8.7. Concentration of (153)Sm-DTPA-bis-biotin in tumor 2, 3 and 24 h after administration, was 5, 15 and 3 times higher than in normal muscle (T/nT). Biodistribution in a 0.083-24 h time period showed that (153)Sm-DTPA-bis-biotin was taken up only by ascites tumor cells and hepatoma cells. Two and 3 h ratio ascites/liver (As/Lv) was 6.4 and 6.0. For (99m)Tc-DTPA-bis-biotin 2 and 3 h T/nT was 15.7 and 4.7 and 2 h As/Lv was 1.4. In conclusion, both radiopharmaceuticals show high uptake in rat AS-30D hepatoma cells in ascites and in implanted tumor. Since lung, thyroid, kidney, liver or pancreas carcinomas are ascites producing cancers (153)Sm-DTPA-bis-biotin would be an adequate therapeutic radiopharmaceutical for these patients whose life quality would be enhanced with control of ascites, and a reduction of the primary tumor and its metastases.