La enseñanza de la morfología médica con módulos de autoaprendizaje y sus efectos sobre el recuerdo a largo plazo

Introducir las técnicas de autoaprendizaje, según las directrices recomendadas por la OMS, adaptándolas a la enseñanza de la morfología médica y comparar sus resultados, a corto y largo plazo, con la enseñanza tradicional. Entrenar a los estudiantes de Medicina en las técnicas de autoaprendizaje. 12 alumnos voluntarios, divididos en subgrupos de 4 de primero de Medicina. La investigación surge en el contexto de las nuevas directrices para la enseñanza de la Medicina aparecidas a finales de los años 70. Se hacen dos grupos de alumnos tomados por orden alfabético, que aprendieron la misma materia con una u otra técnica. Las partes del programa que iban a ser estudiadas con técnicas de auto-instrucción se dividieron en módulos, cada uno fue un conjunto independiente de conocimientos. La estructura de la parte inicial fue desarrollada de modo lineal, estaba compuesta de identificadores, asociaciones nominales de estructura, definiciones simples, etc. Posteriormente, se adoptó una estructura ramificada, interpretación de radiografías, imágenes de tomografía axial computerizada, de resonancia magnética, etc. La evaluación de los resultados se realizó en los terrenos cognoscitivo, afectivo y sensorio motor. Los resultados en el terreno cognoscitivo fueron similares en ambos grupos, posteriormente en otra prueba se apreció un mayor rendimiento en favor de los que habían utilizado el autoaprendizaje y ninguno de los que aprendieron por el método tradicional fue capaz de sobrepasar el percentil 80 del grupo autoinstruido. En el campo psicomotor, el autoaprendizaje se mostró como una técnica que permite alcanzar con facilidad objetivos de los más altos niveles. En el campo afectivo indicaron que los estudiantes prefieren este tipo de enseñanza aunque les exija un mayor esfuerzo que la tradicional. Se mostraron dispuestos a adquirir conocimientos adicionales, no necesarios para aprobar, invirtiendo la Ley del efecto Thorndeke y evidenciando el poder motivacional del autoaprendizaje.Castilla y LeónBiblioteca de Educación del Ministerio de Educación, Cultura y Deporte; Calle San Agustín, 5 - 3 Planta; 28014 Madrid; Tel. +34917748000; Fax +34917748026; [email protected]

Selective calcification of rat brain lesions caused by systemic administration of kainic acid

Dystrophic calcification of previously damaged areas of nervous tissue occurs in a wide range of human diseases. The relationship between astroglial and microglial reactions and deposits of calcium salts was studied for up to five months in rats with a brain lesion produced by systemic administration of kainate. The morphology and atomic composition of the calcium salt deposits was also studied. Two types of lesions, sclerotic and liquefactive, were observed. In sclerotic lesions hyperplasia and hypertrophy of astrocytes partially substituted for the lost neurons, reaching a maximum in about twenty-five days after treatment. In liquefactive lesions, the astrocytic reaction occurred only around the liquefactive area. Microglial reaction was similar in both types of lesion and reached its highest expression in about twenty-five days. Calcium deposits were observed in the sclerotic but not in the liquefactive lesions. Clearly distinguishable granules of calcium salts were observed in sclerotic lesions under scanning electron microscopy after only five days post-injection. The size of calcified granules increased with time reaching 40 µm or more in diameter at five months. The atomic composition of these deposits, studied by X-ray microanalysis, showed a time-dependent increase in calcium concentration. While there was no clear relationship between astroglial and microglial reactions and calcium salt deposits, the systemic injection of kainate produced progressively larger and more concentrated calcium deposits in sclerotic, but not in liquefactive lesions

Absence of relevant effects of 5 mT static magnetic field on morphology, orientation and growth of a rat Schwann cell line in culture

The aim of this study is to observe possible changes in the morphology, orientation or cell growth of an in vitro cultured Schwann cell line by 24 h exposure to 5 mT static magnetic fields. The magnetic field generator basically consists of a pair of circular coils in a Helmholtz arrangement and enables temperature to be controlled (37±0.1°C). We did not find any statistically significant differences in the cell growth rate between control and exposed cells, nor did we observe any differences in cell morphology or orientation

Paravertebral muscles in experimental scoliosis, a light and electron microscopic study

Experimental! structural dextroconvex scoliosis was produced in rabbits by costotransversolisis with transversectomy and releasing of paravertebral muscles between TVII and TX on the right side. Two compensatory curves developed on the upper dorsal and lumbar levels. Biopsies of paravertebral muscles in experimental animals included, besides areas of normal tissue, a considerable derangement of the cell contractile apparatus with sarcoplasmic dilation and eventual cell disintegration and necrosis. Histological changes varied along levels, the convexit!~ being more affected. The severity of changes and retiuction in body weight and length were correlated with the degree of scoliosis. A selective atrophy of slow-twitch fibers was observed in experimental animals, especially at the level of the main curve, whereas fast-twitch fiber atrophy was more important caudally. Control animal biopsies always appeared normal. Our experimental model shows an overt participation of paravertebral muscles in the establishment of compens,atory processes following scoliosis, although the role that paravertebral muscles play in the etiopathogenesis of human idiopathic scoliosis requires further investigation

Bendamustine as part of conditioning of autologous stem cell transplantation in patients with aggressive lymphoma: a phase 2 study from the GELTAMO group

We conducted a phase 2 trial to evaluate the safety and efficacy of bendamustine instead of BCNU (carmustine) in the BEAM (BCNU, etoposide, cytarabine and melphalan) regimen (BendaEAM) as conditioning for autologous stem-cell transplantation (ASCT) in patients with aggressive lymphomas. The primary endpoint was 3-year progression-free survival (PFS). Sixty patients (median age 55 [28–71] years) were included. All patients (except one who died early) engrafted after a median of 11 (9–72) and 14 (4–53) days to achieve neutrophil and platelet counts of >0.5 × 109/l and >20 × 109/l, respectively. Non-relapse mortality at 100 days and 1 year were 3.3% and 6.7%, respectively. With a median follow-up of 67 (40–77) months, the estimated 3-year PFS and overall survival (OS) were 58% and 75%, respectively. Patients in partial response at study entry had significantly worse PFS and OS than patients who underwent ASCT in complete metabolic remission, and this was the only prognostic factor associated with both PFS (Relative risk [RR], 0.27 [95% confidence interval {CI} [0.12–0.56]) and OS (RR, 0.40 [95% CI 0.17–0.97]) in the multivariate analysis. BendaEAM conditioning is therefore a feasible and effective regimen in patients with aggressive lymphomas. However, patients not in complete metabolic remission at the time of transplant had poorer survival and so should be considered for alternative treatment strategies

Busulfan-based myeloablative conditioning regimens for haploidentical transplantation in high risk acute leukemias and myelodysplastic syndromes.

[eng] Background High‐risk acute leukemia (AL) and myelodysplastic syndrome (MDS) remain a therapeutic challenge. Unmanipulated haploidentical‐related donor transplantation based on a myeloablative conditioning regimen (HAPLO‐MAC) and post‐transplant cyclophosphamide (PT‐Cy) as prophylaxis against graft vs host disease (GvHD) is now a promising rescue strategy that could become universally available. Objective To evaluate the results of HAPLO‐MAC with PT‐Cy in patients with AL and MDS reported to the Haploidentical Transplantation Subcommittee of the Spanish Group for Hematopoietic Transplantation (GETH). Patients and methods We report our multicenter experience using an IV busulfan‐based HAPLO‐MAC regimen and PT‐Cy for treatment of 65 adults with high‐risk AL and MDS. Results Engraftment was recorded in 64 patients (98.5%), with a median time to neutrophil and platelet recovery of 16 and 27 days, respectively. The cumulative incidence of grade II‐IV acute GvHD and chronic GvHD was 28.6% and 27.5%, respectively. After a median follow‐up of 31 months for survivors, the cumulative incidence of non‐relapse mortality and relapse at 2 years was 18.8% and 25%, respectively. Estimated 30‐month event‐free survival and overall survival were 56% and 54.5%, respectively. Conclusion HAPLO‐MAC comprising an IV busulfan‐based conditioning regimen enabled long‐term disease control with acceptable toxicity in high‐risk AL and MDS