Consideraciones sobre integrantes del acto médico tomadas de la literatura / Considerations on Members of the Medical Act Taken from the Literature

Se acepta que la literatura puede ser útil para la enseñanza de la medicina porque ambas disciplinas trabajan con sentimientos de personas y consideran la relación interpersonal como el marco de referencia de su actividad profesional. En este trabajo se aportan una serie de ejemplos integrados por fragmentos de textos narrativos tomados de diferentes obras literarias que inciden en el valor de las descripciones y percepciones de diversos autores sobre aspectos de la interacción entre diferentes actores del acto médico. En síntesis, se refleja la imagen cambiante de la medicina y los médicos, del médico como persona, del efecto curativo de la interacción médico-enfermo, y de la interacción con el sistema sanitario. Si bien se aprecia el carácter altruista y abnegado de la práctica médica, los testimonios vertidos en algunos textos literarios dejan constancia de la necesidad de prestar más atención a la formación en empatía no sólo de los profesionales sanitarios, sino también de cuantas personas realizan su trabajo en el ámbito sanitario. (AU)

It is well accepted that literature can be useful for the teaching of medicine because both disciplines study people's feelings and consider the interpersonal relationship as the frame of reference for their professional activity. In the present work, a set of examples are provided, made up of fragments of narrative texts taken from different literary works that have impact on the value of the descriptions and perceptions of several authors on aspects of the interaction between different participants in the medical act. Briefly, it reflects the changing picture of medicine and doctors, the doctor as a person, the healing effect of the doctor-patient interaction, and of the interaction with the healthcare system. Whilst the altruistic and selfless nature of medical practice is appreciated, the proofs expressed in some literary texts show the need to pay more attention to training on the empathy not only for health professionals, but also for all the people who work in the healthcare system. (AU)

Imágenes de tareas universitarias a través de autobiografías, memorias y otros textos literarios / Snapshot of university assignments through autobiographies, memoirs and other literary texts

En este trabajo se aportan una serie de ejemplos integrados por fragmentos de textos narrativos tomados de diferentes obras que inciden en el valor de las descripciones y percepciones de diversos autores sobre aspectos educativos seleccionados. Se han utilizado textos memorialísticos, literarios y estudios sobre cuestiones relacionadas con los fines de la universidad. En concreto, se recoge información relacionados con planes de estudios, demografía universitaria, libertad de cátedra, aprendizaje, recuerdos del profesorado o elección de especialidad. Cuando ha sido posible se han invocado circunstancias históricas que pueden haber condicionado el estado actual de la universidad española. (AU)

This manuscript provides a series of examples intedrated by fragments of narrative texts from different works that discuss the value of the descriptions and perceptions of various authors on selected educational aspects. Memorialistic, literary texts and studies onitems related to the university goals have been used. Specifically, information related to study plans, university demography, academic freedom, learning, memories of the teaching staff or choice of specialty is collected. When possible, historical circumstances that may have conditioned the current state of the Spanish university were taken into consideration. (AU)

Valor formativo del cine y la literatura en los estudiantes de Ciencias de la Salud. Aspectos generales / Formative value of cinema and literature in health sciences students. General features

El objetivo de este trabajo es presentar los fundamentos conceptuales de la asignatura optativa Cine, Literatura y Medicina que se imparte en segundo año del grado en Medicina de la Universidad de Oviedo desde el curso académico 2011-2012. Los contenidos que se comentan suponen una introducción general a las formas en las que el cine y la literatura pueden contribuir a la enseñanza de la medicina y de cómo pueden contribuir a la exposición de los estudiantes a aspectos transversales de la medicina dispersos a lo largo de los cursos del Grado. El lenguaje cinematográfico facilita el abordaje de temas complejos en los que las cuestiones éticas y sociales de las enfermedades pueden tratarse mediante la interpretación por actores de forma clara, concisa y dirigida a los elementos nucleares de problemas densos que de otra forma sería dificultoso y lento comprender. La literatura, tanto mediante la escritura como de la lectura, permite aliviar la tensión emocional que produce la enfermedad, interiorizar de forma paciente y reflexiva la experiencia de enfermar, y reorientar la actividad vital en consonancia con la imposición de limitaciones que son propias y características de cada proceso nosológico. (AU)

The aim of this work is to present the conceptual BASIS of the optional subject Cinema, Literature and Medicine that is taught in the second year of the degree in Medicine at the University of Oviedo since 2011-2012 school year. The contents discussed are a general introduction to the ways in which film and literature can help to the teaching of medicine and how they can contribute to the exposure of students to cross-cutting aspects of medicine unfocused throughout the whole Degree. Cinematographic language facilitates the approach to complex issues in which the ethical and social aspect of disease can be aced clearly, concisely and directed at the main elements through the interpretation by actors of COMPLEX problems that, OTHERWISE, would be difficult and hard to understand. Literature, both through writing and reading, allows to alleviate the emotional tension caused by the disease, patiently and reflexively internalize the experience of becoming ill, and rearraange vital activity in line with the imposition of limitations that are specific and characteristic of each nosological process. (AU)

Involvement of CD4+ and CD8+ T-lymphocytes in the modulation of nociceptive processing evoked by CCL4 in mice.

AIMS: To explore the mechanisms involved in the transformation of analgesia produced by low doses of CCL4 (pg/kg) to hyperalgesia when higher doses (ng/kg) are administered to mice. MAIN METHODS: The unilateral hot plate test was used to assess thermal nociception. CD3+, CD4+ or CD8+ blood cells were depleted with selective antibodies. Expression of CCR5 and IL-16 in lymphocytes was studied by flow cytometry and IL-16 blood levels were measured by ELISA. IL-16 and CD8 were detected by immunofluorescence. KEY FINDINGS: IL-16 and CCR5 expression were demonstrated in CD4+ and CD8+ T-lymphocytes by flow cytometry. Furthermore, CCL4-induced hyperalgesia was abolished by reducing circulating T-lymphocyte levels or by selectively depleting CD4+ lymphocytes. In contrast, when the anti-CD4 antibody was acutely administered, CCL4 induced analgesia instead of hyperalgesia. A similar response was obtained when administering A-770041, that prevents CD4-mediated CCR5 desensitization by inhibiting p56lck kinase. As occurred with the analgesic effect evoked by low doses of CCL4, analgesia evoked by combining CCL4 and A-770041 was reverted by naloxone, naltrindole or an anti-met-enk antibody. Interestingly, flow cytometry assays showed that the number of CD8+, but not CD4+, T-cells expressing IL-16 is reduced after the acute administration of CCL4, a result compatible with the description that CD8+-lymphocytes can rapidly release preformed IL-16. Accordingly, the rise in IL-16 blood concentration evoked by CCL4 was prevented after CD8+ lymphocyte depletion. SIGNIFICANCE: CCL4-evoked hyperalgesia is related to the desensitization of CCR5 in CD4+ T-cells and to the release of IL-16 from CD8+ lymphocytes.

Kappa-opioid receptor-mediated thermal analgesia evoked by the intrathecal administration of the chemokine CCL1 in mice.

BACKGROUND: The chemokine CC motif ligand 1 (CCL1) participates in immune cell recruitment and, as other chemokines, is also involved in nociceptive processing. In contrast with previous reports indicating its participation in allodynia and cold hypernociception when spinally administered, its ability to evoke heat thermal analgesia, mediated by circulating leukocytes and endocannabinoids, after systemic administration has recently been reported. OBJECTIVES: Aiming to explore the role played by CCL1 on spinal nociception, we study here the effect of its intrathecal administration on thermal nociception in mice. METHODS: Behavioral nociceptive assays, immunohistochemical experiments, white cell blood depletion procedures and qRT-PCR experiments were performed. RESULTS: The intrathecal administration of CCL1 (0.3-30 ng) produced analgesia as measured by the unilateral hot plate test. This effect peaked 1 h after injection, was prevented by the CCR8 antagonist R243 and was accompanied by a reduction of c-Fos expression in spinal neurons. Whereas blood leukocyte depletion did not modify it, analgesia was abolished by the microglial inhibitor minocycline, but not the astroglial inhibitor aminoadipate. Furthermore, antinociception remained unmodified by the coadministration of cannabinoid type 1 or 2 receptors antagonists. However, it was reversed by naloxone but not by selective blockade of mu- or delta-opioid receptors. The inhibitory effect induced by the selective kappa-opioid receptor antagonist, nor-binaltorphimine, and by an anti-dynorphin A 1-17 antibody indicates that analgesia evoked by spinal CCL1 is mediated by endogenous dynorphins acting on kappa-opioid receptors. CONCLUSIONS: Endogenous dynorphin and microglia behave as key players in heat thermal analgesia evoked by spinal CCL1 in mice.

Sobre la vocación médica a través de opiniones tomadas de la literatura médica y de ficción / The medical vocation through literatura

La vocación es una cualidad que define al buen médico y está presente en los profesionales sanitarios de referencia. La vocación médica puede definirse de varias formas, pero tal vez alcance un amplio consenso la que propone que es una motivación profunda de servicio al enfermo y a la sociedad que está determinada por las vivencias y el entorno. Si bien la mayoría de médicos y estudiantes de medicina invocan la vocación y el atractivo intelectual para su elección, no es menos cierto que el azar o la pertenencia a un determinado grupo social pueden ser decisivos en algunos casos. Los literatos, por su parte, suelen atribuir a sus personajes valores tradicionales de la medicina y de la vocación médica como el altruismo o la empatía, así como algunos estereotipos de la imagen de la profesión

The vocation is a value intangible that defines the good doctor and is present in the reference healthcare professionals. The medical vocation can be defined in several ways, a broad consensus of acceptance for the one that proposes it as a deep motivation of service to the patient and society which is determined by the experiences and the environment. While most physicians and medical students invoke the vocation and intellectual appeal for their choice, it is not less true that the chance or being part of certain social groups can be decisive in some cases. The writers, on the other hand, usually attribute traditional values of medicine and medical vocation to their characters such as altruism or empathy, as well as some stereotypes of the profession's

Razones por las cuales los estudiantes justifican la elección del Grado en Medicina / Reasons why students justify the choice of Medical Degree

OBJETIVO: Identificar las razones por las cuales los estudiantes acceden al Grado en Medicina. SUJETOS Y MÉTODOS: Estudiantes de primer curso de Grado en Medicina de los años académicos 2014-2015, 2015-2016 y 2017-2018 realizaron una descripción abierta de sus razones de acceso al grado. Éstas se identificaron y clasificaron para su análisis, y se calculó el número de razones aducidas por el conjunto y en cada año académico, y su distribución según sexo. Se clasificaron en categorías para su comparación con otros estudios. RESULTADOS: Participaron 367 estudiantes (252 mujeres y 115 hombres). La diferencia en el porcentaje medio de respuesta entre mujeres (83,71 ± 4,8%) y hombres (82,4 ± 5,1%) no fue estadísticamente significativa. Los estudiantes justificaron su acceso por una media de 2,5 ± 0,06 razones, sin diferencias de sexo ni entre los tres años académicos. Se identificaron 23 razones diferentes para acceder al grado, que se agruparon en categorías, siendo las principales el altruismo, el conocimiento científico, los motivos instrumentales y las razones personales. Aumentó significativamente el acceso por adquisición de conocimiento entre los cursos 2014-2015 y 2017-2018 y se redujeron los accesos por vocación. La consideración social de la medicina o la imagen social del médico se invocaron con muy poca frecuencia. Las mujeres refieren con más frecuencia los motivos altruistas y los relacionados con el conocimiento para el acceso, pero sin diferencias significativas. CONCLUSIÓN: Los valores altruistas continúan siendo los más frecuentes motivos de acceso al Grado en Medicina. La vocación se reduce y la adquisición de conocimientos científicos aumenta como motivos de acceso

AIM: To identify the reasons why students access the Degree in Medicine. SUBJECTS AND METHODS: First-year medical students in 2014-15, 2015-16 and 2017-18 provided an open description of their reasons for access to the degree. These were identified and classified for analysis, the number of reasons given by the whole and in each academic year, as well as their distribution according to gender was calculated. They were classified into categories for comparison with other studies. RESULTS: A total of 367 students (252 women and 115 men) participated. The distribution of women (83.71 ± 4.8%) and men (82.4 ± 5.1%) was not statistically significant. The students justified their access for an average of 2.5 ± 0.06 reasons, with no gender differences or between the three academic years. Twenty-three different reasons for accessing the degree were identified and grouped into categories, the main ones being altruism, scientific knowledge, instrumental motives and personal reasons. There was a significant increase in access through knowledge acquisition between the 2014-15 and 2017-18 academic years, and a reduction in access by vocation. The social consideration of medicine or the social image of the doctor is rarely invoked by students as a reason for accessing the degree. Women refer altruistic and knowledge-related motives for access more frequently than men, but without significant differences. CONCLUSION: Altruistic values continue to be the most frequent reasons for accessing to the Degree in Medicine. The vocation is reduced and the acquisition of scientific knowledge increases as reasons for access

Noticias sobre medicina y salud en un diario de difusión nacional. Potencial utilidad educativa en estudiantes de ciencias de la salud / News about medicine and health in a national newspaper. Potential educational use in health sciences students

Las noticias de prensa tienen potencial interés formativo en estudiantes de ciencias de la salud por una serie de motivos: a) son frecuentes; b) cubren, al menos parcialmente, la demanda social de información sobre salud; c) aportan información sobre hechos incidentales de forma ágil, lo que favorece el debate crítico; d) permiten la apropiación social del conocimiento propio de las profesiones sanitarias incluyendo la educación para la salud; e) permiten apreciar la difusión del lenguaje médico; f) aportan el contexto sociológico que puede condicionar, al menos en parte, la enfermedad, su imagen social y las medidas que los sistemas públicos ponen en funcionamiento para la atención a los ciudadanos; g) facilitan el desarrollo de competencias de análisis crítico, habilidades de documentación y comunicación; y h) se adaptan bien a la utilización de diferentes metodologías docentes. El artículo propone aspectos de interés formativo a los que pueden contribuir las noticias de prensa, y presenta ejemplos para el abordaje de algunos de ellos

Press news have a potential educational interest in students of health sciences for several reasons: a) they are frequent; b) cover, at least partially, the social demand for health information; c) provide information on incidental events in an agile manner, which favors critical debate; d) allow the social appropriation of knowledge of health professions including health education; e) allow to know the diffusion of medical language; f) provide the sociological context that can condition, at least in part, the disease, its social image and the measures that the public systems put into operation for the care of citizens; g) facilitate the development of critical analysis skills, documentation and communication skills; and h) adapt well to the use of different teaching methodologies. The article proposes aspects of formative interest to which press news can contribute, and presents examples for addressing some of them

Utilización de noticias de prensa en la enseñanza de la medicina / Use of press news in the training of medicine

No disponible

Aceptación de actividades de fomento de la investigación en estudiantes de Grado en Medicina / Medical students acceptance of activities promoting research

OBJETIVO: Comunicar algunas actividades de iniciación a la investigación en el Grado en Medicina. MÉTODO: Hemos incorporado competencias de investigación en una asignatura obligatoria con contenidos metodológicos (teóricos y prácticos) y seminarios relacionados con descubrimientos científicos, y en tres asignaturas optativas en las que realizan un trabajo científico supervisado por un tutor. RESULTADOS: Las calificaciones de las tareas de la asignatura obligatoria son elevadas (3,7 ± 0,07 sobre 4 puntos) y el 43,8% de los inscritos concluye las tres optativas. La satisfacción con las actividades es elevada (3,46 y 3,9 sobre 5 puntos), lo que sugiere que contribuyen a adquirir las competencias científicas en la formación del médico y que la labor de los tutores es importante (4,4 sobre 5 puntos). CONCLUSIÓN: La exposición a tareas de investigación en el Grado en Medicina es bien aceptada por los estudiantes

AIM: To present activities for the initiation of research in the medical degree. METHOD: Research skills have been included as a compulsory subject with methodological contents (theoretical and practical) and seminars related to scientific discoveries, as well as in three optional subjects in which students perform a scientific project supervised by a tutor. RESULTS: The grades of the tasks of the compulsory subject are high (3.7 ± 0.07 out of 4 points), and 43.8% of the enrolled students completed the three optional subjects. Satisfaction with the activities was high (3.46 and 3.9 out of 5 points), which suggests that they contribute to acquiring scientific skills in medical education, and that the work of the tutors is important (4.4 out of 5 points). CONCLUSION: Exposure to research tasks in the medical degree is well accepted by the students

Dual dose-related effects evoked by CCL4 on thermal nociception after gene delivery or exogenous administration in mice.

As recently described, the administration of extremely low doses (pg/kg) of CCL4 (Macrophage inflammatory protein 1ß, MIP-1ß) can induce antinociceptive effects in mice (García-Domínguez et al., 2019b). We describe here that hydrodynamic delivery of a plasmid containing CCL4 cDNA provokes a biphasic response consisting in an initial thermal hyperalgesic reaction for 8 days followed by analgesia at days 10-12, being both responses blocked after the administration of the CCR5 antagonist DAPTA. Both the luminiscence evoked in liver after the administration of a plasmid containing CCL4 and luciferase cDNAs and the hepatic concentration of CCL4 measured by ELISA were maximal 4 days after plasmid administration and markedly diminished at day 10. A dose-effect curve including a wide dose range of exogenous CCL4 revealed thermal analgesia after the administration of 10-100 pg/kg whereas 1000 times higher doses (30-100 ng/kg) induced, instead, thermal hyperalgesia inhibited by DAPTA. This hyperalgesia was absent in mice with reduced white blood cells after cyclophosphamide treatment, thus supporting the involvement of circulating leukocytes. A multiarray bioluminescent assay revealed increased plasma levels of IL-1α, CCL2, CXCL1, CXCL13, IL-16 and TIMP-1 in mice treated with 100 ng/kg of CCL4. The hyperalgesic response evoked by CCL4 was prevented by IL-1R, CXCR2 or CCR2 antagonists or by the neutralization of CXCL13 or IL-16, but not TIMP-1, with selective antibodies. The administration of the anti-IL-16 antibody was the unique treatment able to convert hyperalgesia evoked by 100 ng/kg of CCL4 in an analgesic effect. The ability of IL-16 to evoke hypernociception was confirmed by studying the response to its exogenous administration (10-30 ng/kg). In summary, the present results demonstrate that CCL4 induces a dual modulation of nociception and describe some mechanisms involved in the hyperalgesic response evoked by this chemokine.

El enfermo transparente y la rehumanización de la medicina / The transparent sick and the rehumanization of medicine

No disponible

Ciencia, medicina y medicamentos en la prensa diaria: estudio del período 2001-2016 / Science, medicine and drugs in the daily press: a study of the period 2001-2016

Objetivo: Describir los temas más frecuentes sobre ciencia y tecnología, medicina y salud, y medicamentos en prensa escrita durante el período 2001-2016, seleccionados por su potencial interés formativo. Materiales y métodos: Se seleccionaron noticias de la colección CONPRE Oviedo. Los criterios de selección incluyen: título alusivo, autor identificable, noticia basada en hechos reales y contener una narración completa. Las noticias se agruparon por temas y se realizó una distribución dentro de cada apartado. Resultados: Se seleccionaron 1.933 noticias sobre ciencia y tecnología, 2.001 sobre medicina y salud y 1.960 sobre medicamentos. Los temas más frecuentes en ciencia y tecnología fueron la investigación fundamental y biomédica, el genoma y aspectos sociales de la política de investigación. Las enfermedades más citadas se clasificaron en las categorías 1 ('ciertas enfermedades infecciosas y parasitarias'), 10 ('enfermedades del aparato respiratorio'), y 15 ('embarazo, parto y puerperio') de la CIE-10, siendo también numerosas las referidas a salud pública. Los grupos de medicamentos más frecuentes en las noticias pertenecen a los grupos J ('antiinfecciosos para uso sistémico') y G ('sistema genitourinario y hormonas sexuales'). Un número elevado de medicamentos se clasifican como agentes dopantes, o como drogas según el Real Decreto 2829/1977. Se observaron dos patrones, uno incidental y otro mantenido en el tiempo. Conclusión: La cantidad y diversidad de noticias seleccionadas sugieren la potencial utilidad formativa de la prensa escrita en estudiantes de ciencias de la salud

Aim: To describe the most frequent topics on science and technology, medicine and health, and drugs in newspaper articles from 2001-2016 selected for their potential formative interest. Materials and methods: Newspaper articles from the CONPRE Oviedo collection were used in this study. The selection criteria are allusive title, identifiable author, articles based on real events, and articles that contain a complete narration. They were grouped in to common themes and a classification was made within each section. Results: We selected 1933 newspaper on science and technology, 2001 on medicine and health, and 1960 on drugs. The most frequent topics in science and technology were fundamental and biomedical research, the genome and social aspects of research policy. The most cited diseases were classified to be from categories 1 ('certain infectious and parasitic diseases'), 10 ('diseases of the respiratory system'), and 15 ('pregnancy, childbirth and puerperium') of the ICD-10. Additionally, articles referring to public health were also numerous. The most frequent drugs groups in the newspaper belong to the groups J ('anti-infectives for systemic use') and G ('genitourinary system and sexual hormones'). A large number of drugs are classified as doping agents, or as narcotics and psychotropic drugs according to RD 2829/1977. Two patterns were observed, one incidental and the other maintained over time. Conclusion: The number and diversity of selected news suggests the formative potential of the written press in health sciences students

Competencias de investigación en el Grado en Medicina en la universidad española / Research competences in Medicine Degree at Spanish universities

Objetivo: Analizar la distribución de competencias generales y específicas de investigación en los Grados en Medicina. Sujetos y métodos: Se utilizaron las memorias de verificación, las fichas de las asignaturas y la información del Registro de Universidades, Centros y Titulaciones como bases documentales para el estudio. Las competencias generales y específicas analizadas son las contenidas en la Orden ECI 332/2008. Se consideraron asignaturas de investigación las que así lo indican en su denominación, y complementarias, aquellas otras relacionadas con el proceso de investigación. Resultados: El Grado en Medicina es impartido en 40 universidades, que proponen 49 asignaturas de investigación: 22,5% básicas, 40,8% obligatorias y 36,7% optativas. Las asignaturas complementarias identificadas fueron 91: 46,1% básicas, 41,8% obligatorias y 12,1% optativas. Las competencias generales de investigación se encuentran mayoritariamente en asignaturas relacionadas con los módulos 'Medicina social, habilidades de comunicación e iniciación a la investigación' y 'Prácticas tuteladas y trabajo de fin de grado', mientras que las competencias específicas se concentran en los módulos 'Medicina social' y 'Optatividad'. Algunos grados no asignan competencias generales (n = 11) ni específicas (n = 30) de investigación al trabajo de fin de grado; de los que lo hacen, 16 le atribuyen todas las competencias generales, y cinco, todas las específicas. Conclusiones: La distribución de competencias y la presencia de asignaturas de investigación es heterogénea. En pocas universidades, el trabajo de fin de grado tiene una clara orientación a la investigación. Los grados en general no están orientados a la investigación

Aim: To analyse the distribution of general and specific research competences in Medicine Degrees. Subjects and methods: Verification reports, subject sheets and information included in the RUCT were used as documentary bases for the study. The general and specific competences analysed were those contained in the legislation ECI 332/2008. As research subjects were considered those that mentioned research in their name, and as complementary subjects those related with the research process. Results: Medicine Degree is taught at 40 universities across Spain, with 49 research subjects: 22.5% core, 40.8% mandatory and 36.7% optional. Ninety-one complementary subjects have been identified: 46.1% core, 41.8% mandatory and 12.1% optional. General research competences were found to a greater extent in subjects related to the module 'Social Medicine, Communication Skills and Initiation to Research' and the module 'Clinical Clerkships and Degree Final Project'. The specific competences were focused on modules 'Social Medicine' and 'Optional'. Several degrees analysed did not assign competences of research to the degree final project, neither general (n = 11) nor specific (n = 30) competences. However, other degrees assigned competences of research attributed to general and specific research competences with a distribution of sixteen and five, respectively. Conclusions: The distribution of competences and the presence of research subjects across Medicine Degrees in Spain was very heterogeneous. Surprisingly, only in a few universities the degree final project has a clear research orientation, suggesting a main focus on clinical medicine. Medicine Degree are not oriented to research

Iniciación a la investigación en el Grado en Medicina mediante la realización de proyectos tutorados / Introduction to research in the Medical Degree through supervised projects

Objetivo: Presentar la experiencia de iniciación a la investigación con estudiantes de medicina mediante asignaturas optativas: 'Proyectos de investigación de grado' (1, 2 y 3). Sujetos y métodos: Han participado estudiantes de segundo, tercero y cuarto año de los cursos académicos 2011-2012 a 2017-2018 que se matricularon sucesivamente en 'Proyectos 1' (identifi cación del tema, documentación y elaboración de hipótesis y objetivos), 'Proyectos 2' (diseño metodológico y adquisición de datos) y 'Proyectos 3' (divulgación científi ca). Cada grupo, de 2-4 estudiantes, trabajó bajo la dirección de un tutor, realizó presentaciones y elaboró un manuscrito sobre su actividad. En 'Proyectos 3', presentaron un póster con la actividad de los tres cursos que se expuso en una jornada monográfi ca. La evaluación de la satisfacción de los estudiantes se realizó mediante una encuesta. Resultados: En total, 546 estudiantes han iniciado la experiencia en 'Proyectos 1', de los que el 43,9% la completan. El número de tutores participantes ha sido de 83. Se han abordado 195 temas de investigación, de los que el 59% son de investigación clínica, el 31% de investigación fundamental y el 10% de otros. Las califi caciones obtenidas han sido superiores a 9 puntos sobre 10. La encuesta resalta que los estudiantes valoran el papel de los tutores y el potencial formativo de la actividad. Conclusión: El diseño de los cursos permite que el estudiante tome contacto con diferentes aspectos del proceso de investigación, actividad que consideran gratifi cante y apropiada a su formación como médico

Aim: To present the experience of an initiation in to research for medical students through optional courses: 'Research Projects of Degree' (1, 2, and 3). Subjects and methods: Medical students in their second, third, and fourth year from the academic years 2011-2012 to 2017-2018, enrolled consecutively in the subjects: 'Projects 1', identifi cation of the topic, documentation and elaboration of hypotheses and objectives; 'Projects 2', methodological design and acquisition of data; and 'Projects 3', scientifi c disclosure. Each group, of 2-4 students, did a research project under the supervision of a tutor; the research project was presented orally and on paper. In 'Projects 3', students made a poster about the activities performed during the three courses, posters were shown in a monographic exhibition. Evaluation of student satisfaction was carried out through a survey. Results: A total of 546 students started the experience in 'Projects 1', of which 43.9% completed it. The number of participating tutors was 83, addressing 195 research topics, of which 59% were clinical research, 31% fundamental research and 10% were termed others. The scores obtained in these courses were higher than 9 points out of 10. The survey highlights the important role of advisers and the training potential of the activity. Conclusion: The design of the course allows the students to be in contact with diff erent aspects of the biomedical research processes. Students considered the activity rewarding, useful, and appropriate to their training as a physician

The Systemic Administration of the Chemokine CCL1 Evokes Thermal Analgesia in Mice Through the Activation of the Endocannabinoid System.

Apart from its involvement in immune functions, the chemokine CCL1 can participate in the modulation of nociceptive processing. Previous studies have demonstrated the hypernociceptive effect produced by CCL1 in the spinal cord, but its possible action on peripheral nociception has not yet been characterized. We describe here that the subcutaneous administration of CCL1 (1-10 µg/kg) produces dose-dependent and long-lasting increases in thermal withdrawal latencies measured by the unilateral hot plate test in mice. The antinociceptive nature of this effect is further supported by the reduction of spinal neurons expressing Fos protein in response to a noxious thermal stimulus observed after the administration of 10 µg/kg of CCL1. CCL1-induced antinociception was inhibited after systemic, but not spinal administration of the selective antagonist R243 (0.1-1 mg/kg), demonstrating the participation of peripheral CCR8 receptors. The absence of this analgesic effect in mice treated with a dose of cyclophosphamide that produces a drastic depletion of leukocytes suggests its dependency on white blood cells. Furthermore, whereas the antinociceptive effect of CCL1 was unaffected after the treatment with either the antagonist of opioid receptors naloxone or the cannabinoid type 1 receptor blocker AM251, it was dose-dependently inhibited after the administration of the CB2 receptor antagonist SR144528 (0.1-1 mg/kg). The detection by ELISA of an increased presence of the endocannabinoid 2-arachidonoylglycerol after the administration of an analgesic dose of CCL1 supports the notion that CCL1 can evoke thermal analgesia through the release of this endocannabinoid from circulating leukocytes.

The Chemokine CCL4 (MIP-1ß) Evokes Antinociceptive Effects in Mice: a Role for CD4+ Lymphocytes and Met-Enkephalin.

In the present study, we characterize the antinociceptive effects produced by the chemokine CCL4 in mice. The intraplantar administration of very low doses of CCL4 (0.1-3 pg) produced bilateral antinociception assessed by the unilateral hot-plate test (UHP) without evoking chemotactic responses at the injection site. Moreover, the subcutaneous administration of CCL4 (3-100 pg/kg) also yielded bilateral antinociception in the UHP and the paw pressure test and reduced the number of spinal neurons that express Fos protein in response to noxious stimulation. The implication of peripheral CCR5 but not CCR1 in CCL4-evoked antinociception was deduced from the inhibition produced by systemic but not intrathecal, administration of the CCR5 antagonist DAPTA, and the inefficacy of the CCR1 antagonist J113863. Besides, the inhibition observed after subcutaneous but not intrathecal administration of naloxone demonstrated the involvement of peripheral opioids and the efficacy of naltrindole but not cyprodime or nor-binaltorphimine supported the participation of δ-opioid receptors. In accordance, plasma levels of met-enkephalin, but not ß-endorphin, were augmented in response to CCL4. Likewise, CCL4-evoked antinociception was blocked by the administration of an anti-met-enk antibody. Leukocyte depletion experiments performed with cyclophosphamide, anti-Ly6G, or anti-CD3 antibodies indicated that the antinociceptive effect evoked by CCL4 depends on circulating T lymphocytes. Double immunofluorescence experiments showed a four times more frequent expression of met-enk in CD4+ than in CD8+ T lymphocytes. CCL4-induced antinociception almost disappeared upon CD4+, but not CD8+, lymphocyte depletion with selective antibodies, thus supporting that the release of met-enk from CD4+ lymphocytes underlies the opioid antinociceptive response evoked by CCL4.

Aproximación a la investigación en el Grado en Medicina de la Universidad de Oviedo / Approach to research in the Degree of Medicine of the University of Oviedo

Objetivo: Presentar iniciativas de fomento de la investigación científica realizadas en el primer curso del Grado en Medicina. Sujetos y métodos: Participaron 150 estudiantes de primer curso que recibieron lecciones teóricas (12 horas, en grupos de 75) y cuatro sesiones (6 horas y 45 minutos) de seminarios sobre descubrimientos científicos, análisis de publicaciones y diseño experimental, en grupos de 4-5. Las tareas de los seminarios estuvieron disponibles con 7-15 días de antelación y, sobre ellas, debían elaborar una presentación para las sesiones y un documento escrito. Ambas actividades fueron objeto de calificación. La evaluación de la satisfacción de los estudiantes se realizó mediante una encuesta. Resultados: Las tareas relacionadas con descubrimientos científicos se refirieron a aspectos relevantes de la fisiología, la patología, la terapéutica y los desarrollos tecnológicos aplicados a la medicina. También, han analizado y discutido publicaciones científicas y han elaborado propuestas de diseños de investigación a partir de textos breves facilitados por el profesor. Las calificaciones globales obtenidas, sobre cuatro puntos, han sido: 3,71 ± 0,07 y 3,9 ± 0,3 en las tareas sobre descubrimientos y comentarios de artículos científicos, respectivamente, y 3,6 ± 0,2 en el diseño experimental. El 84% de los matriculados cumplimentaron la encuesta que reflejó una opinión favorable (sobre cinco puntos) de los contenidos teóricos (4,01 ± 0,07), seminarios sobre descubrimientos (3,97 ± 0,1) y diseño experimental (3,87 ± 0,1). Conclusiones: Los estudiantes tienen una opinión favorable de las actividades realizadas y consideran que pueden contribuir a la formación de los médicos en investigación

Aim: To present initiatives for the promotion of scientific research in the Degree of Medicine. Subjects and methods: The participants included 150 first-year students who received theoretical lessons (12 hours, in groups of 75) and, in groups of 4-5, four sessions (6 hours and 45 minutes) of seminars on scientific discoveries, publication analysis and experimental design. The topics of seminars were available 7-15 days in advance on which students had to prepare a presentation, and a written document. Both activities were scored. The evaluation of student satisfaction was carried out through a survey. Results: The tasks were related to scientific discoveries and referred to relevant aspects of physiology, pathology, therapeutics and technological developments applied to medicine. Students also analyzed and discussed scientific publications and prepared research design proposals based on short texts provided by the lecturer. The marks obtained, out of four points, were 3.71 ± 0.07 and 3.9 ± 0.3 on the tasks of discoveries and comments of scientific articles, respectively, and 3.6 ± 0.2 in the experimental design. 84% of those enrolled completed the survey that indicated a favorable opinion (out of five points) on the theoretical contents (4.01 ± 0.07) and seminars on discoveries (3.97 ± 0.1) and experimental design (3.87 ± 0.1). Conclusions: The students had a favorable opinion on the activities and considered that they could contribute to the training of research doctors

Utilidad potencial de las artes visuales en la enseñanza de la medicina / Potential utility of the visual arts in medical teaching

INTRODUCCIÓN Y OBJETIVO: Las habilidades de observación pueden facilitarse mediante la descripción de obras de arte. Presentamos una experiencia de observación y descripción de obras pictóricas desarrollada en la Facultad de Medicina de la Universidad de Oviedo. Sujetos y métodos: Los estudiantes (150-155/curso) realizaron 2 seminarios (4 h y 45 min) en subgrupos de 4-5. En el primer seminario, el profesor comenta los objetivos generales y particulares y realiza un ejercicio de lectura de varios cuadros incidiendo en los aspectos que debe observar el estudiante. En el segundo, cada subgrupo expone la tarea realizada sobre los cuadros asignados. Se evaluó el contenido, la organización y la expresión oral. La evaluación de la satisfacción de los estudiantes se realizó mediante una encuesta. RESULTADOS: Las obras de arte utilizadas han sido 90, con predominio de las realizadas en los siglos XVII (n = 30) y XIX (n = 32). De los 9 apartados que contiene la actividad de observación, descripción y documentación, analizada en los cursos 2015-2016 y 2016-2017, los estudiantes cumplimentaron una media de 6,9 ± 0,28 y 6,4 ± 0,25, respectivamente, e identificaron 2,7 ± 0,24 frente a 3,02 ± 0,26 elementos de interés médico. Las calificaciones de la presentación oral fueron superiores al 90% de la máxima posible. La encuesta, cumplimentada por el 95,4% de los asistentes, muestra que el 78,3% de los estudiantes está satisfecho con la actividad y el 63,4% la considera relevante para su formación médica. CONCLUSIÓN: La observación y descripción de obras de arte es aceptada por los estudiantes de medicina como una actividad educativa relevante en su formación

INTRODUCTION AND OBJECTIVE: Art-based teaching is a strategy for increasing the observational skills of medical students. We present our experience using artworks with first-year students in the Faculty of Medicine, University of Oviedo. Subjects and methods: The activity was performed in the form of 2 seminars (4 h and 45 min). Students (150-155 per year) perform this activity in subgroups of 4 or 5. In the first seminar, the lecturer explains the general and specific aims, and presents several pictures with the relevant aspects that the students should observe. During the second of the seminars, each group presents the work they have carried out on the assigned artistic image. The contents, structure and oral expression of the presentations were evaluated. Student satisfaction was measured using a questionnaire. RESULTS: The number of paintings used was 90, distributed from XVII (n = 30), XIX (n = 32) and others centuries (n = 28). An evaluation of the observation, description and documentation of the artworks was performed through 9 questions. The students of the 2015-2016 and 2016-2017 academic course completed 6.9 ± 0.28 and 6.4 ± 0.25 of these items. Likewise, these students identified 2.7 ± 0.24 vs. 3.02 ± 0.26 elements of medical interest. Oral presentations scores were over 90% of the maximum possible. A survey, completed by 95.4% of participant's suggested that 78.3% were satisfied with the activity, and that 63.4% considered it relevant for their medical training. CONCLUSION: The observation and description of artworks is accepted by students as a relevant educational activity for their medical education