Understanding the Antilymphoma Activity of Annona macroprophyllata Donn and Its Acyclic Terpenoids: In Vivo, In Vitro, and In Silico Studies.

Annona macroprophyllata Donn (A. macroprophyllata) is used in traditional Mexican medicine for the treatment of cancer, diabetes, inflammation, and pain. In this work, we evaluated the antitumor activity of three acyclic terpenoids obtained from A. macroprophyllata to assess their potential as antilymphoma agents. We identified the terpenoids farnesyl acetate (FA), phytol (PT) and geranylgeraniol (Gg) using gas chromatography-mass spectroscopy (GC-MS) and spectroscopic (1H, and 13C NMR) methods applied to petroleum ether extract of leaves from A. macroprophyllata (PEAm). We investigated antitumor potential in Balb/c mice inoculated with U-937 cells by assessing brine shrimp lethality (BSL), and cytotoxic activity in these cells. In addition, to assess the potential toxicity of PEAm, FA, PT and Gg in humans, we tested their acute oral toxicity in mice. Our results showed that the three terpenoids exhibited considerable antilymphoma and cytotoxic activity. In terms of lethality, we determined a median lethal dose (LD50) for thirteen isolated products of PEAm. Gg, PT and AF all exhibited a higher lethality with values of 1.41 ± 0.42, 3.03 ± 0.33 and 5.82 ± 0.58 µg mL-1, respectively. To assess cytotoxic activity against U-937 cells, we calculated the mean cytotoxic concentration (CC50) and found that FA and PT were closer in respect to the control drug methotrexate (MTX, 0.243 ± 0.007 µM). In terms of antilymphoma activity, we found that FA, PT and Gg considerably inhibited lymph node growth, with median effective doses (ED50) of 5.89 ± 0.39, 6.71 ± 0.31 and 7.22 ± 0.51 mg kg-1 in females and 5.09 ± 0.66, 5.83 ± 0.50 and 6.98 ± 0.57mg kg -1 in males, respectively. Regarding acute oral toxicity, we classified all three terpenoids as category IV, indicating a high safety margin for human administration. Finally, in a molecular docking study of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, we found binding of terpenoids to some amino acids of the catalytic site, suggesting an effect upon activity with a resulting decrease in the synthesis of intermediates involved in the prenylation of proteins involved in cancer progression. Our findings suggest that the acyclic terpenoids FA, PT, and Gg may serve as scaffolds for the development of new treatments for non-Hodgkin's lymphoma.

Antitumor Potential of Annona muricata Linn. An Edible and Medicinal Plant in Mexico: In Vitro, In Vivo, and Toxicological Studies.

Annona muricata (Am) is a plant used in traditional Mexican medicine to treat cancer. In this study, ethanol extracts of Am collected in Acapulco and Tecpan from Guerrero state were evaluated orally on Balb/c mice inoculated with 4T1 cells, for cytotoxic activity (CA) on 4T1 cells, in brine shrimp lethality assay (BSLA), and for acute oral toxicity in mice. In addition, ethanol extracts were subjected to high-performance liquid chromatography (HPLC) with diode array detection. Results showed that the extracts collected in December in Acapulco (AcDe) and Tecpan (TeDe) exhibited the most significant antitumor and cytotoxic activity. In the BSLA, the most important effect was observed in the extracts from Acapulco and Tecpan collected in June (AcJu) and August (TeAg), respectively. The samples from Acapulco (AcJu, and AcAg) and Tecpan (TeJu and TeAg) showed the highest toxicity. The analysis of the extracts, AcDe and TeDe, by HPLC revealed that flavonoids, rutin, narcissin, and nicotinflorin were the major components. These findings suggest that extracts from Am collected in Acapulco and Tecpan in the month of December may be an important source to obtain flavonoid glycosides with anticancer potential specifically against breast cancer. This also supports the use of Am to treat cancer in Mexican traditional medicine.

Antihyperglycemic and Antilipidemic Properties of a Tea Infusion of the Leaves from Annona cherimola Miller on Streptozocin-Induced Type 2 Diabetic Mice.

The antihyperglycemic and antilipidemic effects of the tea infusion extracts of leaves from Annona cherimola Miller (IELAc-0.5, IELAc-1.5, and IELAc-3.0) were evaluated on normoglycemic (NG) and streptozocin-induced diabetic (STID) mice. In the acute test, IELAc-1.5 at 300 mg/kg bodyweight (bw) exhibited antihyperglycemic activity on STID mice since the first hour of treatment. Then, its antidiabetic potential was analyzed in a subchronic evaluation. IELAc-1.5 was able to reduce the blood glucose level, glycated hemoglobin (HbA1c), cholesterol (CHO), and triglycerides (TG); high-density lipoprotein (HDL) showed an increase at the end of treatment. IELAc-1.5 did not modify the urine profile at the end of the evaluation, and neither toxicity nor macroscopic organ damage were observed in acute and subchronic assays. In addition, a major flavonol glycoside present in the tea infusion extracts was identified using high-performance liquid chromatography with diode array detection (HPLC-DAD). The analysis of the tea infusion extracts by HPLC revealed that rutin was the major component. This study supports the use of tea infusions from Annona cherimola for the treatment of diabetes and suggests that rutin could be responsible, at least in part, for their antidiabetic properties.

Biodegradable photoresponsive nanoparticles for chemo-, photothermal- and photodynamic therapy of ovarian cancer.

Ovarian cancer (OC) is the deadliest gynecological cancer. Standard treatment of OC is based on cytoreductive surgery followed by chemotherapy with platinum drugs and taxanes; however, innate and acquired drug-resistance is frequently observed followed by a relapse after treatment, thus, more efficient therapeutic approaches are required. Combination therapies involving phototherapies and chemotherapy (the so-called chemophototherapy) may have enhanced efficacy against cancer, by attacking cancer cells through different mechanisms, including DNA-damage and thermally driven cell membrane and cytoskeleton damage. We have designed and synthesized poly(lactic-co-glycolic) nanoparticles (PLGA NPs) containing the chemo-drug carboplatin (CP), and the near infrared (NIR) photosensitizer indocyanine green (ICG). We have evaluated the drug release profile, the photodynamic ROS generation and photothermal capacities of the NPs. Also, the antitumoral efficiency of the NPs was evaluated using the SKOV-3 cell line as an in vitro OC model, observing an enhanced cytotoxic effect when irradiating cells with an 800 nm laser. Evidence here shown supports the potential application of the biodegradable photoresponsive NPs in the clinical stage due to the biocompatibility of the materials used, the spatiotemporal control of the therapy and, also, the less likely development of resistance against the combinatorial therapy.

Antihyperglycemic Effects of Annona diversifolia Safford and Its Acyclic Terpenoids: α-Glucosidase and Selective SGLT1 Inhibitiors.

Annona diversifolia Safford and two acyclic terpenoids were evaluated to determine their antihyperglycemic activity as potential α-glucosidase and selective SGLT-1 inhibitiors. Ethanolic extract (EEAd), chloroformic (CHCl3Fr), ethyl acetate (EtOAcFr), aqueous residual (AcRFr), secondary 5 (Fr5) fractions, farnesal (1), and farnesol (2) were evaluated on normoglycemic and streptozocin-induced diabetic mice. EEAd, CHCl3Fr, Fr5, (1) and (2) showed antihyperglycemic activity. The potential as α-glucosidase inhibitors of products was evaluated with oral sucrose and lactose tolerance (OSTT and OLTT, respectively) and intestinal sucrose hydrolysis (ISH) tests; the potential as SGLT-1 inhibitors was evaluated using oral glucose tolerance (OGTT), intestinal glucose absorption (IGA), and urinary glucose excretion (UGE) tests. In OSTT and OLTT, all treatments showed significant activity at two and four hours. In ISH, half maximal effective concentrations (CE50) of 565, 662 and 590 µg/mL, 682 and 802 µM were calculated, respectively. In OGTT, all treatments showed significant activity at two hours. In IGA, CE50 values of 1059, 783 and 539 µg/mL, 1211 and 327 µM were calculated, respectively. In UGE Fr5, (1) and (2) showed significant reduction of the glucose excreted compared with canagliflozin. These results suggest that the antihyperglycemic activity is mediated by α-glucosidase and selective SGLT-1 inhibition.

Visión holística de nuevos desafíos: paradigmas tecnológicos y fundamentos bioéticos en la Medicina futurista / Holistic view of new challenges: technological paradigms and bioethical basis of Futuristic Medicine

Introducción.La medicina del siglo XXI será un punto de fusión de numerosas nuevas tecnologías. Surgirán transformaciones en los paradigmas de la atención médica. Objetivo: Ofrecer una visión de lo que podría ser la atención médica futura. Material y Métodos: Se revisa en la literatura médica las ultimas y nuevas herramientas tecnológicas al servicio de la Medicina, sus posibles transformaciones y aplicación futura a través de la exploración en las principales bases de datos indexadas en los últimos 7 años, que originarán un cambio en el pensamiento científico y una visión predictiva en la atención médica a nivel mundial que realizaran reflexiones sobre enfoques médicos que origina la medicina traslacional. Se analiza el papel de la nanotecnología en la farmacología futurista, así como la genética y robótica, y se establecen comparaciones entre la cantidad de investigaciones por países y el estado actual en la América Latina y cómo influirán los nuevos adelantos científicos en la bioética lo que pudiera dar origen al transhumanismo. Resultados: El influjo de las nuevas tecnologías está ligado con el desarrollo económico y social, por lo que su aplicación no será equitativa, existiendo una diferencia importante en la formulación de patentes, investigaciones indexadas y citaciones entre países desarrollados y subdesarrollados, donde ningún país latinoamericano se encuentra entre los primeros 10 lugares del ranking mundial. Conclusiones: La tecnología actual le da solución a algunos problemas, pero no ha sido capaz de dominar muchas enfermedades. La utilización de la nanotecnología, la genética y la robótica provocarán cambios en los paradigmas de enfrentamiento a las enfermedades. Pudieran ocasionar deshumanización y problemas bioéticos(AU)

Introduction: Medicine in the 21st century will be a fusion point of numerous new technologies. Changes in the paradigms of medical attention will emerge. Objective:To present a view of what future medical attention could be. Material and methods:A review of the last and new technological tools at the service of Medicine is made, and their possible transformations and future implementation are studied through the search of the main databases of the data indexed during the last seven years, which will make a change in the scientific thought and a predictive view of the medical attention worldwide, and make reflections on the medical approaches that arise from translational medicine. The role of nanotechnology in the futuristic pharmacology is analyzed, as well as genetics and robotics; and comparisons are made regarding the amount of research by countries and the current condition in Latin America, and the way the new scientific innovations will influence in the Bioethics, which could give rise to transhumanism. Results:The influence of the new technologies is linked to the economic and social development. Therefore, its implementation will not be equitable, existing an important difference in establishment of patents, indexed research, and quotations between developed and underdeveloped countries, where no Latin American country is among the 10 first places in the world ranking. Conclusions:Current technology gives solution to some problems, but it has not been able to be acquainted with many diseases. The use of nanotechnology, genetics, and robotics will provoke changes in the confrontation paradigms of diseases, which could cause dehumanization and bioethical issues(AU)

Del razonamiento clínico al aprendizaje del proceso diagnóstico en medicina / No disponible

No disponible

Antiprotozoal, Antibacterial and Antidiarrheal Properties from the Flowers of Chiranthodendron pentadactylon and Isolated Flavonoids.

BACKGROUND: Chiranthodendron pentadactylon Larreat. (Sterculiaceae) is a Mexican plant used in traditional medicine for the treatment of heart disease symptoms and infectious diarrhea. OBJECTIVE: To evaluate in vitro antiprotozoal and antibacterial activities and in vivo antidiarrheal activity from the flowers of C. pentadactylon using the extract, fractions, and major isolated flavonoids. MATERIALS AND METHODS: Bioassay-guided fractionation of the methanol extract of C. pentadactylon (MECP) led to the isolation of five flavonoids, tiliroside, astragalin, isoquercitrin, (+)-catechin, and (-)-epicatechin. Antimicrobial activities were tested on two protozoa (Entamoeba histolytica and Giardia lamblia) and nine bacterial enteropathogens (two Escherichia coli strains, two Shigella sonnei strains, two Shigella flexneri strains, two Salmonella sp. strains, and Vibrio cholerae) isolated from feces of children with acute diarrhea or dysentery and resistant to chloramphenicol. Also, antidiarrheal activity was tested on cholera toxin-induced diarrhea in male Balb-c mice. RESULTS: Epicatechin was the most potent antiamoebic and antigiardial compound with IC50 values of 1.9 µg/mL for E. histolytica and 1.6 µg/mL for G. lamblia; tiliroside showed moderate antiprotozoal activity against both protozoan. In contrast, in the antibacterial activity, tiliroside was the most potent compound on all microorganisms with minimum inhibitory concentration values less than 0.7 mg/mL. In the case of cholera toxin-induced diarrhea, epicatechin was the most potent flavonoid with IC50 of 14.7 mg/kg. CONCLUSION: Epicatechin and tiliroside were the flavonoids responsible for antimicrobial andantidiarrheal activities of C. pentadactylon. Its antiprotozoal, antibacterial, and antidiarrheal properties are in good agreement with the traditional medicinal use of C. pentadactylon for the treatment of infectious diarrhea. SUMMARY: Epicatechin was the most potent antiamoebic and antigiardial compound with IC50 values of 1.9 µg/mL for E. histolytica and 1.6 µg/mL for G. lamblia.Tiliroside showed antibacterial activity against all microorganisms tested with MIC values less than 0.7 mg/mL.Epicatechin was the most potent flavonoid on cholera toxin-induced diarrhea with IC50 of 14.7 mg/kg. Abbreviations used: MECP: Methanol extract of C. pentadactylon.

Visión integradora del pase de visita médico asistencial y docente en hospitales universitarios de Ecuador / Integrated vision of the clinical and educational round at Ecuador university hospitals

Introducción: El pase de visita docente asistencial en las instituciones docentes hospitalarias es complejo y hay que vencer diferentes objetivos en una misma actividad. Objetivo: Proponer un diseño a partir de concepciones pedagógicas actuales del pase de visita médico asistencial y docente en hospitales universitarios ecuatorianos. Material y Métodos: Se realizó una revisión de la bibliografía relacionada con los procesos pedagógicos de la educación en el trabajo en la formación médica. Se utilizaron los buscadores PubMed, Cochrane Library y Google académico, para identificar, seleccionar, estructurar y dar una visión sistémica del pase de visita médico docente-asistencial, proponiendo bases estructurales y metodológicas, partiendo de la experiencia cubana y directivas académicas propias de Ecuador. Desarrollo: El pase de visita docente- asistencial como forma de educación en el trabajo para obtener la excelencia debe de ser más integrador donde no solo se utilice el método clínico, sino el clínico y epidemiológico, y donde estén integrados objetivos gerenciales, se utilicen métodos pedagógicos constructivistas, concepciones del entorno salud-enfermedad del tipo holísticos, a través de estrategias de participación heurísticas. Conclusiones: La utilización de un modelo de actuación con fundamentos científicos, adecuadamente estructurado y basado en transformaciones pedagógicas cualitativas que se interrelacionen con los procesos asistenciales, gerenciales y donde el paciente sea evaluado integralmente, ofrece un enfoque más sistemático de esta actividad(AU)

Introduction: The educational and assistance round in the educational-hospital institutions is complex and it is necessary to overcome different goals in the same activity. Objective: To provide a design from current pedagogical conceptions of educational-medical rounds at Ecuadorian university hospitals. Material and Methods: It carried out review of the related bibliography with the pedagogic processes of education in the work of medical formation. Were used the searchers PubMed, Cochrane Library and Google scholar to know, select, built, analyze and give a systematic view of the educational and assistance round in Ecuador, proposing structural and methodological bases, starting from the Cuban’s experience and the own Ecuadorian academic directives. Development: Educational-medical rounds as educational method of labor to obtain excellence must be more inclusive not using only the clinical method, but also clinical and epidemiological method shall be included and where integrated management objectives must be joined, using pedagogical constructional methods, holistic health-disease environment through heuristic participation strategies. Conclusion: The use of a proceeding model on a scientific basis properly structured and based on qualitative educational transformations that interrelate with medical caretaking and management issues where patients are evaluated integrally, provides a systemic approach process to this activity(AU)

Visión integradora del pase de visita médico asistencial y docente en hospitales universitarios de Ecuador / Integrated vision of the clinical and educational round at Ecuador university hospitals

Introducción: El pase de visita docente asistencial en las instituciones docentes hospitalarias es complejo y hay que vencer diferentes objetivos en una misma actividad. Objetivo: Proponer un diseño a partir de concepciones pedagógicas actuales del pase de visita médico asistencial y docente en hospitales universitarios ecuatorianos. Material y Métodos: Se realizó una revisión de la bibliografía relacionada con los procesos pedagógicos de la educación en el trabajo en la formación médica. Se utilizaron los buscadores PubMed, Cochrane Library y Google académico, para identificar, seleccionar, estructurar y dar una visión sistémica del pase de visita médico docente-asistencial, proponiendo bases estructurales y metodológicas, partiendo de la experiencia cubana y directivas académicas propias de Ecuador. Desarrollo: El pase de visita docente- asistencial como forma de educación en el trabajo para obtener la excelencia debe de ser más integrador donde no solo se utilice el método clínico, sino el clínico y epidemiológico, y donde estén integrados objetivos gerenciales, se utilicen métodos pedagógicos constructivistas, concepciones del entorno salud-enfermedad del tipo holísticos, a través de estrategias de participación heurísticas. Conclusiones: La utilización de un modelo de actuación con fundamentos científicos, adecuadamente estructurado y basado en transformaciones pedagógicas cualitativas que se interrelacionen con los procesos asistenciales, gerenciales y donde el paciente sea evaluado integralmente, ofrece un enfoque más sistemático de esta actividad(AU)

Introduction: The educational and assistance round in the educational-hospital institutions is complex and it is necessary to overcome different goals in the same activity. Objective: To provide a design from current pedagogical conceptions of educational-medical rounds at Ecuadorian university hospitals. Material and Methods: It carried out review of the related bibliography with the pedagogic processes of education in the work of medical formation. Were used the searchers PubMed, Cochrane Library and Google scholar to know, select, built, analyze and give a systematic view of the educational and assistance round in Ecuador, proposing structural and methodological bases, starting from the Cubans experience and the own Ecuadorian academic directives. Development: Educational-medical rounds as educational method of labor to obtain excellence must be more inclusive not using only the clinical method, but also clinical and epidemiological method shall be included and where integrated management objectives must be joined, using pedagogical constructional methods, holistic health-disease environment through heuristic participation strategies.Conclusion: The use of a proceeding model on a scientific basis properly structured and based on qualitative educational transformations that interrelate with medical caretaking and management issues where patients are evaluated integrally, provides a systemic approach process to this activity(AU)

La acupuntura como alternativa terapéutica en el abordaje de la fibromialgia / Acupuncture as a therapeutic alternative in the approach to fibromyalgia

Introducción: La fibromialgia es una enfermedad crónica, no articular, frecuente y compleja. Es la segunda enfermedad más frecuente en la consulta reumatológica y el 75% de los pacientes son mujeres. La acupuntura, considerada como medicina tradicional China y expandida a nivel global, busca incorporarse como un método coadyuvante en aliviar el dolor que se presenta en pacientes afectados. Objetivo: Describir el abordaje terapéutico de la fibromialgia utilizando la acupuntura, mediante revisión de la literatura, para un enfoque integrador de tratamiento. Método: Es un artículo de revisión, realizado mediante búsquedas en base de datos electrónicos, en Pubmed, Google Scholar, Cochrane Library, Science Direct, Elsevier, encontrándose más de 633 artículos, a partir del año 2010 a febrero 2016, de los que se seleccionaron solo 39 para realizar esta revisión, en torno a fibromialgia y acupuntura que reunían las evidencias de mayor calidad de acuerdo con los criterios de Grading of Recommendations of Assessment Development and Evaluations en relación a la utilidad de la misma como terapia complementaria o única en la mejoría del paciente afectado por fibromialgia.Resultados: Se encontró que la acupuntura es una alternativa en el manejo de dolor en las pacientes con fibromialgia, que para obtener mejores resultados, amerita utilizar de manera sincrónica todos los puntos que puedan resultar beneficiosos en el alivio del dolor. Conclusión: Todavía existe la necesidad de continuar investigando la eficiencia de la acupuntura para aplicar en forma estandarizada y utilizarla como alternativa en el tratamiento no farmacológico en el manejo de la fibromialgia.

Debut clínico del SIDA y su diagnóstico tardío / AIDS Clinical Onset and its Late Diagnosis

Introducción: el debut clínico es un fenómeno particular dentro de la epidemia de VIH/SIDA que se viene observando en todo el mundo. Objetivo: describir un caso de debut clínico de SIDA cuyo diagnóstico fue tardío. Presentación del caso: se reporta un caso con Virus de Inmunodeficiencia Humana que su debut clínico estuvo caracterizado por manifestaciones respiratorias y lesiones por herpes virus genitales y peri anales de más de 3 meses de evolución, en el cual su diagnóstico serológico fue tardío, presentándose con estado de inmunodepresión por conteo TCD4. El diagnóstico fue hecho hospitalario, pero pudo haberse realizado antes. Se identificó el elemento epidemiológico como población clave de mayor riesgo. Conclusiones: en el caso estudiado se realizó el diagnóstico tardío de SIDA, en etapa clínica categoría C3. Un buen interrogatorio, que incluya aspectos de antecedentes de tipo epidemiológico y un correcto y completo examen físico, es la base para un certero razonamiento científico en el proceder diagnóstico(AU)

Introduction: the clinical presentation is a particular phenomenon in the HIV / AIDS that has been observed worldwide. Objective: to describe a case of AIDS clinical onset whose diagnosis was delayed. Objective: to describe a case of clinical debut of been whose diagnosis was late.Case presentation: a case is reported with Human Immunodeficiency Virus (HIV). Its clinical onset was characterized by respiratory symptoms and genital and perianal injuries by herpes virus for more than 3 months. In this case, HIV diagnosis was late. A state of immunosuppression by CD4+ T count was present. A hospital diagnosis was made, but it could have done earlier. The epidemiological element as target population in higher risk was identified. Conclusions: in this case, late diagnosis of AIDS was made in clinical stage category C3. A good interview, including epidemiological background aspects and a correct and complete physical examination are the basis for an accurate scientific reasoning in the diagnostic procedure(AU)

Debut clínico del SIDA y su diagnóstico tardío / AIDS Clinical Onset and its Late Diagnosis

El debut clínico es un fenómeno particular dentro de la epidemia de VIH/SIDA que se viene observando en todo el mundo. Objetivo: describir un caso de debut clínico de SIDA cuyo diagnóstico fue tardío. Presentación del caso: se reporta un caso con Virus de Inmunodeficiencia Humana que su debut clínico estuvo caracterizado por manifestaciones respiratorias y lesiones por herpes virus genitales y peri anales de más de 3 meses de evolución, en el cual su diagnóstico serológico fue tardío, presentándose con estado de inmunodepresión por conteo TCD4. El diagnóstico fue hecho hospitalario, pero pudo haberse realizado antes. Se identificó el elemento epidemiológico como población clave de mayor riesgo. Conclusiones: en el caso estudiado se realizó el diagnóstico tardío de SIDA, en etapa clínica categoría C3. Un buen interrogatorio, que incluya aspectos de antecedentes de tipo epidemiológico y un correcto y completo examen físico, es la base para un certero razonamiento científico en el proceder diagnóstico...

The clinical presentation is a particular phenomenon in the HIV / AIDS that has been observed worldwide. Objective: to describe a case of AIDS clinical onset whose diagnosis was delayed. Objective: to describe a case of clinical debut of been whose diagnosis was late.Case presentation: a case is reported with Human Immunodeficiency Virus (HIV). Its clinical onset was characterized by respiratory symptoms and genital and perianal injuries by herpes virus for more than 3 months. In this case, HIV diagnosis was late. A state of immunosuppression by CD4+ T count was present. A hospital diagnosis was made, but it could have done earlier. The epidemiological element as target population in higher risk was identified. Conclusions: in this case, late diagnosis of AIDS was made in clinical stage category C3. A good interview, including epidemiological background aspects and a correct and complete physical examination are the basis for an accurate scientific reasoning in the diagnostic procedure...

El proceso diagnóstico y su enseñanza en la medicina / The diagnostic process and its teaching in medicine

El método clínico constituye una categoría fundamental en las Ciencias Clínicas y su utilización como método de enseñanza en las disciplinas y asignaturas en el ciclo clínico de la carrera de Medicina. Contribuye a la sistematización de todas aquellas habilidades que, en forma de sistema, se integran en la ejecución del mismo. El desarrollo de estas habilidades es esencial en el proceso de diagnóstico en Medicina Este artículo tiene como propósito su vinculación a la tarea docente de la Discusión Diagnóstica dentro de la Educación en el Trabajo con recursos didáctico-metodológicos con fines docentes para la enseñanza y aprendizaje de habilidades profesionales del futuro médico(AU)

The clinical method constitutes a fundamental category in the clinical sciences and its utilization as a teaching method in the disciplines and subjects of study in the clinical cycle of Medicine's race. Contribute to the systematization of all those abilities that, in the shape of system. They integrate in the execution of the same one. The development of these abilities is fundamental in the process of diagnosis in medicine the article has as a fundamental purpose its linkage to the teaching task of Diagnostic Discussion within the on-the-job education with didactic resources methodologists with teaching ends for the teaching and learning of professional abilities of the medical future(AU)