[Study of the introduction of the European Credit Transfer System (ECTS) in pediatrics and modification of the teaching methodology]. / Estudio sobre la introducción del Sistema de Transferencia de Créditos Europeo en Pediatría y modificaciones de la metodología docente.

INTRODUCTION: Spanish medical faculties have initiated the new curriculum reform process within the framework of the European Higher Education Area and are required to incorporate the European Credit Transfer System (ECTS) to new syllabi before 2010. OBJECTIVES: To test the introduction of the ECTS in pediatrics and modify the teaching methodology. STUDY DESIGN: The theoretical and practical programs were adapted; academic objectives and a student evaluation system were established. Students were surveyed on starting the second term of the 2004-05 academic year before the theory examination and again on terminating the academic year: a 5-point Likert-type scale was used for responses. Priorities for generic and specific competencies selected by students were compared with those selected by the National Deans Conference (NDC). The results were analyzed using non-parametric tests. RESULTS: Fifteen credits became 11 ECTS, with 297 student working hours. The theory program was reduced from 80 to 52 lessons. The students prepared 14 tutor-supervised case presentations. The teaching staff considered that learning of theory was similar to previous years (66 %) and that practical learning improved (73.3 %). The students thought the program should continue (73.2 %) but 98.8 % considered the workload excessive. The students believed that their practical training and their ability to prepare and make case presentations significantly improved during the semester. Academic performance was significantly higher than that in students of the previous year. Students agreed with NDC priorities for 9/9 general and 4/17 specific competencies. Estimation of workload by students was significantly higher than that by staff, and 73.3 % of the students believed that workload should be reduced and the examination system improved. CONCLUSIONS: Introducing the ECTS improved academic performance, practical training, and self-directed learning. The project was satisfactory for staff and students. Student workload was underestimated.

[Urinary excretion of N-acetyl-beta-D-glucosaminidase and microglobulin 2 in type I diabetes mellitus]. / Estudio de la eliminación urinaria de N-acetil-beta-D-glucosaminidasa y beta 2 microglobulina en la diabetes mellitus tipo I.

We studied the urinary elimination of two indicators of renal proximal tubular function. N-Acetyl-Gluosaminidase (NAG) and beta 2 microglobulin (beta 2m) in 23 healthy and 67 diabetic children aged 2-15 years and with disease evolution times between 1 month and 12 years. In order to obviate the variations of glomerular filtration present in the diabetes, both proteins were evaluated in the form of indices of excretion (IE). It was found that the diabetic children as a whole presented higher values of NAGIE than the controls (p less than 0.001), and that this increased as the degree of metabolic control worsened, the latter being judged by either fructosamin or HbA C (r = 0.59 for both). The increase in the urinary elimination of NAG had a directly proportional relation with the evolution time of the diabetes. With respect to the beta 2mIE, no significant differences were found on dividing the children according to the degree of metabolic control, although the values did increase with longer evolution times. Thus it may be concluded that NAGIE was shown to be a more useful parameter than beta 2m for evaluating the renal proximal tubular function in infant and juvenile diabetes.

[Xanthinuria. New Report. Review of the literature]. / Xantinuria. Nueva aportación. Revisión de la literatura.

Description a new case--the most precociously diagnosed in medical literature--of Xanthinuria, with the peculiarity of having débuted with cerebral haemorraging without lithiasis at any time. Metabolism of purines, characteristics of the disease in general and of the case concerned, and published cases are reviewed.