Evolution of Eponyms use in General Surgery Residency Publications in Argentina

Table of contents

1. I. Introduction

ponyms are terms in which meaning is associated to a person's name; a name adopting an already existing reference and generally is named after who makes the discovery. The tendency to use these names and traditional anatomic terms when identifying anatomic structures, often used by the medical community in general, and more often used locally at the surgical sphere, has become deeply rooted. However, anatomy teaching as well as international publications today use the International Anatomical Terminology (IAT) (Photograph 4), released in 1998 by the Federative International Committee on Anatomical Terminology (FICAT) that belongs to the International Federation of Associations of Anatomists (IFAA) to encourage the use of an universal, uniform and updated terminology 1,3 . The IAT, as the official list of anatomical structures, aims at facilitating communication and understanding among health professional globally 2,8,9,12 (Photographs 2 and 3). Anatomical training in Argentinean medical schools has been under the influence of classic French anatomical treaties, and their translation to Spanish kept students and graduates away from international terminology, adopting the use of eponyms 4,5,13 . In this way, there are many different anatomical descriptions, both in scientific publications and in the everyday surgical sphere, generating problems when trying to manage without them. This situation brings, in many occasions, communication problems among general surgeons when debating anatomical-surgical issues, surgical pathologies, their diagnoses and treatment. It is necessary to come to an agreement regarding the use of International Anatomical Terminology, highlighting that using the IAT is most convenient as medical information is growing steadily at an international level 6,16 .

2. II. Objectives

To demonstrate the use of the traditional anatomical terminology that employs eponyms in scientific publications in Argentina. To reconcile the Anatomical Nomenclatures, highlighting the use of the IAT within the context that describes a growing impulse to globalize medical information. The analysis included reference to anatomical structures, frequency and use of eponyms and the International Anatomical Terminology (IAT) in all articles.

3. III. Materials and Methods

4. IV. Results

Out of 91 articles published, 14 (15.38%) did not use reference to anatomical structures, and 77 (84.62%) did use reference to anatomical structures (Graphic 1); from these 77 articles, 28 (36.36%) included eponyms and 49 (63.64%) used anatomical structures according to the IAT (Graphic 2).

We identified 32 eponyms in the publications that we revised (Figure 1); 'Calot's triangle' was the most frequently used, appearing in 11 publications (34.37%), followed, according to frequency, by 'Wirsung's duct', 'Cooper's ligament' and 'Scarpa's triangle', each appearing in 5 publications (15.62%); 'Vater's ampulla' was present 4 times (12.50%); and 'Douglas's cul de sac', named 3 times (9.37%). Others were less frequent: 'His's angle', 'Treitz's angle', 'Drummond's arcade', 'Riolan's arcade', 'Ladd's bands', 'Budge-Waller's ciliospinal center', 'Luschka's cystic hepatic ducts', 'Meckel's diverticulum', 'Oddi's sphyncter', 'Morrison's space', 'Bogros's space', 'Toldt I fascia', 'Toldt II fascia', 'Cloquet's gland', 'Bartholin's gland', 'Grüber's ligament', 'Gerard-Marchant's lateral ligament', 'Spieghel's line', 'Müller's muscle', 'Griffith's point', 'Sudeck's critical point', 'Rokitansky-Aschoff's sinus', 'Simon's triangle', 'Petit's inferior lumbar triangle', 'Grynfelt's superior lumbar triangle' and 'Heister's valve' (Graphic 3). Additionally, we observed that most of the articles identifying anatomical structures using eponyms also used traditional anatomical nomenclature; Latin was not used at all.

5. V. Discussion

For years, anatomical terminology created disagreement and controversy among anatomists. Its main objective was reducing the number of eponyms and synonyms to identify anatomical structures. An endless search for a common language started to facilitate communication and avoid obstacles 3 . Using a universal, uniform and updated terminology is an agreement among morphological discipline professionals and everyday clinical specialists 4,10,11 . The need for communication and understanding among national and international specialists and professionals makes it essential the knowledge and use of IAT. This represents a permanent postgraduate educational effort aiming at encouraging continuous updating and standardizing terms 1,2,5,6 , especially in during medical residencies where eponym use has become rooted and generates communication barriers within the scientific community. It is also necessary to implement continuous training programs in order to improve education, eliminate communication obstacles, and refine the academic and professional performance of general surgeons 7,14,15 . As years went by, an increased number of specialists became familiar with and implemented the IAT as the official source of anatomical terminology. But most still does not know of its existence. It is essential to encourage continuous training in order to standardize terms, making the teaching-learning process easier and avoiding misunderstandings in scientific communication among physicians who may be different regarding age, country, and years of expertise. The use of eponyms lacks descriptive weight and can create huge misunderstandings when they have multiple meanings. Specialists in morphological disciplines and those professional who apply these in everyday clinical environments are responsible for encouraging and spreading knowledge of the IAT 7,8 .

6. VI. Conclusions

Anatomy must be explained in the most clear and understanding way, thus minimizing the chance to be misunderstood. Still today, most professionals are not familiar with the existence or name of the International Anatomical Terminology (IAT), though this is the official list of anatomical structures. Scientific publications as well as medical professionals still use the traditional terminology with eponyms to identify anatomical structures. However, Latin names are no longer used.

Correct

Figure 1. A
statistical retrospective study was performed in which 91 articles published in the Argentinean Journal of Surgical Residents from 2008 to 2013 (Photograph 1) were reviewed and compared: In 2008, 10 articles were published; in 2009, 17 articles; in 2010, 20 articles; in 2011, 16 articles; in 2012, 17 articles; and in 2013 11 articles. All of them deal with issues on surgery, clinical surgery, history of medicine, education and research.
Figure 2.
Figure 3.
Figure 4.
Figure 5.
Figure 6. 84,62% 14; 15,38% 0 10 20 30 40 50 60 70 80 Con referencias anatómicas Sin referencias anatómicas
Evolution of Eponyms use in General Surgery Residency Publications in Argentina
35,00%
30,00%
25,00%
0,00% 5,00% 10,00% 15,00% 20,00% use of the IAT in medical residencies implies a continuous educational effort during immediate postgraduate courses, where eponym use is deeply rooted. It is our responsibility to encourage knowledge and use, as part of a continuous medical training program, in order to improve scientific communication. 49; 63,64% Without anatomical references 17. Graphic 3 : Frequency of eponyms used. 28; 36,36% Anatomical references Bartholin's gland Bogros's space Budge-Waller's ciliospinal center Calot's triangle Cloquet's gland Cooper's ligament Douglas's cul de sac Drummond's arcade Gerard-Marchant's lateral ligament Griffith's point Grynfelt's superior lumbar triangle Grüber's ligament Heister's valve His's angle Ladd's bands Luschka's cystic hepatic ducts Meckel's diverticulum Morrison's space Müller's muscle Oddi's sphincter Petit's inferior lumbar triangle Riolan's arcade Rokitansky-Aschoff's sinus Scarpa's triangle Simon's triangle Spieghel's line Sudeck's critical point Toldt I fascia Toldt II fascia Treitz's angle Vater's ampulla Wirsung's duct 15,62% 15,62% 15,62% 12,50% 9,37% Calot´s triangle 0 10 20 30 40 50 Wirsung´s Cooper´s Scarpa´s Vater´s Figure 1 : 34,37% duct ligament triangle ampulla Year 2015
Con epónimos With Eponyms Con TAI With IAT
Note: 77;
1

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Date: 2015-07-15