Viral hepatitis: An alternative teaching method.

OBJECTIVES: Our teaching experience has shown that dealing with the immunological aspects of viral hepatitis poses several difficulties. Therefore, we developed a game to verify whether or not this active-learning exercise could enhance students' learning and arouse their interest in subjects that are basically complex. METHODS: Fifteen cards with clinical cases of hepatitis A, B, C, D, and E, and 50 explanatory cards with the description of epidemiological, clinical, and immunological aspects of the hepatitis mentioned above. The objective of the game was to match the explanatory cards with the respective clinical case. Pre- and post-tests were used to assess students' grade improvement. FINDINGS: One-hundred-and-forty students participated in the activity. The overall response of the students to the game was very positive: 129 (92.1%) found the game encouraged clinical thinking, and 105 (75%) regarded the game as an important way of consolidating learning. The students' grades significantly improved (p < 0.05). CONCLUSION: Games allow understanding the subject matter through global knowledge. They also foster the student-professor relationship, simplifying the solution to the questions that may arise from a more comprehensive study.

Stress regulates the lymphocyte homing receptor CD62L (L-selectin).

Based on a previous study showing that panic disorder patients had increased expression of na ve phenotype lymphocytes (CD45RA+ and CD62L+), increased plasma cortisol, as well as decreased interleukin-2 (IL-2) producion, we hypothesized that changes in the percentage of expression of these lymphocyte surface molecules could be related to the substances released by the hypothalamic-pituitary-adrenal (HPA) axis and possibly associated to panic disorder (cortisol, IL-2, serotonin and epinephrine). In order to study the altered expression, blood mononuclear cells of normal volunteers were stimulated with mitogen, in the presence of dexamethasone, IL-2, serotonin and epinephrin. CD62L is decreased by IL-2 in vitro. Serotonin and epinephrine did not promote changes in the expression of these surface molecules. The results of the ex vivo study are in agreement with a previous clinical study with panic patients. It could be suggested that stress is responsible for certain immunologic dysfunctions and new studies should be conducted.

Stress regulates the lymphocyte homing receptor CD62L (L-selectin)

Based on a previous study showing that panic disorder patients had increased expression of naïve phenotype lymphocytes (CD45RA+ and CD62L+), increased plasma cortisol, as well as decreased interleukin-2 (IL-2) producion, we hypothesized that changes in the percentage of expression of these lymphocyte surface molecules could be related to the substances released by the hypothalamic-pituitary-adrenal (HPA) axis and possibly associated to panic disorder (cortisol, IL-2, serotonin and epinephrine). In order to study the altered expression, blood mononuclear cells of normal volunteers were stimulated with mitogen, in the presence of dexamethasone, IL-2, serotonin and epinephrin. CD62L is decreased by IL-2 in vitro. Serotonin and epinephrine did not promote changes in the expression of these surface molecules. The results of the ex vivo study are in agreement with a previous clinical study with panic patients. It could be suggested that stress is responsible for certain immunologic dysfunctions and new studies should be conducted