Clinical competency evaluation of Brazilian chiropractic interns.

OBJECTIVE: This study compares the results of an objective structured clinical examination (OSCE) between 2 groups of students before an internship and after 6 months of clinical practice in an internship. METHODS: Seventy-two students participated, with 36 students in each cohort. The OSCEs were performed in the simulation laboratory before the participants' clinical practice internship and after 6 months of the internship. Students were tested in 9 stations for clinical skills and knowledge. The same procedures were repeated for both cohorts. The t test was used for unpaired parametric samples and Fisher's exact test was used for comparison of proportions. RESULTS: There was no difference in the mean final score between the 2 groups (p = .34 for test 1; p = .08 for test 2). The performance of the students in group 1 was not significantly different when performed before and after 6 months of clinical practice, but in group 2 there was a significant decrease in the average score after 6 months of clinical practice. CONCLUSIONS: There was no difference in the cumulative average score for the 2 groups before and after 6 months of clinical practice in the internship. There were differences within the cohorts, however, with a significant decrease in the average score in group 2. Issues pertaining to test standardization and student motivation for test 2 may have influenced the scores.

Hyperbaric oxygen therapy protects the liver from apoptosis caused by ischemia-reperfusion injury in rats.

PURPOSE: : The present paper aimed to investigate the role of hyperbaric oxygen treatment (HBO) and the apoptosis in rat liver ischemia-reperfusion injury (IRI). METHODS: : Thirty-seven male Wistar rats were subjected to 30 minutes of hepatic ischemia and 30 minutes of reperfusion and randomly distributed into six groups: G-I/R (n = 8), control without HBO; G-HBO/I (n = 8), HBO only during the ischemia period; G-HBO/R (n = 8), HBO only during the reperfusion period; G-HBO-I/R (n = 8), HBO during both the ischemia and reperfusion periods; G-Sh (n = 3), HBO without ischemia or reperfusion as sham group; G-C (n = 2) for control of current apoptosis expression on the normal liver tissue. HBO was carried out using a transparent, cylindrical acrylic chamber with a pressure of 2.0 ATA. Hepatic samples were stained for caspase-3 cleavage. RESULTS: : Apoptotic cells were identified in all groups. In the hepatic specimens of animals HBO-treated during ischemia (GHBO-I), there was a significant decrease (P < 0.001) in the number of cells undergoing apoptosis (1.62 +/- 0.91). The apoptotic index showed no significant difference in the animals HBO-treated during ischemia/reperfusion (5.75 +/- 1.28) compared with the G-I/R (3.5 +/- 0.75), which had no HBO treatment. The apoptosis index (11.25 +/- 1.90) was significantly higher (P < 0.01) in HBO-treated animals during the reperfusion period when compared with any of the other groups. CONCLUSION: : A favorable effect was obtained when hyperbaric oxygen was administered early during ischemia. The hyperbaric oxygen in later periods of reperfusion was associated with a more severe apoptosis index. (c) 2009 Wiley-Liss, Inc. Microsurgery 2009.

Perfusion pressure in kidneys of arthritic rats and the influence of L-NAME.

Kidneys of control and arthritic rats were perfused with a hemoglobin-free perfusion fluid with simultaneous monitoring of perfusion pressure and oxygen uptake. The basal values of renal perfusion pressure were 76.3 +/- 4.63 and 59.96 +/- 3.65 mm Hg in control and arthritic rats, respectively. Infusion of 100 microM Nomega-nitro-L-arginine methyl ester (L-NAME) an inhibitor of constitutive and inducible nitric oxide synthase, increased the renal perfusion pressure to 91.6 +/- 5.52 and 106.69 +/- 8.47 mm Hg in control and arthritic rats, respectively. Oxygen uptake of kidneys from control rats was 2.48 +/- 0.74 micromol min(-1) g(-1) and that of the arthritic rats was 2.44 +/- 0.75 micromol min(-1) g(-1). These results are consistent with an increased production of hemodynamically active nitric oxide in kidneys of arthritic rats.