Impact of an E-Learning Histology Course on the Satisfaction and Performance of Medical, Nursing and Midwifery Students / Impacto de un Curso E-Learning de Histología en la Satisfacción y Desempeño de Estudiantes de Medicina, Enfermería y Obstetricia

SUMMARY: The importance and relevance of e-learning courses in medicine and health sciences has increased significantly in the last decade. Despite this, there are few published teaching experiences of e-learning histology courses in the literature worldwide. The histology course we designed was structured on the Moodle platform as a learning management system, and the content was proposed in a synchronous (zoom) and asynchronous (recordings) format. We also included the use of free virtual microscopy tools. This study aimed to investigate the impact of an e-learning histology course on the satisfaction and performance of medical, nursing and midwifery students. The sample included 424 Chilean medical, nursing, and midwifery students from two cohorts. A Likert-type survey was administered at the end of the course. We performed exploratory analysis and ordinary least squares regression. In this study, we present a positive experience of an e-learning histology course. Exploratory factor analysis revealed three main factors related to "e- learning satisfaction", "in-person class activities", and "course design and teaching quality". We also found that there was a positive and significant relationship between students' perceptions of the adaptation of the traditional (face-to-face) histology course into an e-learning format and their academic performance. Our study shows that e-learning histology courses that integrate lectures and practical sessions can be a valuable teaching method for learning histology. Curriculum developers and teachers need to consider the limitations and advantages of this type of teaching and incorporate these three factors into the design and assessment of e-learning histology courses.

La importancia y relevancia de los cursos e-learning en medicina y ciencias de la salud ha aumentado significativamente en la última década. A pesar de ello, existen pocas experiencias docentes publicadas de cursos de histología e-learning en la literatura a nivel mundial. El curso de histología que diseñamos se estructuró en la plataforma Moodle, y los contenidos se propusieron en formato síncrono (zoom) y asíncrono (grabaciones). También incluimos el uso de herramientas gratuitas de microscopía virtual. Este estudio tuvo como objetivo investigar el impacto de un curso de histología e-learning en la satisfacción y el rendimiento de los estudiantes de medicina, enfermería y obstetricia. La muestra incluyó 424 estudiantes chilenos de medicina, enfermería y obstetricia de dos cohortes. Se aplicó una encuesta tipo Likert al final del curso. Se realizó un análisis exploratorio y una regresión por mínimos cuadrados ordinarios. En este estudio, presentamos una experiencia positiva de un curso de e-learning de histología. El análisis factorial exploratorio reveló tres factores principales relacionados con la "satisfacción sobre el aprendizaje e-learning", "clases presenciales versus clases virtuales" y el "diseño del curso y la calidad de la enseñanza". También encontramos que existía una relación positiva y significativa entre las percepciones de los estudiantes sobre la adaptación del curso de histología tradicional (presencial) a un formato e-learning y su rendimiento académico. Nuestro estudio muestra que los cursos de histología e-learning que integran clases teóricas y sesiones prácticas pueden ser una valiosa herramienta de enseñanza. Los responsables de la elaboración de planes de estudios y los profesores de histología deben tener en cuenta las limitaciones y ventajas de este tipo de enseñanza y sugerimos incorporar estos tres factores al diseño y la evaluación de los cursos de histología en línea.

Presurgical diagnosis of diffuse gliomas in adults: Post-WHO 2021 practical perspectives from radiologists in neuro-oncology units.

The 2021 World Health Organization classification of CNS tumours was greeted with enthusiasm as well as an initial potential overwhelm. However, with time and experience, our understanding of its key aspects has notably improved. Using our collective expertise gained in neuro-oncology units in hospitals in different countries, we have compiled a practical guide for radiologists that clarifies the classification criteria for diffuse gliomas in adults. Its format is clear and concise to facilitate its incorporation into everyday clinical practice. The document includes a historical overview of the classifications and highlights the most important recent additions. It describes the main types in detail with an emphasis on their appearance on imaging. The authors also address the most debated issues in recent years. It will better prepare radiologists to conduct accurate presurgical diagnoses and collaborate effectively in clinical decision making, thus impacting decisions on treatment, prognosis, and overall patient care.

Anatomical Study of the Relationship between the Riché-Cannieu Anastomosis and the Kaplan Cardinal Line / Estudo anatômico da relação entre a anastomose de Riché-Cannieu e a linha cardinal de Kaplan

Abstract Objective To identify the location of the Riché-Cannieu anastomosis (RCA) in relation to the Cardinal Kaplan Line (KCL) and the Y line. Methods A total of 20 hands of 10 recently-deceased adult male cadavers aged between 27 and 66 years were dissected for the investigation of the relationship of the most distal point of the RCA with the KCL and with the Y line, drawn from the axis of the third metacarpal head, following the longitudinal axis of the hand. Results In 20 limbs, the most distal point of the nerve communication was positioned distally in relation to the KCL. The Y line was positioned on the radial side in relation to the most distal point of the RCA in 14 limbs, and it was positioned on the ulnar side in relation to the Y line in 6 limbs. The crossing between the KCL and the Y line occurred proximal to the RCA in 18 limbs; in 1 hand, it was positioned distal to the intersection between these lines; and in another hand, the KCL was positioned exactly on the RCA. Conclusion Knowledge of these anatomical relationships can prevent damage to nerve branches and thus also prevent paralysis of intrinsic muscles in surgical procedures in the palm of the hand.

Resumo Objetivo Identificar a localização da anastomose de Riché-Cannieu (ARC) em relação à linha cardinal de Kaplan (LCK) e à linha Y. Métodos Ao todo, 20 mãos de 10 cadáveres adultos do sexo masculino com idades entre 27 e 66 anos, recentemente falecidos, foram dissecadas para a investigação da relação do ponto mais distal da ARC com a LCK e a linha Y traçada a partir do eixo da cabeça do terceiro metacarpo seguindo o eixo longitudinal da mão. Resultados Nos 20 membros, o ponto mais distal da comunicação nervosa era distal à LCK. A linha Y estava no lado radial em relação ao ponto mais distal da ARC em 14 membros, e no lado ulnar em relação à linha Y em 6 membros. O cruzamento entre a LCK e a linha Y foi proximal à ARC em 18 membros; em 1 mão, era distal à intersecção entre essas linhas e, em outra mão, a LCK estava exatamente na ARC. Conclusão O conhecimento dessas relações anatômicas pode prevenir danos aos ramos nervosos e, assim, também prevenir a paralisia dos músculos intrínsecos em procedimentos cirúrgicos na palma da mão.

The Impact of Various Factors on the Difficulties in Learning and Teaching Strategies for Histology / El Impacto de Diversos Factores en las Dificultades en el Aprendizaje y las Estrategias de Enseñanza de Histología

SUMMARY: Histology is considered one of the most important but challenging topics in health sciences. Deficiencies in teaching and general histology directly affect the student's understanding, performance and promote dynamism and integration while covering the primary curriculum. The goal of the current study was to assess and provide a better experience of difficulties in learning histology, examine some standard teaching strategies, and determine how to implement suitable changes to improve the curriculum from students' perspectives. The study comprised of a self-administered questionnaire that included descriptive questions. Data was collected based on the survey conducted via 100 students studying histology. Data was analyzed further qualitatively and quantitatively to elaborate on the difficulties in this area. Many of them strongly agreed that the lack of essential comprehension regarding using light and electron microscopes resulted in challenges with comprehending and identifying tissue samples for image identification due to inadequate anatomical knowledge. Moreover, according to students, some difficulties understood the topic, perception of new terminologies, and insufficient teaching strategies to grasp students' interests. They also agreed that improvement was needed in terms of the modes of teaching employed by histology teachers; they felt that modern education techniques based on practical tasks should be incorporated to stimulate student interest and make understanding histological concepts easier. The Institution should modify the teaching system to allocate more time to relevant subjects to make this subject matter more interesting. This survey-based study evaluated that students faced some challenges while studying the current curriculum of histology. From the student's perspective, it is identified that some changes are needed to improve the course curriculum and way of teaching to make it more understandable.

La histología se considera uno de los temas más importantes pero desafiantes de las ciencias de la salud. Las deficiencias en la enseñanza y en la histología general afectan directamente la comprensión, el desempeño del estudiante y promueven el dinamismo y la integración al abarcar el currículo primario. El objetivo del estudio actual fue evaluar y proporcionar una mejor experiencia de las dificultades en el aprendizaje de histología, examinar algunas estrategias de enseñanza estándar y determinar cómo implementar cambios adecuados para mejorar el plan de estudios desde la perspectiva de los estudiantes. El estudio constaba de un cuestionario auto administrado que incluía preguntas descriptivas. Los datos se recopilaron a partir de una encuesta realizada a 100 estudiantes de histología. Los datos se analizaron más a fondo de forma cualitativa y cuantitativa para profundizar en las dificultades en esta área. Muchos de ellos estuvieron totalmente de acuerdo en que la falta de comprensión esencial sobre el uso de microscopios ópticos y electrónicos resultó en desafíos para comprender e identificar muestras de tejido para la identificación de imágenes debido a un conocimiento anatómico inadecuado. Además, según los estudiantes, algunas dificultades en la comprensión del tema, percepción de nuevas terminologías y estrategias de enseñanza insuficientes para captar los intereses de los estudiantes. También coincidieron en que era necesario mejorar los métodos de enseñanza empleados por los profesores de histología; sintieron que deberían incorporarse técnicas educativas modernas basadas en tareas prácticas para estimular el interés de los estudiantes y facilitar la comprensión de los conceptos histológicos. La Institución debería modificar el sistema de enseñanza para asignar más tiempo a materias relevantes para hacer esta materia más interesante. Este estudio basado en encuestas evaluó que los estudiantes enfrentaron algunos desafíos mientras estudiaban el plan de estudios actual de histología. Desde la perspectiva del estudiante, se identifica que se necesitan algunos cambios para mejorar el plan de estudios del curso y la forma de enseñar para hacerlo más comprensible.

Escape Room como Herramienta Didáctica en la Enseñanza de la Histología / Escape Room as a Didactic Tool in Histology Teaching

En el marco de un proceso de aprendizaje activo, se investigó el rendimiento académico a corto y a largo plazo de los estudiantes en dos sesiones prácticas de la asignatura de Histología a las que se incorporó un escape room. También se evaluó su impacto en la motivación y la retención del conocimiento. Los estudiantes fueron clasificados en un grupo control, que siguió una metodología de enseñanza tradicional, y un grupo experimental, que participó en la actividad del escape room. Los resultados revelaron mejoras significativas en las calificaciones posteriores a la intervención en el grupo experimental. El estudio también evaluó la percepción estudiantil de la experiencia del escape room que demostró valoraciones muy satisfactorias.

SUMMARY: In the context of an active learning process, this study investigated the short-term and long-term academic performance of students in two practical sessions of the Histology course, which included an escape room activity. The impact of this approach on motivation and knowledge retention was also assessed. Students were divided into a control group, which followed a traditional teaching methodology, and an experimental group, which participated in the escape room activity. The results revealed significant improvements in post-intervention grades in the experimental group. Additionally, the study assessed students' perceptions of the escape room experience, which showed highly satisfactory evaluations.

Principales indicadores del Programa de Diagnóstico Precoz del Cáncer Cervicouterino en un hospital de Santiago de Cuba

Introducción: El cáncer cervicouterino ocupa el tercer lugar como causa de defunción por neoplasias malignas a nivel mundial, afectando principalmente a los países de ingresos bajos y medianos. Hacia el 2020 se estimó una incidencia de 604 000 nuevos casos. Objetivo: Caracterizar los principales indicadores hospitalarios del Programa de Diagnóstico Precoz del Cáncer Cervicouterino. Métodos: Se realizó un estudio observacional, descriptivo y transversal, que permitió caracterizar los principales indicadores hospitalarios del Programa en el Servicio de Patología de Cuello del Hospital General Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba, de enero del 2020 a diciembre del 2022. La población de estudio estuvo constituida por 443 mujeres. Los datos recopilados fueron analizados mediante técnicas de estadística descriptiva, expresándose en frecuencia y porcentajes. Resultados: De las mujeres estudiadas, 60,9 % presentaron lesión intraepitelial cervical de alto grado de malignidad, con 32,6 % positivo a cáncer cervicouterino. El porcentaje global de pruebas citológicas no útiles fue de 2,07 y sin células de la zona de transformación, de 4,01; ambos indicadores de calidad. Existió una alta significación en cuanto a la tasa de cobertura global de las mujeres en riesgo (K=0,615), demostrando que los resultados de la citología reflejan en gran medida los diagnósticos de la histología, con una buena concordancia. Conclusiones: La prueba citológica cérvico-vaginal sigue siendo el método diagnóstico de mayor valor para detectar neoplasia intraepitelial cervical y carcinoma en estadio precoz en grandes masas de población.

Introduction: Cervical cancer is the third leading cause of death from malignancies worldwide, affecting mainly low- and middle-income countries. By 2020 an incidence of 604,000 new cases was estimated. Objective: To characterize the main hospital indicators of the Cervical Cancer Early Diagnosis Program. Methods: An observational, descriptive and cross-sectional study was carried out to characterize the main hospital indicators of the Program in the Neck Pathology Service of the General Hospital Dr. Bruno Zayas Alfonso of Santiago de Cuba, from January 2020 to December 2022. The study population consisted of 443 women. The data collected were analyzed using descriptive statistic techniques, expressed in frequency and percentages. Results: Of the women studied, 60.9 %had cervical intraepithelial lesion of high degree of malignancy, with 32.6 % positive for cervical cancer. The overall percentage of useless cytological tests was 2.07 and no cells from the processing zone was 4.01, both quality indicators. There was a high significance in terms of the overall coverage rate of women at risk (K=0.615), showing that the results of the cytology largely reflect the diagnosis of histology, with a good agreement. Conclusions: Cervical-vaginal cytology remains the most valuable diagnostic method for detecting cervical intraepithelial neoplasm and early-stage carcinoma in large populations

Acercamiento imagenológico e histológico para el diagnóstico de lesiones pulmonares por SARS-CoV-2. Informe de un caso / Imaging and Histological Approach for the Diagnosis of Pulmonary Lesions by SARS-CoV-2. Report of a Case

Resumen Se trata de paciente del sexo femenino, de 52 años de edad, caucásica, maestra de profesión, sin antecedentes patológicos personales de interés, ingresó a la unidad de cuidados intensivos con neumonía por COVID-19, tras varios tratamientos farmacológicos y 20 días con un patrón ventilatorio restrictivo severo, sin mejoría y finalmente falleció. Se obtuvieron imágenes por radiografía digital y tomografía axial computarizada de tórax, y se realizó estudio histológico pulmonar. La aplicación de los estudios imagenológicos permite observar los cambios histopatológicos para la identificación clínica y la implementación de estrategias terapéuticas eficaces. Se reportan los hallazgos imagenológicos que se corroboraron por el estudio histopatológico.

Abstract This is a 52-year-old Caucasian female patient, a teacher by profession, with no personal pathological history of interest, who was admitted to the intensive care unit with COVID-19 pneumonia, after several pharmacological treatments and 20 days with a severe restrictive ventilatory pattern, without improvement and finally died. Images were obtained by digital radiography and computed axial tomography of the chest, and a lung histological study was performed. The application of imaging studies allows the observation of histopathological changes for the adequate clinical identification of patients and the implementation of effective therapeutic strategies. The imaging findings that were corroborated by the histopathological study are reported.

Platysma: Human and Comparative Anatomy, Histology, and Clinical Aspects / Platisma: Anatomía Humana y Comparada, Histología y Aspectos Clínicos

SUMMARY: The quest for aesthetic procedures is experiencing a steady increase in popularity, concomitant with the expanding array of available treatment options. Of notable interest is the burgeoning trend in the use of minimally invasive techniques. Among the various aspects of facial anatomy, the platysma stands as a pivotal element that significantly influences the aesthetic appearance of the neck region. It has garnered particular attention as a strategic focal point in various treatments geared towards enhancing the neck's visual appeal. Additionally, the versatility of the platysma extends beyond the realm of cosmetic improvements. Its functional significance is recognized in reconstructive surgical procedures, where it may be harnessed for specific maneuvers. Furthermore, the muscle serves as a critical access point for minimally invasive endoscopic surgeries in the neck region. While these developments hold great promise, it is crucial to underscore that safety should always take precedence in any medical or surgical approach. This applies equally to the neck region, which presents a complex and intricate anatomical landscape. An in-depth understanding and meticulous investigation of the platysma in all its diverse aspects are paramount to ensuring the success and safety of any procedure conducted in this region. This comprehensive review aspires to provide a contemporary understanding of the platysma, offering an in-depth analysis that encompasses its intricate anatomy, histological characteristics, and multifaceted clinical implications. By delving into these diverse dimensions, it aims to equip healthcare professionals and researchers with a robust foundation for informed decision-making and practice.

La búsqueda de procedimientos estéticos ha experimentado un aumento constante en popularidad, junto con la creciente gama de opciones de tratamientos disponibles. De notable interés es la creciente tendencia en el uso de técnicas mínimamente invasivas. Entre los diversos aspectos de la anatomía facial, el platisma destaca como un elemento fundamental que influye significativamente en la apariencia estética de la región del cuello. Ha ocasionado especial atención como punto focal estratégico en varios tratamientos orientados a mejorar el atractivo visual del cuello. Además, la versatilidad del platisma se extiende más allá del ámbito de las mejoras cosméticas. Su importancia funcional se reconoce en procedimientos quirúrgicos reconstructivos, donde se puede aprovechar para maniobras específicas. Además, el músculo sirve como punto de acceso crítico para cirugías endoscópicas mínimamente invasivas en la región del cuello. Si bien estos avances son muy prometedores, es fundamental subrayar que la seguridad siempre debe tener prioridad ante cualquier abordaje médico o quirúrgico. Esto se aplica igualmente a la región del cuello, que presenta un aspecto anatómico complejo e intrincado. Una comprensión profunda y una investigación meticulosa del platisma en todos sus diversos aspectos son fundamentales para garantizar el éxito y la seguridad de cualquier procedimiento realizado en esta región. Esta revisión integral aspira a proporcionar una comprensión contemporánea del platisma, ofreciendo un análisis en profundidad que abarca su intrincada anatomía, características histológicas e implicaciones clínicas multifacéticas. Al profundizar en estas diversas dimensiones, su objetivo es dotar a los profesionales e investigadores de la salud de una base sólida para la toma de decisiones y la práctica informadas.

Modified Goldner Trichrome for Non-decalcified Mineralized Tissue Plastinated and Embedded in Resin / Tricrómico de Goldner Modificado para Tejido Mineralizado no Descalcificado Plastinado e Incluido en resina

SUMMARY: Over time, Goldner's trichrome staining has been essential in paraffin soft tissue research. However, its classic application involves prior decalcification, generating disadvantages in the integrity of the samples and the interpretation of results. This study seeks to overcome the limitations associated with decalcification when applying Goldner's trichrome stain with plastic resins. It focuses on detailed visualization of non-decalcified bone and dental samples in animal models. Samples of jaw and tooth from a dog (Canis familiaris) were used, as well as tibia from a rabbit (Oryctolagus cuniculus) with a titanium dental implant and bone graft substitute. Adjustments were made to the original protocol, including a surface treatment prior to staining. Plastination and inclusion in specific plastic resins were part of the process. The microplastinated and stained samples showed optimal quality for optical microscopy. Those from dogs allowed detailed observation of the tooth-periodontal tissue relationship, while those from rabbits revealed a clear differentiation between mineralized and osteoid bone tissue. The staining made it easy to examine the precise interface between soft tissues, bone graft, and implant. The successful adaptation of Goldner's trichrome stain to specimens in plastic resins represents a significant advance in histological investigation of hard tissues. This methodology stands out as an effective tool to evaluate implants and biomaterials in animal models, providing detailed visualization without compromising the integrity of the samples. The combination of histochemistry and plastic resins offers a valuable alternative for microanatomical studies, opening new possibilities in hard tissue research and evaluation of bone structures.

A lo largo del tiempo, la tinción tricrómica de Goldner ha sido esencial en la investigación de tejidos blandos en parafina. Sin embargo, su aplicación clásica conlleva la descalcificación previa, generando desventajas en la integridad de las muestras y la interpretación de resultados. Este estudio busca superar las limitaciones asociadas con la descalcificación al aplicar la tinción tricrómica de Goldner con resinas plásticas. Se enfoca en visualizar detalladamente muestras óseas y dentales no descalcificadas en modelos animales. Se emplearon muestras de mandíbula y diente de perro (Canis familiaris), así como tibia de conejo (Oryctolagus cuniculus) con implante dental de titanio y substituto de injerto óseo. Se realizaron ajustes al protocolo original, incluyendo un tratamiento superficial previo a la tinción. La plastinación y la inclusión en resinas plásticas específicas fueron parte del proceso. Las muestras microplastinadas y teñidas mostraron una calidad óptima para microscopía óptica. Las de perro permitieron la observación detallada de la relación diente-tejido periodontal, mientras que las de conejo revelaron una clara diferenciación entre tejido óseo mineralizado y osteoide. La tinción facilitó examinar la interface precisa entre tejidos blandos, injerto óseo e implante. La adaptación exitosa de la tinción tricrómica de Goldner a muestras en resinas plásticas representa un avance significativo en la investigación histológica de tejidos duros. Esta metodología destaca como una herramienta eficaz para evaluar implantes y biomateriales en modelos animales, brindando una visualización detallada sin comprometer la integridad de las muestras. La combinación de histoquímica y resinas plásticas ofrece una alternativa valiosa para estudios microanatómicos, abriendo nuevas posibilidades en la investigación de tejidos duros y evaluación de estructuras óseas.

Emerging Role of Mast Cells as Biological Markers in the Pathogenesis of Infectious Diseases and their Projection in Health Emergencies / Rol Emergente de los Mastocitos como Marcadores Biológicos en la Patogenia de Enfermedades Infecciosas y su Proyección en Emergencias Sanitarias

SUMMARY: Mast cells (MC) are cells of the immune system that regulate cell and tissue homeostasis, are found in low numbers, have an intact plasma membrane, and a cytoplasm with a wide variety of inflammatory chemical mediators. The activation or degranulation of mast cells implies the release of these chemical mediators (interleukins, cytokines, and more), causing tissue actions ranging from the activation of metalloproteinases to the development of anaphylactic hypersensitivity of different degrees, alterations in vascular permeability, and loss of cell homeostasis. This behavior would allow them to act as sentinels responding to pathophysiological processes. During the COVID-19 pandemic, in positive human patients, the available literature reports the presence and degranulation of mast cells in a generalized manner, especially in the respiratory tract. This study aimed to analyze the emerging role of MCs in the pathogenesis of diseases and their projection as biological markers in the treatment of diseases or pandemics. The analysis of human biopsies showed that MCs are observed as cells with diameters between 8 to 20 µm, and in inflamed tissues, degranulation of MCs is observed. The action of MCs degranulation was related to different inflammatory processes of autoimmune diseases. It is concluded that the potential of MC as therapeutic targets and biomarkers could raise new pharmacological targets, as supportive therapy, and possibly of great help in the treatment of future emerging pandemics such as the current monkeypox.

Los mastocitos (MC) son células del sistema inmune que regulan la homeostasis celular y tisular, se encuentran en escasas cantidades, presentan una membrana plasmática íntegra, y un citoplasma con una amplia variedad de mediadores químicos. La activación o degranulación de los mastocitos implica la liberación de estos mediadores químicos (interleuquinas, citoquina y más), provocando acciones tisulares que van desde la activación de metaloproteinasas hasta el desarrollo de hipersensibilidad anafiláctica de distinto grado, provocando la pérdida de la homeostasis celular. Durante la pandemia de la COVID-19, en pacientes humanos positivos, se informa recurrentemente la presencia y degranulación de mastocitos de manera generalizada sobre todo en las vías respiratorias. El análisis de la degranulación de los MCs podría proporcionar información que podría utilizarse en el desarrollo de tratamientos preventivos contra infecciones virales, bacterianas u otros patógenos. Este comportamiento les permitiría actuar como centinelas en respuesta a procesos fisiopatológicos. El objetivo de este trabajo fue analizar el rol emergente de los MCs en la patogenia de enfermedades y su proyección como marcadores biológicos en el tratamiento de enfermedades o pandemias. En análisis de biopsias humanas se muestran que MCs se observan como células con diámetros de entre 8 a 20 µm, en tejidos inflamados se observa degranulación de MCs. Se relacionó el accionar de degranulación de los MCs en diferentes procesos inflamatorios de enfermedades autoinmunes. Se concluye que el potencial de MC como dianas terapéuticas y biomarcadores podrían plantear nuevos objetivos farmacológicos, como terapia de apoyo, y posiblemente de gran ayuda en el tratamiento de futuras pandemias emergentes como la actual viruela del mono.

Alpaca (Vicugna pacos) Skin Analyzed Under Architecture and Structure / Piel de Alpaca (Vicugna pacos) Analizada Bajo Arquitectura y Estructura

SUMMARY: This study evaluated the morphology of alpacas skin. Biopsies were collected and samples were fixed in 10 % neutral buffered formalin for histological procedures. The sections were stained with hematoxylin and eosin, picrosirius red and Masson's trichrome. Types I, III and IV collagen were analyzed by immunohistochemistry. The derma presented sebaceous and sweat glands, as well as follicular groups with medullated fibers. Type I and type IV collagen were observed at epidermis and dermis as well as in glandular structures and hair follicles. The collagen III, was observed only in dermis.

Este estudio evaluó la morfología de la piel de alpacas. Se recogieron biopsias y las muestras se fijaron en formalina tamponada neutra al 10 % para procedimientos histológicos. Las secciones se tiñeron con hematoxilina y eosina, rojo picrosirius y tricrómico de Masson. El colágeno tipo I, III y IV se analizó mediante inmunohistoquímica. La dermis presentó glándulas sebáceas y sudoríparas, así como grupos foliculares con fibras medulares. Se observó colágeno tipo I y tipo IV en la epidermis y la dermis, así como en estructuras glandulares y folículos pilosos. El colágeno III, se observó únicamente en la dermis.

Estudio Histológico en Embriones de Cobayo (Cavia porcellus) y su Utilidad como Modelo para la Comprensión del Desarrollo Embrionario Humano / Histological Study in Guinea Pig Embryos (Cavia porcellus) and its Usefulness as a Model for Understanding Human Embryonic Development

El cobayo es un modelo animal ampliamente utilizado en la investigación biomédica debido a sus similitudes biológicas con los seres humanos. El objetivo de nuestro estudio es proporcionar sustento morfológico para utilizar preparados histológicos de embriones de cobayo como modelo de estudio para comprender los procesos del desarrollo embrionario humano. Nuestros resultados muestran que los embriones de cobayo presentan características morfológicas similares a las observadas en los embriones humanos, lo que sugiere que pueden utilizarse como un modelo efectivo para estudiar el desarrollo embrionario humano. Este hallazgo tiene importantes implicancias para la investigación y la docencia utilizando este modelo animal. Se analizaron preparados histológicos de embriones de cobayo teñidos con hematoxilina eosina, adquiridos por la Universidad Autónoma de Chile. Se tomaron microfotografías de preparados histológicos de cobayo en diferentes estadios del desarrollo y se seleccionaron las mejores imágenes para la descripción de estructuras y establecer estimados de la embriogénesis. Del análisis de los preparados se desprende que órganos como esófago, médula espinal y corazón presentan similitudes anatómicas e histológicas que hacen posible compararlas con el desarrollo embrionario humano y la edad de gestación en etapas tempranas. El uso de preparados de embriones de cobayo y su análisis desde un aspecto histológico resulta ser una estrategia metodológica factible debido a las similitudes en la embriogénesis de los mamíferos y las concordancias morfológicas con el desarrollo de los órganos entre humanos y roedores. Esto permite implementar este modelo animal como una herramienta para comprender el desarrollo embrionario humano.

SUMMARY: The guinea pig is an animal model widely used in biomedical research due to its biological similarities with humans. The objective of our study is to provide morphological support to use histological preparations of guinea pig embryos as a study model to understand the processes of human embryonic development. Our results show that guinea pig embryos present morphological characteristics similar to those observed in human embryos, suggesting that they can be used as an effective model to study human embryonic development. This finding has important implications for research and teaching using this animal model. Histological preparations of guinea pig embryos stained with hematoxylin eosin, acquired by the Autonomous University of Chile, were analyzed. Photomicrographs of histological preparations of guinea pigs at different stages of development were taken and the best images were selected to describe structures and establish estimates of embryogenesis. From the analysis of the preparations it is clear that organs such as the esophagus, spinal cord and heart present anatomical and histological similarities that make it possible to compare them with human embryonic development and gestation age in early stages. The use of guinea pig embryo preparations and their analysis from a histological aspect turns out to be a feasible methodological strategy due to the similarities in mammalian embryogenesis and the morphological concordances with the development of organs between humans and rodents. This allows this animal model to be implemented as a tool to understand human embryonic development.

Lesions suspected of gastric syphilis: case report with complete remission after treatment with benzathine penicillin / Lesões suspeitas de sífilis gástrica: relato de caso com remissão completa após tratamento com penicilina benzatina

Introduction: Syphilis is a sexually transmitted disease identified as a global health problem. Its gastric, esophageal and/or intestinal involvement occurs in around 1% of cases. The descriptions of endoscopic lesions and histopathological biopsies are similar to other more prevalent diseases, such as mucosal infiltrative tumors, lymphomas related to Helicobacter pylori infection, Crohn's disease and adenocarcinomas. Objective: To report the case of an adult male patient with imaging tests mimicking gastric neoplasia, which were, in fact, lesions suspected of syphilis, its resolution and management. Case report: A 39-year-old man sought care because of severe epigastric pain related to the postprandial period and prolonged fasting, without improvement with medication. He reported weight loss and episodes of dark-colored vomiting. On physical examination, pain on deep palpation in the epigastric region without palpable masses and peristalsis was present. An endoscopy was performed, the report of which indicated endoscopic gastritis with marked flat erosions in the antrum, with eroded, bloody, intensely friable mucosa. Also, a biopsy of the mucosa was performed, with a histopathological report resulting in a large plasma cell infiltrate, with VDRL/FTA-Abs being ordered because of the prevalence of differential diagnoses. The patient was diagnosed with syphilis and was treated with benzathine penicillin 2,400,000 IU IM in three doses, one every seven days, for a total of 7,200,000 IU. He returned in six months for reevaluation. Conclusion: Although this is a rare occurrence of the disease, one should always be aware of possible differential diagnoses to avoid unnecessary surgical interventions and procedures. (AU)

Introdução: A sífilis é uma doença sexualmente transmissível identificada como um problema de saúde mundial. Seu acometimento gástrico, esofágico e/ou intestinal acontece em cerca de 1% dos casos. As descrições das lesões por via endoscópica e biópsias no histopatológico se assemelham com outras doenças mais prevalentes, como, por exemplo, os tumores infiltrativos da mucosa, linfomas relacionados a infecção do Helicobacter pylori, doença de Chron e adenocarcinomas. Objetivo: Relatar o caso de um paciente masculino adulto com exames de imagem mimetizando neoplasia gástrica, sendo, na verdade, lesões suspeitas de sífilis, sua resolução e conduta. Relato de caso: Homem de 39 anos buscou atendimento por conta de forte epigastralgia relacionada a período pós-prandial e a jejum prolongado, sem melhora com medicação. Relatou perda ponderal e episódios de vômitos com cor escura. Ao exame físico, dor à palpação profunda em região epigástrica sem massas palpáveis e peristalse presente. Foi feita endoscopia, cujo laudo apontou gastrite endoscópica com erosões planas acentuada no antro, com mucosa erodida, cruenta, intensamente friável, e feita biópsia da mucosa, com laudo do histopatológico resultando em grande infiltrado de plasmócitos, sendo pedido VDRL/FTA-Abs por conta da prevalência de diagnósticos diferenciais. O paciente foi diagnosticado com sífilis, e foi feito tratamento com penicilina benzatina 2.400.000UI IM três doses, uma a cada sete dias, num total de 7.200.000UI, retornando em seis meses para reavaliação. Conclusão: Apesar de se tratar de um acometimento raro da doença, deve-se sempre estar atento aos possíveis diagnósticos diferenciais a fim de se evitar intervenções cirúrgicas e procedimentos desnecessários. (AU)

Caracterización histológica del melanoma cutáneo en reportes de patología en la ciudad de Cali, 2016-2021 / Histological characterization of cutaneous melanoma in pathology reports in the city of Cali, 2016-2021

Introducción. El melanoma es la proliferación maligna de melanocitos asociado a un comportamiento agresivo. El objetivo de este estudio fue determinar las variables histológicas del melanoma cutáneo. Métodos. Estudio observacional retrospectivo, transversal descriptivo, realizado con reportes de patologías de pacientes con diagnóstico de melanoma cutáneo en un laboratorio de patología en Cali, Colombia, entre 2016-2021. Se incluyeron las variables edad, sexo, localización, subtipo, espesor de Breslow, ulceración, márgenes, mitosis, invasión linfovascular, neurotrofismo, regresión tumoral, nivel de Clark e infiltración tumoral por linfocitos. Resultados. Se obtuvieron 106 reportes y fueron excluidos 54 por duplicación. Se incluyeron 52 registros, la media de edad fue de 61 años, con una mayor frecuencia de mujeres (55,8 %). De los 33 casos donde se especificó el subtipo histológico, el más frecuente fue el de extensión superficial (66,6 %), seguido del acral lentiginoso (18,1 %) y nodular con (15,2 %). La localización más frecuente fue en extremidades (61,5 %). El espesor de Breslow más común fue IV (34,6 %) y el nivel de Clark más frecuente fue IV (34,6 %). La ulceración estuvo en el 40,4 %. El subtipo nodular fue el de presentación más agresiva, donde el 100 % presentaron espesor de Breslow IV. Conclusiones. El subtipo de melanoma más común en nuestra población fue el de extensión superficial; el segundo en frecuencia fue el subtipo acral lentiginoso, que se localizó siempre en extremidades. Más del 50 % de los melanomas tenían espesor de Breslow mayor o igual a III, lo que impacta en el pronóstico.

Background. Melanoma is the malignant proliferation of melanocytes associated with aggressive behavior. The objective of this study was to determine the histological variables of cutaneous melanoma. Methods. Observational, cross-sectional, descriptive, retrospective study carried out with reports of pathologies with a diagnosis of cutaneous melanoma in a pathology laboratory in Cali between 2016-2021. The variables were age, sex, location, subtype, Breslow thickness, ulceration, margins, mitosis, lymphovascular invasion, neurotropism, tumoral regression, Clark level and tumor infiltration by lymphocytes. Results. One hundred and six reports were obtained and 54 were excluded due to duplication. A descriptive analysis was made on the 52 records that were included, the mean age was 61 years, with a higher frequency in women with 55.8%. Of the 33 cases where the histological subtype was specified, the most frequent was superficial extension with 66.6%, followed by acral lentiginous with 18.1% and nodular with 15.2%. The most frequent location was in the extremities (61.5%); the most common Breslow was IV (34.6%), and the most frequent Clark was IV (34.6%). Ulceration was in 40.4%. The nodular subtype was the most aggressive presentation where 100% presented Breslow IV. Conclusions. The most common subtype of melanoma was that of superficial extension. In our population, the second most frequent was the acral lentiginous subtype, which was always located on the extremities. More than 50% of the melanomas had Breslow greater than or equal to III, which affects the prognosis.

Esofagitis eosinofílica de tórpida evolución / Eosinophilic esophagitis with torpid evolution

Introducción: La esofagitis eosinofílica es una enfermedad inmunomediada, crónica y progresiva, combinando disfunción esofágica e infiltrado eosinofílico exclusivo del esófago. Tanto su diagnóstico como su respuesta a los tratamientos requieren de evaluación histológica mediante endoscopias repetidas. Caso clínico. Varón de 11 años con disfagia para sólidos de años de evolución con empeoramiento en los últimos meses; angustia ante las ingestas con estancamiento ponderal; vómitos en impactaciones alimentarias; pirosis postprandial. Antecedentes patológicos: broncoespasmos de repetición y sensibilización a Alternaria. Exploración física: signos de hipotrofia pondero-estatural (somatometría: alrededor de –2 desviaciones estándares; Carrascosa 2017). Pruebas complementarias: analítica general sin alteraciones significativas incluyendo inmunoglobulinas E específicas alimentarias; prick test sensibilización a neumoalérgenos; gastroscopia mucosa esofágica edematosa, estrías longitudinales y exudados blanquecinos, mucosa gástrica signos de gastritis, mucosa duodenal normal; histología con un máximo 35 eosinófilos por campos de gran aumento y gastritis crónica leve-moderada con infección por Helicobacter pylori. Tratamiento y evolución: inducción a la remisión con inhibidores bomba de protones a dosis altas con buena respuesta clínica y macroscópica (parcial histológica), reduciendo a dosis de mantenimiento; ante recaída macroscópica (no histológica) se cambia a dieta exenta de leche y gluten sin respuesta; segundo intento de remisión con inhibidores sin éxito; finalmente se pautan corticoides deglutidos con buena respuesta tanto macroscópica como histológica; pendiente control con dosis de mantenimiento, asintomático. Comentarios. Como se aprecia en nuestro caso, esta enfermedad conlleva un difícil manejo ante la afectación parcheada de la mucosa y la discordancia clínico-histológica, lo que complica la interpretación de sus resultados.(AU)

Introduction: Eosinophilic esophagitis is an immunemediated, chronic and progressive disease, combining esophageal dysfunction and eosinophilic infiltrate exclusive to the esophagus. Both its diagnosis and its response to treatments require histological evaluation through repeated endoscopies. Case report. 11-year-old male with dysphagia for solids of years of evolution with worsening in recent months; anxiety before eating with weight stagnation; vomiting in food impactions; postprandial heartburn. Pathological history: repeated bronchospasms and sensitization to Alternaria. Physical examination: signs of weight-height hypotrophy (somatometry: around –2 standard deviations; Carrascosa 2017). Complementary tests: general blood test without significant alterations including food-specific immunoglobulins E; prick test sensitization to pneumoallergens; gastroscopy edematous esophageal mucosa, longitudinal furrows and whitish exudates, gastric mucosa signs of gastritis, normal duodenal mucosa; histology with a maximum of 35 eosinophils per high-power fields and mild-moderate chronic gastritis with Helicobacter pylori infection. Treatment and evolution: induction of remission with high-dose proton pump inhibitors with good clinical and macroscopic response (partial histological), reducing to maintenance doses; In the event of a macroscopic (non-histological) relapse, a diet free of milk and gluten is started without response; second attempt at remission with inhibitors without success; finally, swallowed corticosteroids are prescribed with good macroscopic and histological response; pending control with maintenance dose, asymptomatic. Discussion. Like our case shows, this disease has a difficult management due to patchy involvement of the mucosa and clinical-histological discordance, which complicates the interpretation of its results.(AU)

Caracterización del desempeño en Histología Humana del especialista en formación de anatomía patológica

Introducción: Para el desarrollo de cualquier sociedad es importante el recurso humano competente, lo que implica enrumbar los esfuerzos hacia el mejoramiento del desempeño profesional en aras de lograr que su impacto contribuya al progreso y desarrollo humanos. Objetivo: Caracterizar el desempeño profesional en Histología Humana de los especialistas en formación de Anatomía Patológica del Hospital Universitario "General Calixto García" durante el período 2015-2020. Métodos: Se realizó un estudio descriptivo-observacional con enfoque mixto. Coincidieron el universo y la muestra, compuestos por 13 especialistas en formación que se encontraban en el primer semestre del primer año de la especialidad y 8 profesores de la especialidad de Anatomía Patológica. El muestreo fue por conveniencia. Se utilizaron métodos teóricos y empíricos. Se empleó una Estadística descriptiva, en particular el análisis porcentual, y la frecuencia absoluta y relativa, a partir de los programas Microsoft Excel y el SPSS, los que permitieron el procesamiento cuantitativo de los instrumentos aplicados. Se empleó la tecnología para la determinación de problemas y potencialidades de la Educación Avanzada. Conclusiones: La aplicación de la tecnología antes mencionada permitió caracterizar el estado actual del desempeño profesional en Histología Humana del especialista en formación de Anatomía Patológica, lo cual reveló carencias y dificultades en las dimensiones: conocimiento teórico-práctico en Histología Humana, comportamiento humano, y comportamiento ético y bioético. La triangulación metodológica aplicada a los resultados de los instrumentos contribuyó a la identificación del inventario de problemas y potencialidades.

Introduction: Competent human resources are important for the development of any society, which implies directing efforts towards the improvement of professional performance in order to achieve their impact on and such contribution to human progress and development. Objective: To characterize the professional performance in Human Histology of specialists being trained in Pathological Anatomy at Hospital Universitario General Calixto García during the period 2015-2020. Methods: A descriptive-observational study with a mixed approach was conducted. The study universe and the sample coincided, composed of 13 specialists being trained in their first semester of the specialty's first academic year and 8 professors of the Pathological Anatomy specialty. The sampling was by convenience. Theoretical and empirical methods were used. Descriptive statistics were used, particularly the percentage analysis, as well as absolute and relative frequency, by using the programs Microsoft Excel and SPSS, which allowed the quantitative processing of the applied instruments. Technology was used for determining problems and potentialities of advanced education. Conclusions: The application of the aforementioned technology allowed characterizing the current state of professional performance in Human Histology of the specialist being trained in Pathological Anatomy, which revealed deficiencies and difficulties in the dimensions theoretical-practical knowledge in Human Histology, human behavior, as well as ethical and bioethical behavior. The methodological triangulation applied to the results of the instruments contributed to the identification of the inventory of problems and potentialities.

Giuseppe Levi, Natalia Ginzburg, and Lessico Famigliare (Family Lexicon): a seminal figure in the history of neuron cell biology and histology seen through his daughter's literary eyes / Giuseppe Levi, Natalia Ginzburg e Lessico Famigliare (Léxico familiar): uma figura seminal na história da biologia celular e histologia neuronais vista pelos olhos literários de sua filha

Abstract One of the most important figures in the history of neurohistology, Giuseppe Levi (1872-1965) contributed in numerous ways to neuroscience, particularly in the fields of neuronal plasticity and the understanding of sensory ganglia. His daughter Natalia Ginzburg, née Levi (1916-1991), on the other hand, achieved fame as one of the most celebrated Italian writers of the twentieth century. Lessico Famigliare (Family Lexicon), from 1963, is a semibiographical account of her life in which she describes the life and character of her father in detail, providing depth and complexity to a seminal figures in the development of neuroscience. A thorough reading of the book enables modern neurologists to fully appreciate Levi's life and contributions, by means of humanizing him and giving context to his life and works. The present article provides a summary of Levi's and Natalia's lives and times as well as an analysis of the book and of the intimate, vivid descriptions of the neurohistologist's life.

Resumo Uma das figuras mais importantes da história da neuro-histologia, Giuseppe Levi (1872-1965) contribuiu de diversas maneiras para a neurociência, particularmente no campo da plasticidade neuronal e na compreensão dos gânglios sensitivos. Sua filha Natalia Ginzburg, nascida Levi (1916-1991), pelo contrário, adquiriu fama como uma das escritoras italianas mais célebres do século XX. Lessico Famigliare (Léxico familiar), de 1963, é um relato semibiográfico de sua vida, na qual ela descreve a vida e o comportamento de seu pai em detalhes, e confere profundidade e complexidade a uma figura seminal no desenvolvimento da neurociência. Uma leitura aprofundada do livro permite que neurologistas modernos apreciem a vida e as contribuições de Levi de forma mais completa, o humanizando e dando contexto a sua vida e suas obras. O autor resume as vidas e épocas de Levi e Natalia, bem como avalia o livro e as descrições íntimas, vívidas, da vida do neurohistologista.

Evaluation of the mesenteric arterial vasculature by computed tomography angiography and its implications for colorectal cancer surgery / Avaliação da vasculatura arterial mesentérica pela angiotomografia computadorizada e suas implicações na cirurgia do câncer colorretal

Abstract Objective: To determine the branching patterns of the inferior mesenteric artery (IMA) and to describe the clinical applicability of computed tomography (CT) angiography in the evaluation of these vessels to facilitate the planning of colorectal cancer surgery. Materials and Methods: We included 100 patients who underwent CT angiography of the abdomen and pelvis. The branching patterns of the IMA were examined and classified as type 1 (bifurcated), including 1A (sigmoid and left colic arteries arising from a common trunk), 1B (sigmoid and superior rectal arteries arising from a common trunk) and 1C (sigmoid arteries arising from both trunks); type 2 (trifurcated); and type 3 (no left colic branch). Results: Among the 100 patients evaluated, we found the variant to be type 1A in 9%, type 1B in 47%, type 1C in 24%, type 2 in 16%, and type 3 in 4%. Conclusion: Preoperative CT angiography for evaluating the IMA branching pattern could inform decisions regarding the surgical approach to colorectal cancer.

Resumo Objetivo: Determinar os padrões de ramificação da artéria mesentérica inferior (AMI) e descrever a aplicabilidade clínica da angiografia por tomografia computadorizada na avaliação desses vasos na elaboração das estratégias pré-operatórias de cirurgia de câncer colorretal. Materiais e Métodos: Foram incluídos 100 pacientes submetidos a angiografia por tomografia computadorizada abdominal e pélvica. Os padrões de ramificação da AMI foram examinados e classificados como tipo 1 (bifurcado), incluindo 1A (artérias sigmoide e cólica esquerda originando-se de um tronco comum), 1B (artérias sigmoide e retal superior originando-se de um tronco comum) e 1C (artérias sigmoide originando-se de ambos os troncos); tipo 2 (trifurcado); e tipo 3 (sem ramo cólico esquerdo). Resultados: Do total de participantes incluídos no estudo, a variante do tipo 1A foi observada em 9%, a do tipo 1B em 47%, e a do tipo 1C em 24%. Com relação à variante tipo 2, esta foi observada em 16% dos pacientes, e a do tipo 3, em 4% dos casos. Conclusão O uso da angiografia por tomografia computadorizada pré-operatória para avaliar o padrão de ramificação da AMI pode ajudar a escolher a abordagem cirúrgica no câncer colorretal.

Correlation between Anatomopathological Aspects and Pelvic Pain in Women with Deep Infiltrating Endometriosis / Correlação entre aspectos anatomopatológicos e dor pélvica em mulheres com endometriose profunda

Abstract Objective To correlate the morphological aspects with pelvic pain in women with deep infiltrating endometriosis. Methods A retrospective study with 67 women with deep endometriosis who underwent surgical treatment in a tertiary hospital from 2007 to 2017. The following variables were considered: age, parity, body mass index, site of involvement, hormonal treatment before surgery, pelvic pain, and morphometric analysis. The histological slides of the surgical specimens were revised and, using the ImageJ software for morphometric study, the percentages of stromal/glandular tissues were calculated in the histological sections. Results The mean age of the women was 38.9 ± 6.5 years. The mean pain score was 8.8 ± 1.9 and the mean time of symptomatology was 4.7 ± 3.5 years, with 87% of the patients undergoing hormone treatment prior to surgery. The average expression of CD10, CK7, and S100 markers was 19.5 ± 11.8%, 9.4 ± 5.9%, and 7.9 ± 5.8% respectively. It was found that the greater the expression of CD10, the greater the level of pain (p = 0.02). No correlation was observed between the expression of CD10, CK7, and S100 markers and age and duration of symptoms. Conclusion Women with deep infiltrating endometriosis have a positive association between the level of pain and the fibrosis component in the endometrial tissue's histological composition.

Resumo Objetivo Correlacionar os aspectos morfológicos com a dor pélvica em mulheres com endometriose profunda. Métodos Estudo retrospectivo com 67 mulheres com endometriose profunda submetidas a tratamento cirúrgico em hospital terciário de 2007 a 2017. As seguintes variáveis foram consideradas: idade, paridade, índice de massa corporal, local do acometimento, tratamento hormonal antes da cirurgia, dor pélvica e análise morfométrica. As lâminas histológicas das peças cirúrgicas foram revisadas e, por meio do software ImageJ para estudo morfométrico, foram calculadas as porcentagens de tecidos estromais/glandulares nos cortes histológicos. Resultados A média etária das mulheres foi de 38,9 ± 6,5 anos. O escore de dor médio foi de 8,8 ± 1,9 e o tempo médio de sintomatologia foi de 4,7 ± 3,5 anos, sendo que 87% das pacientes realizavam tratamento hormonal antes da cirurgia. A expressão média dos marcadores CD10, CK7 e S100 foi de 19,5 ± 11,8%, 9,4 ± 5,9% e 7,9 ± 5,8%, respectivamente. Verificou-se que quanto maior a expressão de CD10, maior o nível de dor (p = 0,02). Não foi observada correlação entre a expressão dos marcadores CD10, CK7 e S100 com a idade e duração dos sintomas. Conclusão Mulheres com endometriose profunda apresentam associação positiva entre o nível de dor e o componente de fibrose na composição histológica do tecido endometrial.

Aspectos Morfológicos de la Mama. Una Revisión de la Literatura / Morphological Aspects of the Breast. A Literature Review

La glándula mamaria tiene su origen embriológico, posteriormente se diferencia histológica y anatómicamente; a lo largo del tiempo se han ido descubriendo nuevos hallazgos, además de nueva terminología. El objetivo de este trabajo consistió en describir la actualización en los aspectos morfológicos de la glándula mamaria. Se realizó una búsqueda de artículos en diferentes fuentes primarias y secundarias de la literatura científica como: Pubmed, Embase, WOS, Scopus, Scielo obteniendo 623 publicaciones, seleccionado 53 para su revisión y 17 incluidos. La mama se ha ido actualizando en los aspectos morfológicos; Los conductos se ubican cercanos a la areola y al pezón donde desembocan directamente, las ramificaciones de los conductos se ubican cercanos a la areola; los pezones tienen entre 15 y 20 lóbulos, de los cuales sólo 5-9 son verdaderos orificios del conducto mamario, no existen senos lactíferos por lo que la leche desemboca directamente en el pezón, en cuanto a la inervación de la mama son inervados por las ramas cutáneas anterior y lateral de los nervios intercostales. La evidencia existente demuestra la necesidad de realizar estudios permanentes en el ámbito de la morfología, como fue descrito en este artículo de revisión sobre la mama. En diferentes aspectos, tales como términos, funciones y estructuras. Está información es importante para, la formación de pregrado, post grado, y su utilización en la clínica, identificación de patologías, clínicas de lactancia, entre otros.

SUMMARY: The mammary gland has its embryological origin, later it differentiates histologically and anatomically; over time new findings have been discovered, as well as new terminology. The aim of this work was to describe the update on the morphological aspects of the mammary gland. A search for articles was carried out in different primary and secondary sources of scientific literature such as: Pubmed, Embase, WOS, Scopus, Scielo, obtaining 623 publications, 53 selected for review and 17 included. The breast has been updated in morphological aspects; the ducts are located close to the areola and the nipple where they open directly, the branches of the ducts are located close to the areola; the nipples have between 15 and 20 lobes, of which only 5- 9 are true mammary duct orifices, there are no lactiferous sinuses, so the milk flows directly into the nipple, in terms of innervation of the breast they are innervated by the anterior and lateral cutaneous branches of the intercostal nerves. The existing evidence demonstrates the need for permanent studies in the field of morphology, as described in this review article on the breast. In different aspects, such as terms, functions and structures. This information is important for undergraduate and postgraduate training, and its use in the clinic, identification of pathologies, lactation clinics, among others.